House - episode 13
I knew it was going to be a bad episode when they pulled out the Ouija board in the first five minutes.
The patient is a twelve-year old boy who presented to the hospital with a week-long history of a fever, respiratory symptoms and a rash. Various kinds of the atypical pneumonia were considered, including Legionnaires’ disease and chlamydial pneumonia. Several jokes are bandied about concerning twelve year-old boys and sex, and the patient gets a sexual history taken. But wait a minute! Chlamydia pneumoniae, a common cause of atypical pneumonia, is a completely different from the sexually transmitted form of chlamydia (C. trachomatis). Any infectious disease expert, and even a medical student, should know that simple fact.
The team discovers that the patient has developed anthrax, which they claim would explain both his rash and respiratory symptoms — except that cutaneous (skin) anthrax and inhalational anthrax are two different and distinct forms of the disease that don’t cross over. The skin infection makes sense considering the opening scene of the episode where he fell on an infected piece of insulation, but suggesting he somehow breathed in enough spores at the same time to cause the lung infection is hard to believe. Furthermore, ciprofloxaxin (Cipro) is still the preferred drug for anthrax, not Levaquin (although Levaquin is suspected to work against anthrax).
The patient begins to develop symptoms that go beyond anthrax. The team looks at a variety of additional diagnoses including various autoimmune diseases and neurofibromatosis. They obtain manyfancy tests (which they run themselves, with no help from people who are actually trained in the procedures), but they tell nothing. As usual, they place him on some particularly powerful and risky treatments based on little evidence. The treatments seem to help a tiny bit at first, but then he begins to lose control of his hand. Ultimately the true diagnosis is made: leprosy. Apparently the patient had dormant leprosy which made him more susceptible to the anthrax which in turn reactivated the leprosy.
There is also an underlying theme of father/son relationships in this episode, contrasting the relationship of the patient and his father to Dr. Chase and his father.
One last question: How did Dr. Chase’s father, an Australian rheumatologist, get credentialed to act as a physician in the hospital that quickly? Does he have a New Jersey medical license? How did the California doctor get similar privileges so quickly in that Episode 9?
The medical mystery this episode earns a C, but the leprosy solution brings the score up to a B. The actual medicine is pretty poor with too many freshmen mistakes and earns a C-. The side plots earn a C, they were just average.
March 2nd, 2005 at 9:19 am
Did you notice that when the female doctor mentioned
Levaquin she called it “the best antibiotic we have?”
Do you smell the stinky stinky taint of a “product placement?”
March 2nd, 2005 at 9:28 am
I noticed that, and the fact that they used the brand name instead of the generic name. They did the same thing with Lupron last week. However, both times they’ve highlighted a particular brand of medication, they’ve used it for the wrong indication. If I were Ortho-McNeil or TAP Pharmaceuticals, I’d want my money back.
March 2nd, 2005 at 2:39 pm
House,MD is a Crock of S**t, Vol. 2
Watching the episode airing on March 1st: 1. I loved, again, the misconception that doctor’s go out to the scene of infection to collect samples. Maybe the CDC, but not common docs. Jumping out the window to get away
March 2nd, 2005 at 2:40 pm
Nice to see someone else ripping this POS series to pieces. I found the Rapid Sequence Intubation they did to be laughable (by the neurologist, no less).
March 3rd, 2005 at 12:39 am
The thing is HOUSE isn’t a medical show. It’s a cop show, dressed up in hospital. The disease is just the criminal they have to corner.
February 11th, 2007 at 9:12 am
The doctors didn’t wear masks. Anthrax is very communicable but not one of them was concerned. I guess production ruled in favor of aesthetic aspects rather than presenting reality. But see, it doesn’t matter if the series has flaws as long as the show delivers. I don’t mean to sound so Machiavellian but I guess this is the part where his principle applies. Television shows especially series have to be provocative to survive. Sometimes these shows could get away from presenting what is actually happening in the hospital for the simple reason that reality could sometimes be boring..
April 2nd, 2007 at 12:18 pm
I agree with Jatser on the intubation … I saw it and the first word out of my mouth whas “WHAT?!?!?” quicly followed by “the” and another word that I’m sure most people can guess. Last time I checked you sedate, paralyze and then intubate … and Ativan (lorazepam) … that just ain’t right.
April 20th, 2007 at 1:48 am
One thing that amused me was the discussion of a short course of antibiotics “curing” leprosy, which is really unlikely; leprosy is treatable with antibiotics, but because of its life cycle, it’s only curable with very long courses of antibiotics - usually (always?) on the order of years.
