Tag Archives: misdiagnosed

Iowa jury gives $27 million verdict in misdiagnosed flu case

A jury has returned a $27 million verdict against a central Iowa medical clinic after a man with bacterial meningitis was misdiagnosed with the flu, suffered strokes and said he has been permanently injured

DES MOINES, Iowa — An Iowa jury has returned a $27 million verdict against a Des Moines medical clinic after a man with bacterial meningitis was misdiagnosed with the flu, suffered strokes and said he has been permanently injured.

The Polk County jury returned the verdict Monday in the lawsuit filed in 2017 against UnityPoint Clinic Family Medicine in Des Moines.

Joseph Dudley and his wife Sarah Dudley filed the lawsuit after Joseph became ill in February 2017 and went to the clinic in southeast Des Moines. They reported he had dizziness, delusions, a headache, high fever and a cough.

A physician’s assistant in charge of the clinic at the time diagnosed him with the flu although tests returned negative, said Dudley’s lawyer Nick Rowley. Dudley was given Tamiflu and a pain reliever and sent home.

Two days later he went to the emergency room at UnityPoint Iowa Methodist Medical Center, where a doctor diagnosed the bacterial meningitis resulting from a heart valve infection. Dudley was put into a medically induced coma and was in intensive care for eight days during which he had a series of strokes causing the loss of hearing in his right ear, vertigo and dizziness, numb feet and legs, and much slower thinking and reaction time, Rowley said.

“Mr. Dudley will suffer from a lifetime of permanent brain damage because they failed to perform a simple blood test, a complete blood count,” said Rowley, founder of Trial Lawyers for Justice.

West Des Moines, Iowa-based UnityPoint Health has 400 clinics, 20 regional hospitals and 19 community network hospitals in Iowa, Illinois and Wisconsin.

UnityPoint Health spokesman Mark Tauscheck said the company believes it met well-established standards of care.

“We respect the jury process but strongly disagree with this verdict and are exploring all options including an appeal,” he said.

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Woman’s Cancerous Skin Mark Was Misdiagnosed As Clogged Oil Gland

  • Alison O’Neill told Good Morning America her cancerous tumor was initially diagnosed as a clogged oil gland.
  • Doctors diagnosed O’Neill with angiosarcoma, a rare cancer that forms in blood vessel lining.
  • Angiosarcoma can appear on the skin as a raised, bruise-like bumps that grow over time.

A woman went in to her dermatologist get an unsightly bump removed from her face — she had been told that it was harmless, but she wanted it done anyway.

She is grateful she did: after the minor operation, her doctor discovered the bump was actually a rare, cancerous tumor.

Alison O’Neill, a 49-year-old woman from Arizona, told Good Morning America she went to a dermatologist in 2017 after noticing a “tiny little mark” on her right cheek. The doctor told O’Neill her mark was likely a clogged oil gland.

The mark grew over time, so O’Neill said she went to get it removed for cosmetic reasons in 2020. A biopsy revealed the spot was actually a cancerous tumor that causes angiosarcoma.

Angiosarcoma is a rare type of cancer that forms in the lining of the blood vessels and lymph vessels, which collect and dispose of bacteria and viruses. Per Mayo Clinic, angiosarcomas can occur in any place in the body, but typically occur in the skin on the head or neck. 

Renowned fashion designer Virgil Abloh died last year of an angiosarcoma on his heart.

Angiosarcoma on the skin appear as a raised, swollen area that looks like a bruise and grows bigger over time. Researchers are not sure what causes angiosarcomas, but identified certain risk factors like exposure to radiation or chemicals.

O’Neill told GMA she is now in remission from angiosarcoma following surgery to remove the tumor and surrounding area, radiation, facial reconstruction surgery, and scar lightening procedures. 

O’Neill shared her story with GMA to motivate other women to speak up they feel they aren’t getting adequate medical care. Women are more likely than men to suffer from misdiagnoses, and female patients tend to wait longer for a cancer diagnosis, Insider’s Anna Medaris previously reported.

“You have to advocate for yourself when going through any medical journey,” O’Neill told GMA. “I describe the last two years as being like crawling through mud. It is incredibly difficult to regain your health and you have to work really, really hard at it.”

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Young Mom Has Terminal Cancer After Doctors Misdiagnosed Her Bone Pain

  • Reanna Tillman was diagnosed with bone cancer a week before her 17th birthday.
  • She had tumors removed from her leg and shoulder, and now the cancer is in her spine.
  • Tillman had a baby girl, who she calls her “medical miracle,” in January 2021.

At age 16, Reanna Tillman started experiencing leg pain so severe that she said she wanted to chop off her limb.

Tillman, now 23, told Insider that her leg would give out seemingly out of nowhere, causing her to collapse on the ground. Months into her year of pain, she had to start homeschooling because it hurt too much to walk around her high school campus.

