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Differential Diagnosis in Internal Medicine: From Symptom to Diagnosis Walter Siegenthaler
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Advisably, the diagnosis should be made by a physician with a broad experience of patients with painful conditions and knowledge of family medicine, internal medicine or pain management. BDivision of Internal Medicine, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy .. The diffuse types of Dercum's disease have traits in common with conditions with general pain: Fibromyalgia. Ulm, Centre for Internal Medicine, Ulm, Germany. Pocket Medicine: The Massachusetts General Hospital Handbook of Internal Medicine. Consults were done in the departments of internal medicine, pulmonology and ophtalmology. Many diagnoses have similar symptoms as the symptoms experienced in Dercum's disease. Outpatient diagnostic evaluation, including abdominal ultrasound and endoscopies, revealed no conclusive explanation for the clinical picture and the patient was admitted to our clinic. The symptoms of the patient in this case were usually provoked by physical activity, developed after lunch (at least on the day of admission), and were exacerbated by aspirin; therefore, FDEIA should be included in the differential diagnosis. The diagnosis should only be .. Correspondence: Alexander Kleger, M.D., Ph.D., Department of Internal Medicine I, University Medical Centre Ulm, Centre for Internal Medicine, Albert Einstein Allee 23, 89081 Ulm, Germany. Although isolated nasal involvement of sarcoidosis is rare, otorhinolaryngologists should consider this condition in a differential diagnosis for sinonasal complaints. Cardiac asthma is commonly mistaken for bronchial asthma since both conditions have similar symptoms and timing. Throughout the 12 months after surgery, the patient remained free of symptoms and all nasal endoscopy examinations were normal. However, an accurate diagnosis is imperative because treatments for the two conditions differ, and incorrect treatment can exacerbate cardiac asthma.2 IV furosemide, nitroglycerin, and morphine are used for the acute treatment of cardiac . In the Case Record regarding a patient with flushing and hypotension (March 24 issue),1 the discussants considered several alternatives, including anaphylaxis, before arriving at the correct diagnosis of mastocytosis.