Sep 5, 2014
Diseases Doctors Often Get Wrong (Part 2.)
You probably know to look out for tick bites and the telltale bullseye rash that can form around them if a person is infected with Lyme disease. But not everyone develops this rash -- and Lyme disease's other symptoms (like fatigue, headaches, joint pain, and flu-like symptoms) can easily be confused for other conditions, says Shapiro.
A blood test can check for Lyme disease antibodies in the blood, but those usually don't show up until a few weeks after infection and the test is notoriously unreliable. It's important to remove the tick immediately and see a doctor right away. Quickly removing a tick can possibly prevent the transfer of dangerous bacteria, and antibiotics for Lyme disease are most effective when given immediately.
The most distinctive sign of lupus -- another chronic inflammatory disease -- is a butterfly-shaped rash across a patient's cheeks, but that's not present in all cases. Lupus can affect the joints, kidneys, brain, skin, and lungs, and can also mimic many different issues.
There is no one way to diagnose lupus, but blood and urine tests, along with a complete physical exam, are usually involved. Treatment also depends on a patient's individual signs and symptoms, and medications and dosages may need to be adjusted as the disease flares and subsides.
Polycystic ovary syndrome
Irregular periods, unexplained weight gain, and difficulty getting pregnant can all be symptoms of polycystic ovary syndrome (PCOS), a hormonal disorder affecting women of reproductive age. Many women with this condition also have enlarged ovaries with numerous small cysts, but not everyone with PCOS has these enlarged ovaries, and not everyone with enlarged ovaries has PCOS.
To be diagnosed with PCOS, a woman must also be experiencing infrequent or prolonged periods or have elevated levels of male hormones, called androgens, in her blood. Androgen excess may cause abnormal hair growth on the face and body, but women of certain ethnic backgrounds (like Northern European and Asian) may not show physical signs.
You might think that an inflamed or burst appendix should be easy to identify, and often, it is: typical appendicitis symptoms include nausea, pain and tenderness around the belly button, and possibly a low-grade fever. But not always.
Some people have an appendix that points backward instead of forward in the body, so the symptoms present in a different location," says Dr. Eugene Shapiro, deputy director of the Investigative Medicine Program at Yale University."And sometimes people do have pain, but then the appendix ruptures and the pain is relieved so they think they're fine."
Many perfectly healthy women deal with menstrual pain and discomfort, so it's not surprising that endometriosis is often misdiagnosed. However, women with endometriosis (in which uterine tissue grows outside the uterus) often report pelvic pain, cramping, and heavy bleeding that's far worse than usual, and that gets worse over time. A pelvic exam can sometimes detect endometrial tissue or cysts that have been caused by it. In other cases, an ultrasound or laparoscopy is required for a definite diagnosis.
In this case, he says, intestinal fluids can seep into the abdominal cavity and cause a potentially life-threatening infection -- but it can take days or even weeks before these symptoms appear.