When she sought medical care, she said the emergency room doctors told her it was probably growing pains causing her discomfort. One primary care doctor even suggested that she lose weight to reduce the strain on her legs, Tillman said.

Those doctors changed their tone once Tillman was able to get an MRI scan, which revealed a sizable tumor in her leg. She was diagnosed with osteosarcoma, the most common type of bone cancer, and quickly got surgery on her leg followed by several cycles of chemotherapy.

However, between rounds of chemo and radiation, she said she experienced a “medical miracle” — a healthy baby girl, also named Reanna, who was delivered via C-section on January 1, 2021.

The tumor in her leg was just the start of Tillman’s cancer story. She said she had multiple tumors in her shoulder, which resulted in a donor bone transplant that later became infected. Now, she has three tumors growing in or around her spine and is paralyzed from the chest down. 

Doctors said she is terminal, and she’s making the most of the time she has left.

She was diagnosed with osteosarcoma a week before her 17th birthday

Tillman said when she first learned she had cancer, the doctor told her she either had osteosarcoma or Ewing’s sarcoma, another type of cancer that affects the bones — and the only way to treat it was to amputate her leg.

At another hospital, a second doctor confirmed that the tumor in her leg was an osteosarcoma, but said he could remove the affected bone while saving the leg. Tillman said the doctor performed a leg salvage surgery, where an orthopedic surgeon removed the tumor in her leg without removing the whole limb.

She said the surgeon cut out part of her femur and knee, and replaced the bone with metal. After that, she went straight into chemotherapy to ensure her leg was cancer-free. She got about eight rounds of methotrexate, a drug used to slow the growth of cancer cells, which she said made her nauseous.

In March 2017, Tillman was cleared to return to school. She finished high school and went straight to college that summer, where she was eager to get on with her life.

But in the middle of summer session — a year after her initial diagnosis — Tillman’s cancer came back, this time in her shoulder.

“I started crying because I was just starting to feel normal, and here we go again,” she said. “To this day, I feel like every time it’s good, here it comes.”

She needed her knee, thigh bone, and shoulder blade replaced

At her annual checkup in 2017, Tillman said her doctors found a tumor in her shoulder blade. They quickly removed the tumor and replaced the top half of the scapula. But the cancer came back again, which meant she needed the whole scapula replaced with a donor bone.

That bone transplant would eventually cause her more pain; in March 2022, the donor bone died. 

“It was leaking, it was eating through my skin,” she said. “They had to remove the donor bone completely and shaved down my clavicle — to clean out the infection most importantly, but then to attach it to my arm.”

Now, Tillman’s right arm is attached to her collarbone. Doctors had to remove the entire shoulder blade and some of the muscle around it, so she said she can no longer rotate her shoulder or move her arm backwards. 

She said she lost even more mobility about six months later, when a tumor on her spine paralyzed her from the chest down. She had been aware of the tumor since 2018 and received radiation to slow its growth, but it finally caught up to her this October.

Amid the cancer relapses, she had a ‘medical miracle’

After finishing radiation in 2019, Tillman said she decided to live a little bit. She said she finally felt normal, “great” even, and fell in love with her child’s father.

During those happy years, the tumor in her spine was growing insidiously. When she went to the doctor for back pain in 2020, she said they told her the cancer was just centimeters away from crushing her spinal cord.

About a month after she learned she could be paralyzed any day, Tillman found out she was unexpectedly pregnant for the first time.

She miscarried the first pregnancy, which still stung despite the odds. But she got pregnant again during lockdown, “and this time, she stuck,” Tilllman said.

Tillman calls her daughter a “medical miracle,” sometimes Tinkerbell or Tink for short. But the baby’s given name is Reanna, so her mother’s memory will live on long after she’s gone.

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Hollywood star Sharon Stone to undergo surgery after doctor misdiagnosed her tumour

Taking to her Instagram Stories with an update on her health, she said that she had “just had another misdiagnosis and incorrect procedure” and went for a “double epidural” to treat her pain. She added the agony grew worse and when she went for a second opinion from a different doctor and they revealed she had a “large fibroid tumour” that “must come out.”

The actress warned her followers: “Ladies in particular, don’t get blown off. Get a second opinion. It can save your life.”

Sharon said it was going to take her between a month and six weeks to recover from the trauma and thanked fans for their concern, signing off, “It’s all good.”

Sharon, mum to sons Roan, 22, Laird, 17, and Quinn, 16, through adoption, told earlier this year how she has lost nine children by miscarriage.

She addressed her other health woes in her 2021 autobiography “The Beauty of Living Twice”, in which she said benign tumours were removed from her body in 2001 she said were “gigantic” and bigger than one of her breasts. She was also hit by a stroke and cerebral haemorrhage the same year.

