Season 7
Episode 13 - Two Stories
Brief Plot Summary
House is waiting to talk to a school principal when he begins to tell 2 other detained students about his patient, who he was previously talking about in another class. The patient had coughed up a large portion of dead lung tissue. House believes it's sarcoidosis. Foreman calls him to tell him that the treatment isn't working. House realizes that the patient swallowed a pea which went down the wrong pipe and into the lungs. It would be small enough to go into the trachea but too big to be washed out by a bronchial lavage, and it wouldn't show up on a CT. It could cause the patient's COPD and wouldn't respond to steroids or antibiotics. The next step would be to perform exploratory surgery to remove the foreign object.
House is waiting to talk to a school principal when he begins to tell 2 other detained students about his patient, who he was previously talking about in another class. The patient had coughed up a large portion of dead lung tissue. House believes it's sarcoidosis. Foreman calls him to tell him that the treatment isn't working. House realizes that the patient swallowed a pea which went down the wrong pipe and into the lungs. It would be small enough to go into the trachea but too big to be washed out by a bronchial lavage, and it wouldn't show up on a CT. It could cause the patient's COPD and wouldn't respond to steroids or antibiotics. The next step would be to perform exploratory surgery to remove the foreign object.
Episode 14 - Recession Proof
Brief Plot Summary
Burt is admitted for a severe rash from an allergic reaction in a restaurant. He works as an industrial cleaner who works on crime-scene cleanup, septic tank repairs, caustic chemical cleanup, etc. They find chemicals at his office and think it could be boric acid poisoning, but he spikes a sharp fever suggesting a bacterial infection. His condition worsens and his feet lose all circulation turning purple and hypoxic, but they are able to restore circulation before amputation is needed. House starts corticosteroid treatment for serum sickness. He has a psychological break but the steroids help the rash. They think it could be a fungal infection. He then spikes a fever again and loses his hearing.When they try to get an MRI, he starts seizing, goes into a coma, and is put on dialysis because his kidneys have shut down. House notices the rash has come back and realizes Burt has Muckle-Wells Syndrome.
Burt is admitted for a severe rash from an allergic reaction in a restaurant. He works as an industrial cleaner who works on crime-scene cleanup, septic tank repairs, caustic chemical cleanup, etc. They find chemicals at his office and think it could be boric acid poisoning, but he spikes a sharp fever suggesting a bacterial infection. His condition worsens and his feet lose all circulation turning purple and hypoxic, but they are able to restore circulation before amputation is needed. House starts corticosteroid treatment for serum sickness. He has a psychological break but the steroids help the rash. They think it could be a fungal infection. He then spikes a fever again and loses his hearing.When they try to get an MRI, he starts seizing, goes into a coma, and is put on dialysis because his kidneys have shut down. House notices the rash has come back and realizes Burt has Muckle-Wells Syndrome.
Diagnosed Disease: Muckle-Wells Syndrome - Very rare genetic condition under the class of cryopyrin-associated periodic syndromes (CAPS) that is caused by an increased activity in cryopyrin. Symptoms are triggered by stress such as cold, heat, fatigue, or may just arise spontaneously.
SymptomsEpisodic flares ups triggered by stress, rash, fever, joint pain, sensorineural deafness, amyloidosis leading to kidney failure
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CausesMutation in cryopyrin gene leading to excess production. This leads to future symptoms. Episodes can also be triggered.
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TestsGenetic sequencing, treatment to see effectiveness
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Treatment/CureRilonacept is a dimeric IL-1 inhibitor which is used to treat MWS as well as other CAPS disorders.
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Episode 15 - Bombshells
Brief Plot Summary
16 yo male coughs up blood during a basketball game but no bleeds are found in his respiratory system or GI tract. They test for angiodysplasia with a pill camera, which reveals no bleeds. Taub discovers the patient is depressed and then notices red spots in his eyes. He also has blood in his urine. They think it could be antiphospholipid syndrome. Patient then loses all feeling in his right arm. An angiogram shows a clot in his middle cerebral artery and they start treatment for it; however, he is unresponsive and they need to do an embolectomy. The clot mysteriously disappears when they poke it with the probe. He goes into a coma and his liver is now slowly shutting down. House figures out it's a bacterial abscess from his staph infection they treated 3 days ago. This abscess is from PVC pipe shrapnel that bacteria grew on that the patient has been blowing up in his free time.
