{"id":2860,"date":"2016-11-29T20:48:15","date_gmt":"2016-11-29T20:48:15","guid":{"rendered":"https:\/\/inmedblogs.us\/nicholascomninellis\/?p=2860"},"modified":"2016-11-29T20:50:07","modified_gmt":"2016-11-29T20:50:07","slug":"somethings-eating-at-me-angola-day-8","status":"publish","type":"post","link":"https:\/\/inmedblogs.us\/nicholascomninellis\/2016\/11\/29\/somethings-eating-at-me-angola-day-8\/","title":{"rendered":"&#8220;Something&#8217;s Eating At Me&#8221; &#8211; Angola Day 8"},"content":{"rendered":"<p><a href=\"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-content\/uploads\/sites\/2\/2016\/11\/liver-abscess.jpg\"><img fetchpriority=\"high\" decoding=\"async\" class=\"alignleft size-full wp-image-2862\" src=\"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-content\/uploads\/sites\/2\/2016\/11\/liver-abscess.jpg\" alt=\"liver-abscess\" width=\"530\" height=\"398\" srcset=\"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-content\/uploads\/sites\/2\/2016\/11\/liver-abscess.jpg 530w, https:\/\/inmedblogs.us\/nicholascomninellis\/wp-content\/uploads\/sites\/2\/2016\/11\/liver-abscess-300x225.jpg 300w\" sizes=\"(max-width: 530px) 100vw, 530px\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<p>He started to laugh as he uttered these words to me, but then suddenly cringed with pain. Solomon, a young man, winced and grabbed at his right side. Three days earlier Solomon developed fever, some abdominal cramping, and just a little dysentery. Such illnesses are quite common here in Angola. Solomon drake some traditional tea made by his grandmother and expected to feel better quite soon.<\/p>\n<p>&nbsp;<\/p>\n<p>Instead, the next day his abdominal discomfort became quite severe. Then came profound weakness and vomiting. Solomon&#8217;s family began the 210-mile journey to our city of Lubango, where I first met him in outpatient clinic. Physical examination was rather unremarkable aside from temperature of 38.5 and right upper quadrant pain with hepatomegally. Here at <a href=\"https:\/\/www.inmed.us\/service-learning\/training-sites\/ceml-hospital-angola\/\" target=\"_blank\">CEML Hospital<\/a> we keep a portable Sonosite ultrasound unit on standby. The size of a laptop computer, it&#8217;s remarkably convenient.<\/p>\n<p>&nbsp;<\/p>\n<p>The above image shows Solomon&#8217;s liver containing an ill-defined, hypodense (black color) lesion. Among all those who provide healthcare in low-resources setting it&#8217;s well known that a<span class=\"st\"><em>mebic liver abscess<\/em> is one of the most frequent complications of <em>Entamoeba histolytica<\/em> infection. Indeed, Solomon&#8217;s stool analysis was positive for cysts of the Entamoeba histolytica organism.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p>What&#8217;s next in management of this man&#8217;s illness? Rather than immediately proceeding to surgical drainage we&#8217;ve opted for treatment with metronidazol and monitoring. Tomorrow he&#8217;ll undergo another assessment, including ultrasound imaging of the abscess. Hopefully next time he can chuckle and say &#8220;Something&#8217;s eating at me&#8221; without wincing in pain.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>&nbsp; He started to laugh as he uttered these words to me, but then suddenly cringed with pain. Solomon, a young man, winced and grabbed at his right side. Three days earlier Solomon developed fever, some abdominal cramping, and just a little dysentery. Such illnesses are quite common here in Angola. Solomon drake some traditional [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[45],"tags":[],"class_list":["post-2860","post","type-post","status-publish","format-standard","hentry","category-2016-angola"],"_links":{"self":[{"href":"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-json\/wp\/v2\/posts\/2860","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-json\/wp\/v2\/comments?post=2860"}],"version-history":[{"count":0,"href":"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-json\/wp\/v2\/posts\/2860\/revisions"}],"wp:attachment":[{"href":"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-json\/wp\/v2\/media?parent=2860"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-json\/wp\/v2\/categories?post=2860"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-json\/wp\/v2\/tags?post=2860"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}