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Woman with multiple sclerosis misdiagnosed for 13 YEARS, told by doctors pain was due to ‘exercise’

A woman with multiple sclerosis said she was misdiagnosed for 13 years, and was told by doctors that she should ‘exercise’ or make herself a ‘mixed drink’ to help her severe pain.

Lindsay Cohen Karp, 39, a children’s book author from Philadelphia, Pennsylvania, said she was plagued with ‘debilitating fatigue, mobility issues, and pain’ for more than a decade.

She eventually became ‘incapable of walking’ since her stamina was so low – but medical professionals could not figure out what was wrong with her.

After spending 13 years searching for an answer, she was finally diagnosed with multiple sclerosis in 2018 – a disease in which the immune system eats away at the protective covering of nerves, which disrupts communication between the brain and the body.

A woman with multiple sclerosis said she was misdiagnosed for 13 years, and was told by doctors that she should ‘exercise’ or make herself a ‘mixed drink’ to help her severe pain

Lindsay Cohen Karp, 39, a children’s book author from Philadelphia, Pennsylvania, said she was plagued with ‘debilitating fatigue, mobility issues, and pain’ for more than a decade

Lindsay (seen with her sons) eventually became ‘incapable of walking’ since her stamina was so low – but medical professionals could not figure out what was wrong with her

And while she was scared of what the disease might do to her body, Lindsay recalled feeling an ‘overwhelming relief’ after being left in the dark about what was wrong with her for so many years.  

What is multiple sclerosis?

  • In MS, the immune system attacks the protective covering of your nerves
  • This causes communication problems between your brain and the rest of your body
  • Eventually, the disease can cause permanent damage or deterioration of the nerves
  • Symptoms include: Numbness or weakness in your limbs, electric-shock sensations that occur with certain neck movements, tremors, lack of coordination, vision problems, slurred speech, fatigue, dizziness, and problems with sexual, bowel, or bladder function
  • Some people with MS may lose the ability to walk independently, while others may experience long periods of remission without any new symptoms
  • There’s no cure for multiple sclerosis. However, treatments can help speed recovery from attacks, modify the course of the disease and manage symptoms 
  • Source: MayoClinic 
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‘I thought I’d dangle from the edge of the undiagnosed mountain for the remainder of my existence,’ she wrote in a recent essay for Insider.

The mother-of-two said she visited numerous doctors in an attempt to find out what was wrong with her – and she even traveled to other states.

‘I endured an unnecessary breast exam because the doctor demanded it,’ she recalled. 

‘[Another] physician told me there was no answer to be had as my body continued to decline until merely existing was a struggle. 

‘The futile suggestions had ranged from exercise to psychotherapy to a mixed drink, as if Smirnoff with a splash of cranberry juice could stop my body from declining.’

On her blog, she explained that while ‘walking and standing were difficult,’ she eventually ‘learned to live with her new body.’ 

‘I had to walk a short distance, sit and rest, and then do a little more,’ she explained. 

‘My legs ached and felt as though they were running out of energy, like a car with a near empty gas tank.

‘I was poked, prodded and poked some more. Getting lab work done constantly was my new normal.

‘Somewhere deep in my overwhelmed brain, a voice told me to keep living my life. A particle of hope assured me that my continued medical search would eventually result in a diagnosis.’

Then, after 13 years, everything changed when one doctor performed an MRI and noticed ‘white spots’ on the image of her brain.

‘These are areas of demyelination,’ she remembered him telling her in her Insider essay. ‘Your spinal fluid showed evidence of inflammation. What we’re dealing with here is multiple sclerosis.’ 

After spending 13 years searching for an answer, she was finally diagnosed with multiple sclerosis in 2018

Lindsay (seen with her husband and kids) recalled feeling an ‘overwhelming relief’ after being left in the dark about what was wrong with her for so many years

Lindsay began taking medication for the condition, which helped her body go back to ‘what it once was.’ And while she still has flare ups, she said she ‘finally recognizes herself again’

She said ‘his words filling her brain’ felt like ‘carbonation from a soda, fizzing through her mind and stifling her thoughts.’

‘It was a good day. An answer meant a treatment, and I deserved that more than anything,’ she explained.

Now, the writer (seen as a baby with her mom) said she thinks about the doctor who finally gave her a diagnosis ‘every day,’ explaining that he’s the only reason her ‘life still exists’ and that her two sons ‘have a mother’

‘He spoke definitively, as if 13 years of no diagnosis for symptoms like debilitating fatigue, mobility issues, and pain, was just a big misunderstanding.

‘The idea that one simple test provided the answer I’d lacked for 13 years seemed like a dream.’

Lindsay began taking medication for the condition, which helped her body go back to ‘what it once was.’ And while she still has flare ups, she said she ‘finally recognizes herself again.’ 

