Medical Potpourri 1

As many of you know, we have had to cut our trip short due to illness in the family. We hope to return to the States on Friday, Feb 13. There are many things we'd like to share so will put a few more posts up.

When we served in Liberia in 1977, we saw children with measles nearly every day. Due to mass immunization programs, many African children have been protected from this potentially fatal illness. However, in remote villages, many kids have not been immunized. Here is a child brought in with high fever, mouth lesions (treated locally with Gentian Violet), and the typical "sandpaper" skin rash. The feared complication of measles is pneumonia so these kids need vigorous support with antibiotics as well as fluids and nutrition.

While leprosy is not common, we

have seen several cases. This elderly man came into clinic with areas of decreased pigmentation on his face and back - the hypopigmented areas had decreased sensation, making the diagnosis of leprosy nearly certain.

On our last day in clinic, I saw a 2 month old child who had "projectile" vomiting and we suspected that she had pyloric stenosis, a narrowing of the outlet from the stomach into the duodenum. Our surgeons are going to try to repair this - the child weighs only 5.5 pounds !! .....update...the child made it through surgery...praise God !

The last patient I saw in clinic was a lady known to be HIV positive. She had a pigmented lesion on her arm that is almost certainly Kaposi's sarcoma, a skin cancer seen in HIV/AIDS and which indicates advanced stage disease. I spoke to the HIV Clinic staff about her and was saddened to learn that there is a temporary shortage of HIV drugs so she can not be treated for now. Sadly, the reality of HIV in developing countries is that many are infected and relatively few are treated. There are something like 33 million people living with HIV in the world and 22 million of those are in sub-Saharan Africa.

Interestingly, the test for HIV is called "BD" here, for "Bad Disease".