Medicine and Health Sciences Commons^™

A Coal Miner With Weakness, Fatigue, Nausea, Fever, Chills, Night Sweats And Dyspnea, Larry Nichols

Marshall Journal of Medicine

Delayed or missed diagnoses are a constant hazard in primary care. This is the case report of a 51-year-old coal miner, who presented as an ambulatory outpatient on a Friday with weakness, fatigue, nausea, fever, chills, night sweats and dyspnea. Chest x-ray on Saturday showed pneumonia and pleural effusion, while blood testing showed renal failure, but these results were not known by his physician until Monday, when he was hospitalized with severe sepsis due to fatal Austrian syndrome of pneumococcal pneumonia, endocarditis and meningitis. Analysis of the delay of diagnosis in this case suggests the possibility that a weekend effect …