this post was submitted on 28 Aug 2023
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I, too, hate that doctors do not have perfect knowledge of everything and sometimes make mistakes like humans.
Its ok to make mistakes but if there is disease u don't understand and u know u don't understand, why give medication that maybe helpful or harmful instead of saying "I don't know".
My extensive medical research from the show House has shown me that it's because they need to rule out what it's not before they can rule out what it is
It's not lupus.
(except for that one time it was)
Sometimes you do not have the luxury of waiting to treat until you have all information. In general a short course of steroids is extremely safe. Additionally, steroids are correct to give in CNS helminth infections anyways, although usually it is dexamethasone, not prednisolone. More likely the mycophenolate was the immunosuppressant that let it get into the brain not the steroid.
More importantly, they did quite a bit of workup, including bronchoscopy with BAL, which indicated she likely had a form of eosinophilic pneumonia, probably Churg-Strauss syndrome. Steroids and immunosuppressants are the standard of care for this, and it is a severe disease if not treated.
This is something that has never occured before in known medicine, so to expect them to have figured it out entirely before initiating a treatment is unreasonable. Her initial symptoms were in January of 2021, final diagnosis was made mid 2022. Would you expect your doctor to hold off on any treatment for a year and a half?
Actual case report here: https://wwwnc.cdc.gov/eid/article/29/9/23-0351_article
Wiki on Churg-Strauss: https://en.wikipedia.org/wiki/Eosinophilic_granulomatosis_with_polyangiitis
Because doctors are only human, and they're doing the best they can with what tools they have and what they know. If someone comes in with all the symptoms of X disease, you're going to treat them for X disease instead of straightaway concluding that they have a worm living in their brain that has never before been seen in humans and treating them with medicine we usually give to horses to get rid of parasites.
How sure do you require a diagnosis to be before treatment can begin? 4 sigma?