BK, a 20 year old young man was brought by his brothers to the emergency at NJH sometime late afternoon. I happened to see him as soon as he came in. He looked quite sick and had yellowish eyes and was putting out dark colored and blood tinged urine.
BK’s brother told me that BK has just reached his home in a village nearby in Manika block. He works in somewhere in South India and has developed fever in the train. It was very high grade fever associated with chills and rigor. BK had blood shot eyes and it was obvious that he either had hepatitis or something else.
But, the diagnosis was quite easy once I found out where he worked. BK was a bit stuporous but he was conscious enough to answer my questions. To my astonishment, BK worked in Kerala. And where in Kerala? He worked in a pineapple estate.
As he told pineapple – I knew the diagnosis and my heart could not wait to ask the next couple of questions and it was obvious that most probably he had leptospirosis.
BK had been working in Kerala for the last 2 years somewhere near Perumbavur, Kerala in a pineapple plantation. It is very commonly known that workers in pineapple plantations are very much susceptible to leptospirosis. It basically occurs because of the pricks they receive from the pineapple thorns. And when they touch contaminated water, they get the disease.
Then I found out that BK knew Malayalam. You should have seen his face, when I asked the next few questions in Malayalam. Poor guy, he got the shock of his life to find a Keralite doctor working near his village. So much so that he was soon out of his stuporous state – though looking sick.
But more surprise waited for him in the Acute Care Unit. He must have got really psyched out when he found out that the nurse who attended to him as he reached the Acute Care Unit was also from Kerala.
His blood investigations were also very much suggestive of leptospirosis. He was lucky that his renal parameters were just turning bad when he came in. He has made an amazing recovery with high dose Penicilline.
Today evening, as I took rounds, BK told me that the previous day he thought he was dreaming when he found the doctor and the nurse asking him questions in Malayalam. He believes that a miracle has brought him here where we could make the correct diagnosis.