April 25th, 2007 at 3:26 pm
When they mentioned the Thalidomide as treatment, why did Cameron balk at the idea? Aside from the fact that a 12 year old boy obviously won’t be having kids, I thought the problem with Thalidomide was that one stereoisomer worked differently to the other, and that nowadays they seperate out the two different forms, so it’s safe to use.
At least, that what I remember from my chem classes. Is that right?
May 31st, 2007 at 8:30 am
How about the father’s carpal tunnel being caused by leprosy? Is that accurate? I ask because my mother in law claims to have carpal tunnel which surgery did not fix. Could it be due to leprosy? She is from India.
Thanks!
June 5th, 2007 at 12:33 am
soooo what you’re saying is that you want someone on an anonymous messageboard to diagnose your mother with leprosy? huh.
June 6th, 2007 at 5:36 am
Yes, that’s why I presented all her symptoms and medical history.
Actually, I was just asking if leprosy could cause symptoms similar to carpal tunnel. Like what happened to the father? In this very episode? That we’re discussing?
July 8th, 2007 at 6:52 pm
The father did not have carpal tunnel. He had leprosy which, according to the show, damaged his ulnar (sp?) nerve and was misdiagnosed as leprosy. This was mentioned to be an atypical presentation of leprosy. If your mother-in-law has a positive diagnosis of carpal tunnel and no other symptoms that indicate leprosy, then there is no reason to think that it might be leprosy.
July 12th, 2007 at 3:25 pm
“I thought the problem with Thalidomide was that one stereoisomer worked differently to the other, and that nowadays they seperate out the two different forms, so it’s safe to use”
You’re right about the fact that the two stereoisomers of thalidomide work differently, with one having the indicated effect against morning sickness during pregancy (S-form) while the other is teratogenic (R-form). The problem however is that the two forms interconvert rapidly in the body (because a weakly acidic hydrogen atom), so you will eventually end up with a racemic mixture even if you start out with just one stereoisomer.
July 23rd, 2007 at 2:56 pm
does leprosy have a cure ?
I am not a doctor, but I read a few things here and there.
I know that one of the cures forleprosy is thalidomid (spl. ?), and a visual check (read it on thomas covenant books), but other wise it’s a chronic disease that doesn’t get better.
is it treatable or even can be cured ?
I understand that no one knows why people get it, but it comes usualy with alot of bad hygene ?
October 17th, 2007 at 4:09 am
I have a burning question about this episode and have been unable to find an answer other than it’s a glaring mistake: Berger’s disease? (Burger’s?)
they say:
Cameron: Burger’s disease. Foreman: He’s never been out of the country.
huh?
“Berger’s” disease is: IgA nephropathy (also known as IgA nephritis, IgAN, Berger’s disease and synpharyngitic glomerulonephritis) is a form of glomerulonephritis (inflammation of the glomeruli of the kidney).
and
“Buerger’s” disease is:(also known as thromboangiitis obliterans or bgritis, an acute inflammation and thrombosis (clotting) of arteries and veins of the hands and feet. It is strongly associated with use of tobacco products,[1] primarily from smoking, but also from smokeless tobacco.
neither has anything to do with non-american geography.
what gives? what are they talking about? parallel universe?
June 14th, 2008 at 2:34 am
Is Thalidomide really a treatment for Leprosy? The wikipedia article on Leprosy says they treat it with other antibiotics.
August 23rd, 2008 at 4:51 pm
“does leprosy have a cure?”
Yes, it has a cure. It is a long term treatment, but it works.
“Is Thalidomide really a treatment for Leprosy?”
Yes. I’ts not the default treatment, but it’s an option.
August 25th, 2008 at 9:57 am
In the beginning Cuddy tells House that Gabe´s pneumonia doesn´t respond to ceftriaxone. I have doubt ceftriaxone would be the first choice to treat pneumonia, especially when caught outside the hospital.
Leave a Reply
Contact Me
Subscribe:
The Best Of...
Special Topics
Archives
Categories
Arbitrarily Interesting Medical Condition
Twitter
Comic Blogs
Medical Blogs
Currently Reading
The Net:
Contents may have settled during shipping. Past results are no guarantee of future performance. No animals were harmed during the production of this product. Void where prohibited by law. All rights reserved. Not valid with other offers or specials. Professional driver on a closed track. Your financial institution may impose other fees. All models are over 18 years of age. Employees must wash hands before returning to work. Results not typical. Many suitcases look alike. 18% gratuity added to tables of six or more.
Do not taunt Happy Fun Ball.
© 2004-2008 Polite Dissent. Powered by WordPress