Now, the writer said she thinks about the doctor who finally gave her a diagnosis ‘every day,’ explaining that he’s the only reason her ‘life still exists’ and that her two sons ‘have a mother.’

‘I think of him every day. I recall his kind nature and his ability to think outside the box,’ she concluded. 

‘I acknowledge my appreciation that the universe connected me to him and allowed him to guide me through the start of my MS journey.  

‘Without him, I’d surely still be undiagnosed, incapable of walking, and with no stamina to go on. Without him, my boys wouldn’t have a mother. 

‘Not many people can say their lives exist because of one good human. I can. And I will never forget it.’ 

She is now working a memoir detailing her experience, and often opens up about living with MS on her blog. 

On her blog, she spoke out about not being able to participate in certain physical activities with her children

She said while she ‘can’t participate in every family activity,’ she has ‘found activities that fit her ability level’

‘There will always be days I spend on the sidelines,’ she wrote. ‘But my hope is that the times I am present will stand happily and strongly in the forefront of their minds’

In one post, she spoke out about not being able to participate in certain physical activities with her children.

‘I can’t participate in every family activity,’ she said. ‘The truth is, my children will remember events without me, and while I’m relieved they can have these experiences with my husband, part of me is mourning the memories I’ll never be a part of.’

While there’s some things she can’t do – like hiking – she said she has ‘found activities that fit her ability level,’ like going for bike rides.

‘When I’m on my bike, I feel as though my body is disease free,’ she continued.

‘The weakness I feel when walking vanishes as I pedal forward. With the wind in my face and my children beside me, we now form family memories they’ll never forget. And, thankfully, I am a part of these memories.

‘There will always be days I spend on the sidelines. My children will remember that I couldn’t be present for important milestones or adventures from time to time. 

‘But my hope is that the times I am present will stand happily and strongly in the forefront of their minds. 

‘Living with MS sometimes means missing wonderful days in my children’s lives, but it also means the times when I am present are that much more meaningful. And that makes it all worth it.’

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Doctors misdiagnosed woman’s cancer as ‘teenage laziness.’

This woman’s doctor allegedly shrugged off her ailments and said “laziness” was the answer — but it turns out she had cancer.  

When Courtney Nettleton, a 21-year-old from Wakefield, West Yorkshire, found herself feeling “uncontrollably” tired and sleeping 14 hours every day over the summer of 2021, she feared something was wrong. 

“I was told by doctors that it was just teenage laziness,” Nettleton told NeedtoKnow.online. But after co-workers noticed a large lump protruding out of the blonde’s neck in January 2022, a specialist uncovered the true cause of her chronic illness.   

“In February, I was diagnosed with thyroid cancer, and doctors told me it was growing fast,” she said. “I was so devastated and worried.” 

The American Cancer Society estimated that there have been 43,800 new cases of thyroid cancer in the United States so far in 2022 — with 11,860 instances found in men and 31,940 in women.

“I knew deep down that something wasn’t right, and being told that it was just teenage laziness by the doctors was incredibly frustrating,” claimed Nettleton, who works as a senior care assistant, told Jam Press.

Doctors initially told Nettleton that her incessant sleepiness was nothing more than “teenage laziness.”
NYPost Composite

In the months before receiving her grim prognosis, Nettleton experienced a series of unusual symptoms including tiredness, breathlessness, hot flashes, unsteadiness, neck stiffness, acne and moodiness. 

But she claims her healthcare provider dismissed her complaints, trivializing them as age-related growing pains. And so, she resumed her regular routine, going to work and hanging out with friends. Nettleton’s original doctors have not yet responded to requests for comment, according to Jam Press.

Although she feared something was wrong with her body, Nettleton took her doctor’s advice and ignored her symptoms.
Jam Press/@courtneynettleton

However, at the top of the year, everything changed after colleagues pointed out the deformity in her neck and urged her to seek a second opinion. 

“My friends noticed a small lump on my neck at work and that combined with my symptoms pushed me to book a doctor’s appointment the next day,” said Nettleton. “I was given a two-week urgent referral for an ultra-sound which confirmed I had a solid tumor in my thyroid.”

After receiving her diagnosis, Nettleton underwent a series of surgeries in hopes of eradicating her cancer.
Jam Press/@courtneynettleton

She immediately began treatment a month later in March had two surgeries scheduled to remove both halves of her thyroid.  

But, unfortunately, Nettleton’s woes were far from over. 

On March 22, in between the surgeries, she claims that doctors informed her she was cancer-free. 

“After my first surgery, my doctor rang me and told me I was completely cancer-free and that I had nothing to worry about,” she recalled. 

But, after enjoying a brief period of relief, Nettleton was told that she still had cancer, and that the cancerous cells had spread to other areas of her body. 

