Wouldn’t a simply x-ray have cleared this up??
X-rays cost money, you know!
Or even cheaper, a TB skin test
They finally did an x-ray, but said it was a ‘chest infection’.........
Maybe and there’s a routine and cheap pin prick to test for it. All teachers used to have to get tested. My son had to get tested before going on some of his meds. Good grief.
The answer to this is somewhat long, but if this were classic TB then having a chest x-ray would have helped a lot to make this diagnosis. There are a ton of issues that this case exemplifies, but I would bet that central to the case is the current policy wonk approach to medicine which encourages physicians to practice ‘cost effective’ medicine. Politicians and epidemiologists are clueless to the realities obscured by such an approach.
It used to be taught in medical school that to be a good physician one had to ‘have a high index of clinical suspicion’. In other words, make sure you don't miss things because you haven't thought about them or because you've assumed the easiest and most benign diagnosis.
Now, one is encouraged to consider the statistical likelihood of disease before ordering tests. In this context, the likelihood that any fifteen year-old girl in the UK is going to have an abnormal chest X-ray is very small, and this is especially true if the symptoms she is exhibiting are somewhat non-specific (e.g. fatigue). So these docs probably went with the odds, and consequently made a fatal mistake.
The bottom line is that medicine has to be practiced as though each person is a unique case - because they are. Night sweats in this population (a common symptom in TB) can be caused by anything from too many covers, to TB or a lymphoma. Fatigue can be caused by anything from texting at night after your parents go to sleep, depression, to a life threatening disease such as leukemia or as in this case TB.
You have to not be lazy, and you have to treat each and every person individually - without dismissing possibilities just because they are unlikely. You don't have to go to medical school to follow an algorithm, but you do to become a good physician, because you need to be able to think far above and beyond algorithms (or as they call them now - ‘critical pathways’).
Anyway, this is a tragic case. Based on this girls surname (Sarag) and her appearance she is probably Indian. A good physician would have factored this into their diagnostic approach and considered whether or not she had spent time in India - a country that has the highest current prevalence of TB in the world.
My advice to any patient is not to trust anyone. Hold your docs feet to the fire, ask questions, and don't hesitate to get second opinions when you feel you need to. It seems that the parents did all of that in this case, and it still ended tragically.
No, but it could have led to a correct diagnosis. Antibiotics will clear it up.
"He said all the problems were in her head and she should see a psychiatrist or spiritual healer.
That is a universal medical punt. When they don't know, doctors seem to either blame the patient ("your imagination", "psychosomatic", 'Delusional Parasitosis", Etc.
A good doctor will admit they don't know and refer the person to a specialist or another doctor.
One you should part ways with will blame you.