Thursday 16 February 2012

Come out,come out...whatever you are...




Saturday morning and the air conditioning was broken,- as usual-,on what was the coldest day of the year so far.
The temperature in the Unit was 13C.
I had 2 layers of clothes on under my scrub suit and another 2 layers on top of the scrub suit.

"Mrs Host...?"

A fair, fat,fertile, forty-something female stood up and made her way slowly into the my room.

"What can I do for you today then Ma'am?"

Well...what it is...obviously...I was on holiday in Africa for a week...

"Yersss...?"

And I got bitten by something and its very itchy...

"Where were you bitten?"

On my bum...

"I meant...what part of Africa?"

Oh...

It was an equatorial part of Africa,rampant with malaria amongst other things.

"And whats been going on then...?"

Well I've got these three big red swollen spots on my bum and they're painful and itchy....

"Jah...?"

And this morning my husband squeezed some pus out of one of them...

"Jah...?"

So I went to the pharmacy and they said I should come and see you to get some antibiotics...

"Uh huh...well...lets have a look then...."

I got Julian to come and chaperone me.

Sure enough,she had what looked like 2 infected insect bites...possibly small abscesses on her left buttock and another one on the right buttock.
Each measured about 3 cm in diameter,all were warm to the touch,and painful to examine.

"Did you do anything odd on your holiday...? Did you leave the hotel at all during your stay? Did you go into the bush,-the jungle-,at all...? Did you swim in a river of any sort...?Do you remember being bitten by anything at all...?"

No...it was so hot....we just stayed at the beach all day...

"Uh huh..."

We couldn't believe how hot it was...

"In Africa,you mean...?"

Yes...it was to hot to do anything but sunbathe...

(Note to self...don't forget to check the patient for melanoma...)

So...what do you think the spots are then...?

"To be honest I just don't know..."

But aren't you from South Africa...?

"Jah....firstly though...South Africa is 4000 miles from where you were on holiday...
...secondly,I didn't do the course on English tourists..."

Oh...

"So I think at the moment that its a moot point about what bit you....I think the bites are infected...and we should give you some Flucloxacillin for that..."

Okay...thanks...

"Also...I want you to pop to the chemist an get some germolene ointment and put some of that on the spots..."

Okay...

"Also....I want you to have a few sitz baths today in hot water to see if the other spots come to a head...and get your husband to have a look at them ...come back if you have any problems..."

She left and I went to find a hit child I could examine so that I could warm my hands.

Fast forward to Sunday morning...when she returned...

"Hello...whats going on today then...?"

Well....I got the antibiotics and the gremolene from the chemist...

"Jah..."

And I had a lots of baths...

"Jah..."

And the spots got very very itchy....

"Jah..."

And then got very painful...like something was trying to dig itself out of my bum...

"Jah..."

And this morning my husband squeezed one of the spots and these came out...

She reached into her handbag and pulled out a little plastic bottle covered with cling-film...inside of which were 2 maggot-like worms...small and white...about the size of a grain of rice...
In fact I thought it was rice until I touched one of them with the tip of Julian's pen...it curled up!

"Gosh...so those came out of the spots on your buttock then...?"

Yes...really...if you don't believe me you're welcome to try and squeeze a spot yourself...I can feel more of them moving around...

(Look...it was a huge bum after all...)

"No...no...I believe you...I just need to phone the medical registrar on call....also...I have curry-and-rice for lunch..."

Result!!

I was able to Buff-and-Turf her to St Vulvas...
...who in turn were able to Buff-and-Turf her either to psychiatry-on-call or to the Hospital for Tropical Diseases



She described the experience as being just like Alien...



4 comments:

  1. Possibly altho i have seen that before
    I have asked her to return and let me know what it was

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  2. Sounds like putsy fly - they lay their eggs in damp clothes/ bed linen/ towels etc. Only way to prevent infestation is to iron all clothes before wearing. We used to have them in Zim but recently visited Kenya and they are very common(on the coast at least) - met your typical tattooed lager lout who got one on his chest (they dried their t-shirts and towels over their balcony) and got a gruesome description of that nasty creature that luckily I have never experienced personally!

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  3. You tube has videos of botsy fly indeed iorn everything need to cut off air supply and cause stress tape over them she will live ... they love cattle can squeeze plenty out of one site rather not appetizing .. you want them infected to use the puss as lubricant to get the maggot out dont attempt removal until its infected and dont cut it open to prevent septicemia and friends ....

    seen them in Lowveld [Nelspruit] also locals in Zim / Zambia know of em from the places ive been

    ReplyDelete