Why didn't they do a stool exam???

I love watching medical dramas and shows because I learn (or relearn) a lot of things. But, sometimes we find something in those shows that are not consistent with what doctors in real life might do.

Last night, my husband and I started with House MD. It was very enjoyable for us, because we were able to relate with the doctors as they try to find out what the problem was with the patient.

We just started with the pilot episode last night. They diagnosed neurocysticercosis, which is an infection with Taenia solium (or pork tapeworm) in which larvae migrated to the brain and caused the patient's neurological symptoms. What I really don't understand -- once they already had that diagnosis in mind and they can't convince the patient to go through the treatment because they don't have evidence that there IS a worm -- they ordered x-rays of the leg so that they can look for the larva encysted in the muscle. Sure, it's rather simple and non invasive, but a simpler and more non invasive test, not to mention one with more yield -- would be a stool exam. Taenia solium is primarily an intestinal parasite. If there are larvae in the brain and in the muscles, it stands to reason that there are probably worms in the intestines and they lay a lot of eggs or shed proglottids which are passed out with the stool. Which could then be seen microscopically. That's what the medical technologists and parasitologists are there for. And, it's quite a cheap test -- at least here in the Philippines.

Oh well, maybe the stool exam is not as dramatic as an x-ray showing the larvae. :D


Anonymous said...

Hi! I guess they can't show the worm in the stool in prime time TV. Knowing House, it's something he would do. :D

theworkingmom said...

You may be right :)

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