Nettleton has undergone surgery, and is anxiously awaiting the results of the procedures.
Jam Press/@courtneynettleton

“My consultant rang me just three days after this to tell me that cancer cells were found in lymph channels and blood vessels within my thyroid and that I would need further surgery and radioiodine,” she said. 

“I was so upset when I found out I still had cancer,” Nettleton said. “I had to tell my family and friends that I wasn’t cancer-free and that I had more treatment to go.”

She’s since undergone two more surgical procedures, which have left her feeling “weak” and “anxious.”

“The first surgery made me very poorly and I was bed bound and the radioiodine made me feel very weak, and I had to be isolated in a room which was really lonely,” she recalled. 

“I will find out the results in roughly around six weeks to see whether this has been successful or not,” added Nettleton, who’s leaning on her friends and family for support during her post-op recovery.  

Nettleton is now raising funds for cancer research and support in her country.
Jam Press/@courtneynettleton

“The wait is sickening, I have the constant reassurance from [Macmillan Cancer Trust] and my social worker and even though my cancer is very curable there’s always that worry that it could spread elsewhere,” she continued. “I suffer from severe anxiety so I am constantly worried.”

She also finds comfort in working, and is thankful for the love she continues to receive from coworkers.  

“Work has been very supportive throughout the whole entire journey and has constantly supported me,” said Nettleton, who’s set to participate in a charity skydiving event to raise awareness and funds for Macmillan Cancer Trust and the Teenage Cancer Trust. 

She’s also launched a GoFundMe to crowdsource money for the cause.

“Although I feel very let down by doctors, the staff at Macmillan, my consultant and Leeds St James’s hospital have been absolutely amazing throughout my journey,” Nettleton said gushingly. 

And she’s now imploring others to always advocate for themselves. 

“Everyone knows their own bodies more than anybody else,” she said. “It is so important to trust your gut and follow your instinct — you have to stand up for yourself when you know something isn’t right.”

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A graphic photo shows a severe monkeypox patient’s crusted, discolored nose, taken days after a red pimple was misdiagnosed as sunburn

A man with a weakened immune system got severe monkeypox that caused his nose tissue to die. Image has been edited to cover the man’s nose.Infection/Boesecke, C., Monin, M.B., van Bremen, K. et al

  • Severe monkeypox caused the nose tissue of a man with undiagnosed AIDs to die, according to a report.

  • A red spot, which was mistaken for sunburn, progressed to dead tissue within three days.

  • This post contains a graphic image of the man’s nose.

Monkeypox caused a man’s nose tissue to die days after it was mistaken for sunburn, according to a report.

The unnamed man in his forties initially went to a family doctor with a red spot on the tip of his nose, which was diagnosed as sunburn. Within three days, the spot had turned to dead tissue, doctors from Germany wrote in the report published in the medical journal Infection on Monday.

The man also had monkeypox lesions on his penis and in his mouth, according to the report.

Since May, 39,047 people have caught monkeypox in countries where it isn’t endemic, Centers for Disease Control and Prevention data shows. The illness typically causes painful boils that scab over within four weeks.

Tests revealed that the man — who hadn’t had a sexually transmitted disease check before — had undiagnosed syphilis and HIV that had progressed to AIDS, causing a severely weakened immune system.

“This case illustrates the potential severity of monkeypox infection in the setting of severe immunosuppression and untreated HIV infection,” the doctors wrote.

A red pimple progressed to dead tissue within days.Infection/Boesecke, C., Monin, M.B., van Bremen, K. et al

Paul Hunter, a professor in medicine at the University of East Anglia, UK, told MailOnline that smallpox, a relative of monkeypox, can cause tissue death — known as necrosis — in the sebaceous glands, which are found in the skin on the nose and face.

Given “the very similar disease pattern in monkeypox,” it is likely this would occur in severe cases of the virus as well, he said.

After a week of treatment with Tecovirimat or TPOXX — a smallpox tablet that can be used for monkeypox — as well as HIV and syphilis drugs, doctors said the man’s skin lesions dried out, and his nose became less swollen.

Read the original article on Insider

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Man With Monkeypox Was Misdiagnosed, Then Almost Lost Eyesight

  • A man who tested negative for monkeypox had such a bad facial rash, doctors feared he might go blind.
  • Kevin Kwong, 33, saw multiple healthcare providers before he was treated for monkeypox.
  • The doctor treating him said he was “shocked” by how quickly Kwong responded to the drug, TPOXX.

A man who tested negative twice for monkeypox had such a bad facial rash that one doctor feared he could go blind, according to local news reports.

Kevin Kwong, 33, was finally diagnosed at the University of California, San Francisco (UCSF) Medical Center in the first week of July, a couple of weeks after his symptoms first emerged.

By the time he met infectious disease specialist Peter Chin-Hong, who diagnosed him, Kwong was “miserable,” with hundreds of sores over his body, he told local news network KPCC.

