I'm currently in my San Lazaro Hospital rotation. This is the center of all infectious diseases. This is where all the other hospitals all over the country refer patients who are ill due to infectious disease. Dengue, malaria, typhoid, TB, H1N1, Leptospirosis, Snake bites, Dog bites..
In my first 3 days in San Lazaro, 5 people died of Leptospirosis. I witnessed patients arriving in the ER with yellowish skin tone (jaundice!!!), they have yellowish-reddish eyes (conjunctival suffusion), muscle pain (myalgia), calf pain, cannot urinate (anuric) or have little urine output (oliguric). Upon admission, these patients were hydrated and made to urinate...
However, after a few hours, they deteriorate rapidly. They cough out blood (hemoptysis), have difficulty of breathing (dyspnea), and then we code. If only they consulted a little earlier, huh? Coding. Doing CPR in these patients do not do much, does it? Dra L told us that almost all.. well maybe all of their patients who have massive hemoptysis usually code after a few minutes to an hour. And they cannot actually be resuscitated cause they already are having internal hemorrhage. So basically, that whole 20minutes of sweating and arm-aching pumping and ambubagging is ... for show? It's really frustrating.
All these patients who died had history of wading in the flood (2weeks ago from this week; so maybe that time when UST was flooded). Leptospirosis is an infection secondary to leptospires, a microorganism that penetrates intact mucous membranes and abraded skin through exposure to water, wet soil or vegetation that is contaminated with urine of infected animals (usually urine of rats).
So if it's possible not to walk in the flood, do not. Otherwise, take in Doxycycline for prophylaxis. Take in doxycycline 100mg/tab, 2 tabs one single dose before you wade the waters.
The initial symptoms of leptospiral infection are flu-like with muscle pain, calf muscle tenderness, conjunctival suffusion, and abdominal pain. This usually occurs 7days to 1week after exposure to contaminated water/wet soil. Later, symptoms would include jaundice, signs of renal failure, hemorrhages, and cardiopulmonary dysfunction.
read more of Leptospirosis here: emedicine> Leptospirosis
Attention DOH. It might be of help that you inform the public once again of LEPTOSPIROSIS. Because most of the patients do not take this seriously. They don't mind walking through the BAHA. They don't take fever seriously. They don't even seek consult even they are already jaundiced! They grow concerned when they cannot urinate, eh! hello naman, kidneys are shutting down by that time! Then, they just die suddenly.. so sudden that they even haven't get to inform their parents that they're in the hospital! Panu naman yun, you'll go home dead na! grrrr.
Dra said that it seems that strain is highly virulent these days, 5 deaths (or is it 6) in my 3rd day in the rotation.. So attention attention!
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after writing this entry, i browsed through my mail, got this link in tumbler. (click on the
i got stuck in san lazaro, i didn't know what's really happening outside. I knew that flood was waist level outside but didn't realize it was pretty pretty bad.
Ondoy ondoy...you've killed people instantly and what else? ... =(
These are pics i took when the flood already subsided.. oo 1/8 nalang to ng baha!
These are pics i took when the flood already subsided.. oo 1/4 nalang to ng baha!
And from Ondoy tumbler....
God. help us.
