lo siento.

Hoy, yo escribo noticias un poco mal. Hoy, yo junto Mario en el puesto de salud de Pajoces. Vemos muchas pacientes -- casi viente en solamente dos horas! Sin embargo, yo hace un accidente hoy...o yo creo que eso. Un neNa que tiene 2 aNos viene con su madre. Ella tenia fiebre todo el ayer, y no comia bien por esto tiempo. Yo di acetominofina para el fiebra y yo ellas mando a la casa. Pero -- y su madre no me dijo! -- ella tenia "varicela" desde ses dias! Por supuesto, yo busco durante el examen physico. Yo pienso que ella probabilmente tenga fiebre por que ella tenga varicela tambien. Pero...ahora yo se que el fiebre viene un dia antes de ranchas, y termina sola un dia despues. Por eso, no creo que el fiebre es por que la varicela. Yo busco en los oidos, la garganta, y el abdomen y no hay problemas. Tampoco, no hay sonidos en los pulmones o otras seNas de enfermedades. Pero, sin embargo, es possible que el fiebre es la seNa de un complicacion de varicela, como pneumonitis, o otitis media, o otra cosa. Quizas mi exam clinico todavia no es perfecto para diagnosticar? Por eso el situacion aca no es perfecto -- no hay ningun otros doctores que busquen los pacientes despues de nosotros. OjalA que la neNa no tiene otros enfermedades...pero no estoy seguro. lo siento. :(

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Today, I write some bad news. I joined Mario today in the puesto de salud at Pajoces. We saw a lot of patients -- almost twenty in only two hours! Anyway, I made a mistake today...or at least I think so. A baby girl, 2 years old, came in with her mother. She had a fever all day yesterday, and she wasn't eating well for that time. I gave her acetominophen for the fever and sent her home. But -- and her mom didn't tell me this, of course -- she also had the chicken pox for the last six days! Of course, I saw this during the physical exam. I thought that she probably had a fever because she had chicken pox also. But...now I know that the fever should come one day before the rash, and leaves one day after the rash starts. For that reason, I don't think the fever was only because of the chicken pox. I looked in her ears and throat, and did an abdominal exam, and there were no problems. I also found no abnormal sounds in the lungs or other signs of fever sources. But...nevertheless...it's possible that the fever is a sign of an underlying complication of the chicken pox, like pneumonitis, otitis media, or something else. Perhaps my clinical exam is not yet perfect to make these diagnoses? That's why the situation here isn't too perfect -- there aren't any other "doctors" who look at the patients after us. I hope that the little girl is okay and doesn't have serious other problems...but I can't be sure. I'm sorry. :(