Short clinical account by Robert Whitfield MD describing a breast cancer patient in whom an unexpected E. coli infection was discovered despite no physical or laboratory signs; oral antibiotics resolved the patient’s fatigue. The speaker reflects on diagnostic challenges and personal stakes due to a family loss from breast cancer.
Questions this video answers
Three patients.
E. coli infection.
No; the white blood cell count was normal.
An oral antibiotic.
Chapters
In my practice, just in the last six months, we've had three patients have breast cancer. So all that stuff always gets sent off. You always have access to it. It's not some difficult thing. Now what has changed is from that patient, we found that they had an E. Coli infection. So that was quite shocking because my sister, who recently passed away from breast cancer, if somebody had missed that on my sister, I would be supremely pissed off. So I had missed this, and I went back through the notes and we went to my NER and everybody in the clinic was like, how'd we miss this? And we hadn't missed anything because there were no physical manifestations for this. There was no change in laboratory, so the white blood cell count was normal. She didn't have redness, she didn't have swelling, she didn't have pain, she didn't have a capture contracture. She didn't have anything that would normally tip you off there was a problem, and this is why I told you, I don't envy providers trying to figure this out. So I put her on an oral antibiotic to treat E. Coli, and magically, all of her fatigue went away. It's amazing.