At this point, he’d attended six online appointments, rung a nurse hotline, visited an urgent treatment center, and been to ER twice, per the San Francisco Chronicle. He’d tried steroids for eczema, antivirals for herpes, and was misdiagnosed with scabies. Monkeypox can cause a progressive rash that can be confused with other conditions.

“Depending on where I was with my symptoms, and who I was speaking to, I was getting different answers,” Kwong said. “Each time I spoke with someone, I just got rapidly worse,” he said, the Chronicle reported.

“Kevin’s case was probably one of the most severe cases of the patients I have seen so far,” Chin-Hong, also a professor of medicine at UCSF, told KRON 4.

Itchy hand that woke him from sleep

Kwong’s symptoms started two days after he got back to California from New York in late June — with a painful, itchy, hand that woke him from sleep, according to KPCC. 

He initially thought it was bad eczema and treated it with his usual steroid cream. But it got worse, progressing to his elbows, and more red spots, that leaked fluid, appeared on his face. 

“Your body is being taken over by this thing that you don’t understand. And you have nowhere to go, so it’s both painful and terrifying,” Kwong told the Chronicle.

In the US, 8,934 monkeypox cases have been confirmed since an unusual outbreak started in May in countries where the disease wasn’t typically reported. New York and California have the highest number of cases, mostly in men who have sex with men but anyone can catch it, regardless of sexuality. Experts think monkeypox is spreading by direct or intimate contact with an infected person, or contaminated objects. 

Kwong told KPCC that he believes he contracted it from a sexual encounter during New York pride. 

Monkeypox is underdiagnosed


UK HSA



Dr. Graham Walker, an emergency physician in San Francisco, told Insider that he’d seen patients, like Kwong, whose monkeypox was “missed.”

This is in part because monkeypox isn’t behaving like “textbook” monkeypox presentations of the past, but also clinicians may not have treated it.

“I didn’t realize how little information was also given to providers and how unprepared they were,” Kwong said. 

Even Dr. Timothy Brewer, a professor of medicine and epidemiology at UCLA who intermittently worked in countries where monkeypox was historically endemic, told the SF Chronicle that he hadn’t treated a case. “Before this current outbreak, monkeypox was a very unusual disease,” he said.

Kwong’s false negative tests made diagnosis more challenging. 

“It’s very difficult as a clinician to really get a good sample in these kinds of lesions because the patient is often in pain,” Chin-Hong said. The CDC recommends clinicians swab lesions twice, and take samples from multiple body parts, or from lesions that look different.

Quick recovery after treatment with TPOXX 

Chin-Hong treated Kwong with Tecovirimat or “TPOXX”— a smallpox tablet that can be used for monkeypox with CDC permission.

Kwong said his facial rash improved from day one, and after two weeks he was recovered, aside from scarring.

“I was shocked by how fast Kevin improved,” Chin-Hong told KPCC.

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Monkeypox Patients Are Getting Misdiagnosed With Other Conditions

  • Experts in San Francisco, Miami, and the UK say many monkeypox cases are being “missed.”
  • Some patients are receiving false negative monkeypox tests, while others are being misdiagnosed.
  • Fear, stigma, miscommunication and misunderstanding all contribute. 

More than 7,100 monkeypox patients have been diagnosed in the US since this outbreak began with a single case in mid-May.

But Dr. Graham Walker, an emergency physician in San Francisco, says that many more monkeypox patients are not being given the care and attention they deserve to prevent, diagnose, and treat this infectious disease efficiently.

Walker says he’s seen “several patients” whose monkeypox diagnosis was “missed” by another provider before they landed in his ER in excruciating pain.

“I had a patient who, I saw their record from another facility, and it said, ‘lesions only in the genitals, so unlikely to be monkeypox,'” he told Insider. 

Other clinicians and scientists in the US, the UK, and West Africa say the same: monkeypox is being widely underdiagnosed. 

Some misdiagnosed patients end up in so much pain they can’t wear clothes

Across the country from Walker’s ER, Dr. Lilian Abbo, an infectious disease specialist at the University of Miami, says she’s noticed the same issue. 

“We have seen patients that have been going up to seven centers: three different urgent cares, dermatologists, and ERs to try to figure out what is going on,” she said during a recent Infectious Diseases Society of America telebriefing, stressing the need for better awareness of how monkeypox can present.

Better awareness can have huge implications for both treatment, and disease containment. It’s possible that if close contacts find out early enough in the course of their infection (meaning, in the first 4 days after an exposure) the Jynneos smallpox vaccine may be used to prevent monkeypox infection altogether.

But, “by the time they arrive,” many patients who’ve been misdiagnosed “may have been healed, or some of them may have progression of disease,” Abbo said. That progression can be painful. 

