Case detective

The farmer who can’t stop sweating

A 38-year-old farmer is carried in by his brothers an hour after spraying the cotton fields. He is vomiting, drowsy and short of breath.

The fever that keeps coming back

A 32-year-old woman has had evening fevers for three weeks, with drenching night sweats and aching in her lower back and knees.

Chest pain and a falling pressure

A 61-year-old diabetic smoker has had crushing central chest pain for an hour. He is grey and sweaty.

The boy with cola-coloured urine

A 7-year-old boy has had puffy eyes for three days, and this morning his urine was dark brown.

One-sided pain and a late period

A 26-year-old woman has sudden pain low on the left side of her abdomen. She feels faint. Her last period was seven weeks ago.

Thirsty, breathless and drowsy

A 19-year-old student has been vomiting for two days, with abdominal pain. Today she is drowsy and breathing fast and deep.

The student with a rash that will not blanch

A 19-year-old engineering student is brought in by his flatmates. He had a headache and fever since the morning; this evening he is confused and there are dark spots on his legs.

The worst headache of her life

A 44-year-old teacher felt a headache explode at the back of her head while lifting a water jug four hours ago. She vomited twice and cannot bear the light.

Fever, fast heart, and a shaking woman

A 34-year-old woman is agitated and vomiting. Her family say she has been losing weight for months and ran out of her tablets two weeks ago. Yesterday she developed a chest infection.

The tanned man who keeps collapsing

A 41-year-old man has been tired for months and has fainted twice this week. Today he has abdominal pain and vomiting, and he looks deeply suntanned for someone who works indoors.

Day four after the hip, and suddenly breathless

A 67-year-old woman, four days after a hip replacement, becomes suddenly breathless while being helped to the chair. She has sharp right-sided chest pain on breathing in.

Tearing pain between the shoulder blades

A 58-year-old man with long-standing untreated hypertension has sudden severe pain in his chest that tore through to his back. He is pale and frightened.

The motorbike rider who cannot get enough air

A 24-year-old man came off a motorbike twenty minutes ago. He is restless, fighting for breath, and will not lie flat.

Shaking chills and yellow eyes

A 63-year-old woman has had right upper abdominal pain for two days with rigors. This morning her family noticed her eyes were yellow and she has become drowsy.

The toddler who draws his knees up and screams

An 11-month-old boy has episodes of inconsolable screaming every twenty minutes, drawing his knees to his chest. Between them he is quiet and pale. He vomited three times today.

The boy who woke at dawn with pain in his groin

A 14-year-old boy woke at 5 a.m. with sudden severe left scrotal pain and vomited twice. It is now 9 a.m. He walks bent forward and will not let anyone near.

Back pain, and he cannot feel the toilet seat

A 46-year-old driver has had low back pain for three weeks. Since yesterday both legs feel weak, and this morning he could not tell when he was passing urine.

A whole family with headache and nausea

A father and his two children arrive on a cold night with headache, nausea and dizziness. The father is confused. They all felt worse indoors and better outside.

Empty blister packs by the bed

A 22-year-old woman is brought in drowsy by her sister, two hours after an argument. Two empty blister packs of her mother’s tablets were on the floor.

Bruises, confusion and dark urine

A 37-year-old woman has had bruising and fatigue for a week. Today she is confused and her urine is dark. She has had no diarrhoea.

Back pain in a man who is always thirsty

A 68-year-old man has had worsening mid-back pain for three months, now waking him at night. He is tired, constipated and drinking constantly.

Pins and needles climbing up from the feet

A 29-year-old man noticed tingling in his feet five days ago. The weakness has climbed to his thighs and today he cannot stand. He had diarrhoea three weeks ago.

Thirty-four weeks, and pain under the ribs

A 31-year-old woman at 34 weeks in her first pregnancy has pain under her right ribs, nausea and a headache since last night. Her midwife sent her in with a high blood pressure.

The coarse tremor that got worse with the flu

A 52-year-old woman with bipolar disorder has been vomiting with a fever for three days. Today she is unsteady, slurring her words and shaking coarsely.