Case of the Day - December 8, 2008
History: A family of 4 children, all under 10 years old, present on different days with high grade fever (lasting 5 days), vomiting and extreme malaise and myalgia (muscle pain). Seven days after the first child's symptoms the father presented with the same high fever, severe vomiting (including small amount of hematemesis) and unable to go to work for three days.
Figure 1.
Finding: Both patients in figure 1. could not retain food for 5 days. Ultimately the orange jello was vomited.
Diagnosis: Influenza A or B
Discussion: Although vomiting is more common in children while infected with the influenza virus, this shows the youthfulness of the dad. None of the family received the influenza vaccine (which was widely advertised in community health system). Miraculously the mother dodged this bullet but had the unfortunate responsibility to care for all invalids. According to the patients, especially the dad, this illness should be avoided as it was the most miserable encountered in some 15 years.
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