Solved on Sermo: July 2019 edition

The Solved on Sermo series continues! We’re bringing you some of the most interesting patient cases recently solved by our physicians. Check out firsthand how Sermo helps enable medical crowdsourcing to improve patients’ lives every day.

Case 1: Is this Schizophrenia or Depression?

Male scholar, 11 years old, is in 6th grade. He is taken to the consultation by the mother, he says that for about 4 or 5 months he feels strange and in these last 15 days he urinated twice in the room, even taking the bath inside it, claiming that he wanted to urinate; He has resisted eating at the table, justifies it by stating that he does not want that type of food, including meat and that he wants to be a vegetarian. At school he does not share with classmates, they really avoid it. However, it does not seem to matter; in the house every time he is in the room for longer. School performance has decreased because it is not as attentive as before, and on one occasion he told the mother to be very careful with the people because they could hurt him.

Family dynamics: The youngest of 2 siblings, the parents separate when the patient was 7 years old. Both engineers. The 42-year-old mother, the 44-year-old father, is currently out of the country.

Total time until solved: 2 days
Total Comments: 33
Diagnosis: Depressive disorder

Member Comment Examples:

Sermo Pediatrician: It can be Depression if we take into account that the parents are separated and the father out of the country, but we must be very aware because wanting to stay in the room, not sharing with classmates in school and lowering school performance are some signs of alarm to think about child abuse.

Sermo Emergency Medicine Physician: Interesting case, I’m going more for the depressive part in view of the background, coupled with that being entering the terrible stage of adolescence. Family therapy should be done.

Case 2: Infant with a Menstrual Period

Patient 1-year-old female infant, who comes to the consultation due to genital bleeding. Family members were prepared for a family outing when changing the diaper of the baby, they found abundant blood coming from the vaginal entrance, without any symptoms or other signs and go directly to consultation.

Personal antecedents: Product of II gesta brother of 4 years, Without perinatal antecedents, Caesarean section for surgical sterilization, weight and size appropriate to the age. Exclusive breastfeeding until 6 months and complementary in the future. Totally healthy No infectious pictures of any kind.

Family Background: Without pathologies, lives alone with their parents and brother only cares for the mother. What other studies should I request?

Total time till solved: 1 day
Total Comments: 48
Diagnosis: The baby is still being monitored and studies are still being done. Fellow doctors suggested to have additional tests done by an infant and juvenile Gynecologist and also Endocrinologist.

Member Comment Examples:

Sermo OB/GYN: Request a hormonal profile and evaluation by gynecology in children and adolescents where they perform a pelvic echogram and decide on hysteroscopy.

Sermo Pediatrician: Interesting case, if there are no clinical signs of precocious puberty such as telarchia, pubic and axillary hair, apocrine odor in armpits would be relevant to study hematology because the PTT is altered, on the other hand, for other causes such tumors, consultation should be requested with endocrine.

Case 3: Eye Injury from a Workplace Accident

A 68-year-old technician in refrigeration who suffered a work accident due to the rupture of the refrigerant gas pipe, dropping its content in the right eye, immediately after the accident he washed his face with water, without going to the emergency center, presenting at the moment with redness and mild burning, self-medicating with ophthalmic vasoconstrictors. Later, 5 days after the accident, he presented with palpebral edema, burning pain, foreign body sensation and greenish discharge.

Total time till solved: 2 Days
Total Comments: 40
Diagnosis: Chemical Conjunctivitis

Member Comment Example:

Sermo General Practitioner: I agree with the behavior it is conjunctivitis caused by an irritating chemical agent that is over infected. After the care done by the general medicine service must be evaluated by the emergency ophthalmology service to perform control and specialized behavior.

Check back soon to stay informed about industry updates and how Solved on Sermo is improving healthcare.