Writing some medical fiction. I’m looking for a symptom that could be commonly misdiagnosed for something that is more serious than it actually is. I’d like have some information about procedures for the misdiagnosis as well as for the proper diagnosis. This takes place in an ER and if possible, I’d like the procedures to be more interesting than just popping some antibiotics.
Thanks to anyone who can answer. If anyone can help me, I know I can find them in the Teeming Masses!
All sorts of diseases start with “flu-like symptoms.” I think rabies, for one.
How about a non-Q wave MI? It can present with back ache and pressure but without the crushing pain and radiating down the left arm. Sometimes coronaries present in women with a jaw pain rather than a chest pain.
You writers for that ER show are getting desperate.
That’s a sign to end it, you know
Bring Dr. Green back to life and we’ll talk 
But we just started a new relationship with Dr. Kovach and that nurse! I mean… um… no, I’m not writing for that show. Ahem.
Check out this website http://dplylemd.com/index.htm. The guy is a doctor who specializes in providing medical scenario advice to writers. His book is pretty good too and can be found in a decent library for my favorite price: free.
If I’m understanding you correctly, you’re looking for something different from what folks have offered you so far, which are dangerous conditions that exhibit symptoms that don’t look like anything serious. You’re looking for nondangerous conditions that exhibit symptoms that look like seriously bad news instead, right?
Indigestion and heartburn (especially from a hiatal hernia) can cause chest pains and respiratory distress and therefore can be misdiagnosed as a heart attack. Is that the kind of thing you mean?
One from my own library which might help: Index of Suspicion in Treatable Diseases by Horwitz and Magee. Don’t know if it is still in print-my copy is dated 1975.
Yeah, that’s precisely the kind of thing I’m looking for. Though maybe something that’s a little more intense than heartburn - but that’s definitely on the right track.
I think the problem here is that, even in the ER, less serious causes of symptoms would be ruled out before the more serious ones are considered.
Only scenario I can come up with is an actor in seriously realistic theatre makeup presenting with “severe lesions” after a car accident.
Hmm…
Rectal bleeding can be pretty alarming, but have a very mundane/benign cause. A crack in the anus - sort of like what happens if you have chapped lips and they split - can result in an alarming amount of bright red blood (not so much quantity as location and color). If someone’s been heavily into the asprin or other blood thinner this could result somewhat prolonged bleeding. Show up in an ER with this they will have to investigate thoroughly, even if they strongly suspect it’s just a case of constipation+straining on the toilet.
Can also be caused by playing too rough during anal sex.
An inner ear infection can cause vertigo, resulting in inability to stand, nausea, vomitting, or passing out, all of which are quite alarming, but the underlying infection may, in fact, be minor in the sense of clearing up on its own and causing no lasting harm. Make it a viral infection and antibiotics won’t work.
Bleeding from the ears can be a Bad Sign, but doesn’t have to be. If the bleeding is a result of a skull fracture it’s a horrible symptom, but if you have an accident where, by some freak, the skin in the ear canal is scratched enough to bleed so it looks like there might be a skull fracture but there really isn’t… might take some work to make it convincing.
Would any of those work?
Of course, in an ER they are likely to discover the Alarming Symptom is really something minor after all. But at least briefly there should be some concern.
How about Bell’s Palsy? Remarkably common. One side of your face gets paralysed and droops - it’s a dead ringer for a serious stroke. However, it generally goes away on it’s own in a month or two.
I’m not a doctor, but I’m guessing that an ER staff would have to do an MRI or something to rule out stroke.
On a related note, my SO had a similar thing happen to him as a kid. He got hit, hard, by a car while he was riding his bike and he was sent flying through the air. He was immediately told to lie absolutely still by passers-by (and the extremely upset driver). When he was examined by the EMTs, he had clear fluid dripping out of his ears, which can be a symptom of cerbrospinal fluid leaking. Very BAD. Of course, it was sweat from biking that had accumulated in his ear while he was lying absolutely still in an odd position.
According to studies (easy to search) 30% of emergency room chest pains are actually costochondritis, although the symptoms are almost exactly the same as those of a heart attack.
(I know because i have it!)
This episode brought to you by the makers of Charmin.
Thanks all the same, I’ll watch the late movie.
Not to hijack the thread, but expand upon it… are there such links or library resources regarding the legal profession and court proceedings? - Jinx
I was married to an ER nurse, and according to her, shortness of breath, chest pain, and even shooting pains down the arm can be due to anxiety. Also an imminent heart attack (aka “Code Blue,” and the act of having a heart attack is called “coding.”) The thing is, no ER nurse is going to deny immediate access to a physician/cardio team to someone reporting those symptoms.
Also, in the hopes it will help your writing, someone in the ER who shouldn’t be there, or is just old, or is held in contempt is called a “gomer” (Acronym for Get Out of My Emergency Room), and the process of getting someone to another department is called “turfing.”
The book House of God and the movie MASH* will tell you everything you need to know about the medical professions.