[An aphasic man with high fever; difficulty with diagnostic procedure].
A 73-year-old man, with known motor aphasia presented with high fever, dyspnoea, and vomiting. Only after several days it appeared that these signs were due to a sepsis as a consequence of a phlegmon of the neck, caused by an aspired part of his set of false teeth. The delay before diagnosis was due to the fact that adequate medical history taking was difficult because of the aphasia and attempts at non-verbal communication were poorly understood. The localization of the corpus alienum was a second pitfall, because it could not be visualized during physical examination or on the initial chest X-ray. The increased risk of colonization of dentures with pathogenic micro-organisms in nursing home residents may have played a role in the severe course of this infection. This case illustrates the diagnostic problems that may exist in patients who are unable to communicate adequately.
Potjewijd
J
J
Atrium Medisch Centrum, afd. Interne Geneeskunde, Heerlen. jpotjewijd@hotmail.com
Buijs
J
J
D000368:Aged; D001037:Aphasia / Q000150:complications*; D003829:Denture, Partial; D005547:Foreign Bodies / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D007239:Infections / Q000209:etiology*; D008297:Male; D009633:Nonverbal Communication