Two cases of a super mimic

Two cases of a super mimic

Author: Murtagh, John

Case 1 History: Ching, a 38 year old school teacher, presented with a 14 day history of tiredness, weakness, anorexia and mouth ulcers. She said that for the past 12 months her health had been poor and that she had struggled to inject much energy into her work. In recent months she had suffered from flatulence, abdominal bloating and loose bowel actions of up to three or four times a day. Sometimes she had periods of constipation. In addition she had lost about 6 kg of weight in the past 6 to 8 months. She had visited a hospital clinic where she was prescribed a herbal remedy for ‘bowel dysfunction’. On physical examination she presented as a pale, thin, tall woman with no subcutaneous fat. Her vital parameters were normal. The only abnormal finding was abdominal distension with hyperactive bowel sounds. Rectal examination was normal.

Case 2 History: Sam, aged 15 months, was brought by his parents because of increasing diarrhoea with 6 large offensive stools daily. Four weeks earlier he had been seen by another doctor who considered an infective cause but stool microscopy and culture showed no parasites and no growth of pathogenic organisms. Despite a trial of tinidazole he continued to be unwell, anorexic, miserable and irritable with abdominal bloating and failure to put on weight. He was eventually diagnosed as coeliac disease.

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Keywords: diarrhoea; tinidazole; coeliac disease;hyperactive bowel; abdominal distension;  flatulence; abdominal bloating; vomiting Document Type: Research Article DOI: http://dx.doi.org/10.15212/FMCH.2013.0209