a positive PPD

Another interesting case today -- a 13 year old girl who came in two weeks ago with vague complaints of abdominal pain, persistent fever, lack of appetite, some vaginal discharge, and general malaise. She had no pulmonary complaints, her lung exam was clear as a bell, and she had no history of TB contact, but we placed a Mantoux (ppd) at the same time as doing several other tests. She didn't come back two days later to have the test read, but came today complaining of persistent abdominal pain and fatigue. While doing her exam, I noticed something strange on her arm. Thinking it was a bizarre skin infection (i'm terrible with derm, especially here!), I asked Dr. Bonito to have a look. It is a very, very, very positive PPD!

The doc's hypothesis: some type of pelvic TB?!? Fascinating. We'll find out more in the next few days.