A surprising diagnosis
BMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7238.849 (Published 25 March 2000) Cite this as: BMJ 2000;320:849The elderly woman was already frail when she came to me complaining of a cough and weight loss. Alarm bells rang as I examined her and arranged for blood tests and a chest x ray examination. As I feared, the chest radiograph was suspicious, and referral was advised.
The chest physician concluded that bronchial carcinoma was almost certain and recommended awaiting the outcome of events, rather than subjecting her to an unpleasant bronchoscopy. Rather to my surprise neither she nor her family agreed, and she came back to me insisting on further investigation.
Some time later I rather hesitantly explained the eventual diagnosis of tuberculosis to her and was astonished by her calm response. “I rather thought it might be that, doctor,” she said, “after that trouble I had years ago. Didn't I ever tell you I'd had tuberculosis as a child?” Red faces all round, but a well, elderly patient five years later.
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