Food Poisoning

Celestine

Last week we had 5 people arrive at the OPD complaining of vomiting and diarrhea after eating a meal of coco yams.  We later found out that a total of 15 people had eaten the coco yams and all 15 became ill.  2 young boys and 2 elderly women required admission.  3 year old Celestine was the sickest and he had multiple seizures over the next 12 hours.

Dr Eugene visited the Family Compound and was able to secure some of the cooked yams and sent one to the Hospital Laboratory for culture.  Today the Lab reported a heavy growth of E. Coli grew from the yams.  While Dr Eugene was at the Family Compound a neighbor showed up and boldly claimed he was so tough that no yam could make him sick.  Against Eugene’s advice the man snarfed a yam down.  We later heard that about 2 hours later the yam was oozing from both ends of his intestinal tract.

Everyone is doing well now.  We removed Celestine’s IV today and hopefully he will be able to go home tomorrow.

Contagious

 Smiling Germar with fading measles rash

 I had reported a couple of weeks ago that we had a family in the hospital that had the measles.  We put then in a ward by themselves because measles is highly contagious.  

Last week my nurse Germar became ill.  She initially had fever and headache so Dr Eugene treated her for malaria.  When she then complained of sore throat and cough I added an antibiotic.  She did not improve and her cough worsened so Dr Eugene sent her home for 5 days of rest.  

She came back today looking better but she reported that she broke out with measles shortly after going home on Saturday.  A good example to us all on the contagious nature of this illness.

TB, ever present.

In our HIV patients we continually need to remember Tuberculosis.  10-15 % of the HIV patients will develop active TB each year.  Because of their immunosuppression they will not always present with classic Tuberculosis symptoms.  Additionally their TB may be non-pulmonary in location.
 
Deborah is a 34 year old lady with HIV who has been in the hospital for over 2 weeks.  She has been spiking fevers of 105 daily.  Despite her fever she continued to smile and claimed to be well except for headache related to fever.  She has been treated for malaria and been given antibiotics for every possible bacterial infection.  Despite this, every night Deborah  continued with spiking fevers.  Last week Dr Eugene started TB medications.  It took 5 days but finally Deborah’s temperature has been normal for 2 days.  She was so happy to be discharged today.

Loa Loa

Loa Loa is the “eye worm” that is endemic to portions of Cameroon.  It can appear on the surface of the eye and being 1-2 inches in length it is quite visible.  

Dr. Eugene stopped by the house the other day very excited.  He had been called to see a patient on the Surgical Ward with eye irritation.  The patient had a very active Loa Loa worm visible in his eye.  It was not long before Dr. Eugene, Dr. Ed, Dr. Jim and Nurse Sunday were all gathered around the patients bed.  I am not sure the patient was more bothered by this worm squirming around just under the surface of his eye or by the presence of all us “worm gazers”.  

Armed with some numbing eye drops, scissors and forceps I went after the worm.  The worm certainly did not like being under the spotlight and soon retreated into the upper corner of his eye out of my reach.  The patient is receiving medication to kill the worm and is improving.  

Every patient complaining of eye irritation this week has been scrutinized for the presence of Loa Loa.

Busy

My days at the hospital remain busy.  Dr. Eugene, a General Practitioner began working last week.  He is fresh out of his training program so he does not have a large amount of experience with direct patient care.  I am therefore doing a fair amount of teaching everyday which has been enjoyable.  He has a lot of enthusiasm which makes it fun.  He grew up near here so he speaks Kom (the local dialect), French, English and the dialect the Moslems speak.  This will certainly enhance the patient care we can deliver.
 
There is a 10 year old boy in the pediatric ward with cerebral malaria.  Keep him in your prayers today as he struggles to recover.