I put together these medical challenges. The cases are hypothetical and do not necessarily represent actual or typical presentations of medical diseases. Disclaimer is at the bottom of this page.
Thursday, November 6, 2014
A 60 year old man who is several weeks out from a bone marrow transplant for multiple myeloma develops fever, shortness of breath, tachycardia, and hypotension. He is started on vancomycin, levofloxacin, and piperacillin-tazobactam and then admitted to the intensive care unit. His lactate is elevated, and he is fluid resuscitated. A flu test is negative. A diagnostic test is sent to look for a specific polysaccharide in the serum that would change the antibiotic management. It comes back positive, but your infectious disease consultant says, "Wait, that test could be a false positive."
Challenge: What is the test and why is it unreliable here?
Image of bone marrow transplant shown under Creative Commons Attribution Share-Alike License, from Wikipedia.
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