Patients in this outbreak have, in some of the most severe presentations, been unable to use the toilet, because the pain around their anus and genitals becomes so severe. “One of my patients said ‘I can’t even wear pants or underwear without pain,'” Walker said. 

‘Textbook’ descriptions of symptoms aren’t always accurate

Matt Ford underestimated the pain from monkeypox.

Matt Ford


Part of the reason why monkeypox is being underdiagnosed is that this disease outbreak isn’t operating like the “textbook” monkeypox presentations of the past, with a classical fever, swollen lymph nodes in the neck, and headache all appearing before pox surface on the face and on the hands.

Instead, monkeypox lesions may be lodged in the rectum, lymph node swelling may be present only in the groin, and it’s not unusual for a single pock to be the only marker of a person’s entire infection.

A July 21 New England Journal of Medicine compilation of 528 case reports from 16 countries around the world establishes some clear patterns for this outbreak. Nearly two-thirds of the patients studied had lesions in their anogenital (private) area, with a majority of patients counting less than 10 lesions on their entire body.

Patients were “presenting with symptoms that weren’t part of the case definitions,” NEJM study author Chloe Orkin told Insider. “The important thing is to help doctors to recognize it.”

Fever, fatigue, muscle aches and headaches were some of the most common pre-rash signs a monkeypox infection was budding, which also makes it easy for people to confuse the condition with COVID, initially. 

“Every single patient I’ve talked to has done a COVID test when they had a fever, and they’re like, ‘oh, it’s not COVID,'” Walker said. 

Other times, diagnoses are missed because providers don’t get a “good, aggressive scrub” of the lesions, he said.

“I’ve seen that before, where people have had a test that came back negative and I’m like, ‘you have literally every symptom of monkeypox, this looks exactly like all the other monkeypox cases I’m seeing, and we’ve ruled out other stuff, like herpes, syphilis, whatever.'” 

Some people avoid monkeypox diagnosis because it can be stigmatizing, painful, and lonely

Early treatment is key to curb a monkeypox infection and prevent the excruciating pain it causes. The antiviral drug Tecovirimat (TPOXX) can help, as well as prescription painkillers which are stronger than Motrin and Advil.

But many patients, fearing stigma and lacking information, are not seeking help.

One of Walker’s patients had been managing his lesions alone for two full weeks, when he finally decided to seek treatment. 

“He just wanted to manage it at home. He was worried about the stigma, he said he’d never had an STD before. But the pain was so severe, he finally came in,” Walker explained. “There’s lots of fear, there’s lots of anxiety, and to be honest, there’s probably a lot of people who aren’t diagnosed yet,” he added. 

Dr. Jason Zucker, an infectious disease specialist at New York Presbyterian hospital, said “even patients with mild disease have been taking it very hard” when they receive a monkeypox diagnosis.

“In addition to this stigma, patients who are diagnosed then isolate at home for up to four weeks alone,” he told journalists on a Zoom call Friday. “It’s important to make sure that we’re all cognizant of this, that we all work together to reduce stigma, and that we offer patients mental health and other supportive resources after their diagnosis.” 

A Nigerian doctor spotted this kind of monkeypox in 2017. He hopes people will finally start funding research on this virus.

In Nigeria, where Dr. Dimie Ogoina has been studying monkeypox outbreaks linked to sexual contact since 2017, he says he’s struggled with similar issues of confusion and stigma, which both make it harder to get a sense of the true scope of any outbreak.

Often, he suspects, patients with “genital lesions” aren’t coming to the hospital to be properly diagnosed, instead, they’re just going to the pharmacy for STD treatment. 

“There are a lot of things that still not known about monkeypox”  because “it has been a neglected disease,” Ogoina told Insider. “Since the global north is now having cases, I’m sure there will be investments in research, and we will be able to uncover most of these unknowns.”

Read original article here

An ER doctor says he’s sick of seeing monkeypox patients misdiagnosed, only to end up in the hospital in excruciating pain

Dr. Graham Walker, an emergency physician, treats monkeypox patients in San Francisco.Courtesy of Graham Walker

  • Experts in San Francisco, Miami, and the UK say many monkeypox cases are being “missed.”

  • Some patients are receiving false negative monkeypox tests, while others are being misdiagnosed.

  • Fear, stigma, miscommunication and misunderstanding all contribute.

More than 7,100 monkeypox patients have been diagnosed in the US since this outbreak began with a single case in mid-May.

But Dr. Graham Walker, an emergency physician in San Francisco, says that many more monkeypox patients are not being given the care and attention they deserve to prevent, diagnose, and treat this infectious disease efficiently.

Walker says he’s seen “several patients” whose monkeypox diagnosis was “missed” by another provider before they landed in his ER in excruciating pain.

“I had a patient who, I saw their record from another facility, and it said, ‘lesions only in the genitals, so unlikely to be monkeypox,'” he told Insider.

