Many years ago, I worked in a hospital in Aberdeen, Scotland. A family had just returned after a long stay in the tropics. The mother brought her daughter Rosy to see me at the clinic. She had had fever continuously for a week. Her recorded temperature had a step-ladder pattern. I found rose spots on her abdomen. Rosy seemed thrilled. But it was typhoid fever.
Beneath scarlet fever
After some time came a teenager who had had fever for a couple of days. Her face was flushed and she had rashes all over her arms and legs. Seeing her strawberry tongue, I diagnosed it as scarlet fever.
To my surprise, she got excited and thrilled. I realised that scarlet fever was also known as love-sickness! She had met an American marine and fallen in love. I told her it was due to streptococcal infection, and assured her the fever and rashes would subside in a few days.
Kissing bugs
Now about the kissing bugs: there is nothing romantic about them. The bites of cosmopolitan bed bugs such as Cimex are painless, but the sensitised individuals develop erythema, itching and wheels.
Of the cone-nose bugs, Assassin and wheel bugs inflict pain, whereas bites of nocturnally feeding kissing bugs are painless — although subjects may develop papules, vesicles, bullae and fever.
Triatomine infestants , the kissing bugs found in South America, are vectors of Trypanosoma cruzi and may cause Chagas’ disease. The kissing bugs are not benign enough to lure me; their affectionate bites may even turn fatal.
The case of the poet
Lastly, the story of a very sick man who was a poet. He appeared wasted and anaemic, had severe pain and could hardly stand. After a full investigation he was diagnosed to have POEMS syndrome.
The poet was extremely happy – what more could he have asked for! In reality, the features of this syndrome include Polyneuropathy, Organomegaly showing an enlarged liver, spleen and lymph glands, Endocrinopathy affecting hormones, and M-proteins of myeloma. Skin changes include hyperpigmentation, hirsuitism and hyperhidrosis. The relatives were told he was terminally ill; the prognosis was grave.
These are semi-fictional accounts but based on medical facts. Terms may be catchy but diseases aren’t – and beware how the patients react. The medical men who coined these terms wanted to combine science with art. It is up to us to be discreet and see that the patients’ feelings are not hurt.
The author is Consultant Chest Physician at the Christian Medical College and Hospital, Vellore. Email: debidasray1@yahoo.co.in
