What's your Medical Diagnosis? 63y Female dyspnea, resp. failure

The Isabel tool touts an extensive database of conditions for differential diagnosis support, and we often will test its accuracy with real patient cases from the New England Journal of Medicine.

About the Isabel Diagnosis Challenge

The New England Journal of Medicine (NEJM) publishes interesting presentations of common diseases and unusual cases in the Clinical pathology Conference (CPC) series. These cases are educational and can pose diagnostic challenges even to the expert physicians at the Massachusetts General Hospital.

Using the clinical features of these cases you can evaluate your own diagnostic skills and compare your diagnostic performance to that of the physicians at MGH. If you are registered with Isabel as a client or have a free-trial subscription, you can use the diagnosis reminder system and run through some scenarios to get a list of likely suspects. Clicking on a diagnosis will take you through to various knowledge sources and links available from within Isabel.

Today's Case

Demographic: Female, 63 yrs, Not pregnant, North America
Clinical features:

• respiratory failure
• chest wall mass
• dyspnea on exertion
• thrombocytopenia
• large ecchymoses
• non-productive cough
• decreased oxygen saturation
• alveolar haemorrhage
• pulmonary infiltrates

STOP !

Before you read further, construct your own:

• Complete differential diagnosis
• Final diagnosis

Final Diagnosis of the case according to NEJM:

1. Angiosarcoma of the chest wall associated with a silicone breast implant
2. Kasabach-Merritt syndrome
3. Invasive pulmonary aspergillosis

Was the final diagnosis given by Isabel: Yes:

1. Lung neoplasms in Respiratory
2. Kasabach-Merritt syndrome
3. Invasive pulmonary aspergillosis under Aspergilliosis in Infectious