Other clinicians and scientists in the US, the UK, and West Africa say the same: monkeypox is being widely underdiagnosed.

Some misdiagnosed patients end up in so much pain they can’t wear clothes

Across the country from Walker’s ER, Dr. Lilian Abbo, an infectious disease specialist at the University of Miami, says she’s noticed the same issue.

“We have seen patients that have been going up to seven centers: three different urgent cares, dermatologists, and ERs to try to figure out what is going on,” she said during a recent Infectious Diseases Society of America telebriefing, stressing the need for better awareness of how monkeypox can present.

Better awareness can have huge implications for both treatment, and disease containment. It’s possible that if close contacts find out early enough in the course of their infection (meaning, in the first 4 days after an exposure) the Jynneos smallpox vaccine may be used to prevent monkeypox infection altogether.

But, “by the time they arrive,” many patients who’ve been misdiagnosed “may have been healed, or some of them may have progression of disease,” Abbo said. That progression can be painful.

Patients in this outbreak have, in some of the most severe presentations, been unable to use the toilet, because the pain around their anus and genitals becomes so severe. “One of my patients said ‘I can’t even wear pants or underwear without pain,'” Walker said.

‘Textbook’ descriptions of symptoms aren’t always accurate

Matt Ford underestimated the pain from monkeypox.Matt Ford

Part of the reason why monkeypox is being underdiagnosed is that this disease outbreak isn’t operating like the “textbook” monkeypox presentations of the past, with a classical fever, swollen lymph nodes in the neck, and headache all appearing before pox surface on the face and on the hands.

Instead, monkeypox lesions may be lodged in the rectum, lymph node swelling may be present only in the groin, and it’s not unusual for a single pock to be the only marker of a person’s entire infection.

A July 21 New England Journal of Medicine compilation of 528 case reports from 16 countries around the world establishes some clear patterns for this outbreak. Nearly two-thirds of the patients studied had lesions in their anogenital (private) area, with a majority of patients counting less than 10 lesions on their entire body.

Patients were “presenting with symptoms that weren’t part of the case definitions,” NEJM study author Chloe Orkin told Insider. “The important thing is to help doctors to recognize it.”

Fever, fatigue, muscle aches and headaches were some of the most common pre-rash signs a monkeypox infection was budding, which also makes it easy for people to confuse the condition with COVID, initially.

“Every single patient I’ve talked to has done a COVID test when they had a fever, and they’re like, ‘oh, it’s not COVID,'” Walker said.

Other times, diagnoses are missed because providers don’t get a “good, aggressive scrub” of the lesions, he said.

“I’ve seen that before, where people have had a test that came back negative and I’m like, ‘you have literally every symptom of monkeypox, this looks exactly like all the other monkeypox cases I’m seeing, and we’ve ruled out other stuff, like herpes, syphilis, whatever.'”

Some people avoid monkeypox diagnosis because it can be stigmatizing, painful, and lonely

Early treatment is key to curb a monkeypox infection and prevent the excruciating pain it causes. The antiviral drug Tecovirimat (TPOXX) can help, as well as prescription painkillers which are stronger than Motrin and Advil.

But many patients, fearing stigma and lacking information, are not seeking help.

One of Walker’s patients had been managing his lesions alone for two full weeks, when he finally decided to seek treatment.

“He just wanted to manage it at home. He was worried about the stigma, he said he’d never had an STD before. But the pain was so severe, he finally came in,” Walker explained. “There’s lots of fear, there’s lots of anxiety, and to be honest, there’s probably a lot of people who aren’t diagnosed yet,” he added.

Dr. Jason Zucker, an infectious disease specialist at New York Presbyterian hospital, said “even patients with mild disease have been taking it very hard” when they receive a monkeypox diagnosis.

“In addition to this stigma, patients who are diagnosed then isolate at home for up to four weeks alone,” he told journalists on a Zoom call Friday. “It’s important to make sure that we’re all cognizant of this, that we all work together to reduce stigma, and that we offer patients mental health and other supportive resources after their diagnosis.”

A Nigerian doctor spotted this kind of monkeypox in 2017. He hopes people will finally start funding research on this virus.

In Nigeria, where Dr. Dimie Ogoina has been studying monkeypox outbreaks linked to sexual contact since 2017, he says he’s struggled with similar issues of confusion and stigma, which both make it harder to get a sense of the true scope of any outbreak.

Often, he suspects, patients with “genital lesions” aren’t coming to the hospital to be properly diagnosed, instead, they’re just going to the pharmacy for STD treatment.

“There are a lot of things that still not known about monkeypox”  because “it has been a neglected disease,” Ogoina told Insider. “Since the global north is now having cases, I’m sure there will be investments in research, and we will be able to uncover most of these unknowns.”

Read the original article on Insider

Read original article here