Side Plot:
Dr. Cuddy wakes up and has blood in her urine. It's found that she has a small mass on her kidney and the biopsy is inconclusive. Further imaging shows masses in her lungs as well, which is what kidney cancer metastasis looks like. They find the tumor was benign and the lung masses were masses of antibodies in an allergic response to antibiotics.
16 yo male coughs up blood during a basketball game but no bleeds are found in his respiratory system or GI tract. They test for angiodysplasia with a pill camera, which reveals no bleeds. Taub discovers the patient is depressed and then notices red spots in his eyes. He also has blood in his urine. They think it could be antiphospholipid syndrome. Patient then loses all feeling in his right arm. An angiogram shows a clot in his middle cerebral artery and they start treatment for it; however, he is unresponsive and they need to do an embolectomy. The clot mysteriously disappears when they poke it with the probe. He goes into a coma and his liver is now slowly shutting down. House figures out it's a bacterial abscess from his staph infection they treated 3 days ago. This abscess is from PVC pipe shrapnel that bacteria grew on that the patient has been blowing up in his free time.
Side Plot:
Dr. Cuddy wakes up and has blood in her urine. It's found that she has a small mass on her kidney and the biopsy is inconclusive. Further imaging shows masses in her lungs as well, which is what kidney cancer metastasis looks like. They find the tumor was benign and the lung masses were masses of antibodies in an allergic response to antibiotics.
Diagnosed Disease: Bacterial Abscess - Pocket of bacteria walled-off by the body. If burst can cause a large release of bacteria into patient system.
SymptomsTypical bacterial infection, fever, chills, pneumonia, along with some kind of abscess where bacteria could reside
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CausesLike in the episode, foreign particles, if left inside the body, can create a perfect growth environment for bacteria that the body will wall-off with fibrous tissue.
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TestsImaging and scanning will help with detection if a physical exam doesn't reveal its location.
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Treatment/CureAntibiotics and rest
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Source Links:
Episode 16 - Out of the Chute
Brief Plot Summary
Lane, a bull rider, is hit and trampled by a bull after completing his rodeo. He has suffered a ruptured diaphragm, cracked sternum, broken nose, and partial hearing loss from the incident. They test for inner ear damage thinking it could have been present prior to the accident, but find none. Lane then presents with jaundice and they see a mass on his liver in x-rays which then disappears during surgery. His airway shuts during another procedure when they notice a horrible smell coming from his feet. Despite the pain that will be caused from the metal in his sternum heating up, they do an MRI on his brain, but it comes out normal. House realizes he could be having mini black-outs, but the infection isn't in his brain, it's in his heart. They need to put his heart under immense pressure until something gives out (House believes the aorta) revealing the site of the infection.
Lane, a bull rider, is hit and trampled by a bull after completing his rodeo. He has suffered a ruptured diaphragm, cracked sternum, broken nose, and partial hearing loss from the incident. They test for inner ear damage thinking it could have been present prior to the accident, but find none. Lane then presents with jaundice and they see a mass on his liver in x-rays which then disappears during surgery. His airway shuts during another procedure when they notice a horrible smell coming from his feet. Despite the pain that will be caused from the metal in his sternum heating up, they do an MRI on his brain, but it comes out normal. House realizes he could be having mini black-outs, but the infection isn't in his brain, it's in his heart. They need to put his heart under immense pressure until something gives out (House believes the aorta) revealing the site of the infection.
Diagnosed Disease: Bartonella Infection - Infection that can be transmitted to humans and animals via cat scratches, lice, and insect bites.
SymptomsFever, swollen lymph nodes, headache, rash, etc.
Complication can include heart valve or vessel infection |
CausesInsect bites that transmit the bacteria.
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TestsBlood serum cultures can confirm the diagnosis, but it is usually made based on history and symptoms.
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Treatment/CureAzithromycin is used to treat the infection if it doesn't clear on its own. There are also other antibiotics that are effective.
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Source Links: CDC
