Prejudice causes bone cancer to be misdiagnosed as pneumonia

Mr. Lin, who is in his 60s, has usually been in good health. However, 20 days ago, he was too exhausted from attending a family funeral. He felt weak all over and couldn't eat. Later, he developed a low fever and cough. He took antibiotics at home for many days but they had no effect at all.

Lao Lin thought he had pneumonia and rushed to the hospital for a checkup. The results of the physical examination showed that his temperature was 37.6 degrees Celsius, he was thin, and his superficial lymph nodes were not large. A routine chest X-ray showed a small shadow under the right lung. Hemoglobin was 90g/L, erythrocyte sedimentation rate was 70mm/hour, and creatinine was 167umol/L.

Based on the results of the physical examination and Lao Lin's description, the doctor judged that it was pneumonia, and the treatment was mainly anti-inflammatory, and Lao Lin was given fluids and electrolytes. However, he did not pay much attention to mild anemia, increased erythrocyte sedimentation rate and slightly elevated creatinine, thinking that they were all caused by poor appetite and pneumonia. He also did not pay attention to the back pain that the patient had described recently, and still thought it was caused by pneumonia or fatigue at home.

After more than ten days of treatment, Lao Lin's condition did not improve and his back pain worsened. After careful examination, it was found that the patient had percussion pain in the thoracic vertebrae 10-12. Thoracic spine X-rays were taken immediately, and the results showed that the thoracic vertebrae 11 and 12 showed osteolytic lesions and the globulin level increased significantly. He was finally diagnosed with multiple myeloma.

When there was a history of fatigue, fever, fatigue, cough, and a small shadow on the chest X-ray, the patient still focused on the changes in the lungs and attributed other manifestations to "pneumonia". Mild anemia and a slight increase in creatinine were not taken seriously, which was an important reason why Lao Lin was misdiagnosed.