Crossing diagnostic borders: Herpes encephalitis complicated by cultural and language barriers

John Muench, Alexandra Verdieck, Alfonso Lopez-Vasquez, Melinda Newell

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: The patient who complains of vague mental status changes requires extra vigilance in that the underlying condition might itself affect the patient's ability to communicate well and relate a medical history. The differential diagnosis of delirium is broad, ranging from the benign to the potentially fatal. The diagnostic uncertainty inherent in primary care is compounded when language and cultural differences interfere with physician-patient communication. Methods: We undertook a MEDLINE-assisted review of the medical literature concerning herpes simplex encephalitis. Additionally, we performed an Internet search of several government Web sites to find current legal and federal guidelines concerning the use of medical interpreters. Results and Conclusions: We recount the case of a young Eastern European immigrant who complained initially of vague mental status changes and was found to have herpes simplex encephalitis. Diagnosis could have been made sooner had the physician been familiar with the patient's baseline mental status or had cultural and language barriers not stood between the physician and the patient and his mother. Herpes simplex encephalitis is a rare, but specific, cause of delirium for which prompt diagnosis and treatment with intravenous acyclovir can prevent death or serious sequelae.

Original languageEnglish (US)
Pages (from-to)46-50
Number of pages5
JournalJournal of the American Board of Family Practice
Volume14
Issue number1
StatePublished - Jan 2001

Fingerprint

Communication Barriers
Herpes Simplex Encephalitis
Emigration and Immigration
Delirium
Physicians
Aptitude
Acyclovir
Mentally Ill Persons
MEDLINE
Internet
Uncertainty
Primary Health Care
Differential Diagnosis
Language
Communication
Mothers
Guidelines

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Crossing diagnostic borders : Herpes encephalitis complicated by cultural and language barriers. / Muench, John; Verdieck, Alexandra; Lopez-Vasquez, Alfonso; Newell, Melinda.

In: Journal of the American Board of Family Practice, Vol. 14, No. 1, 01.2001, p. 46-50.

Research output: Contribution to journalArticle

Muench, John ; Verdieck, Alexandra ; Lopez-Vasquez, Alfonso ; Newell, Melinda. / Crossing diagnostic borders : Herpes encephalitis complicated by cultural and language barriers. In: Journal of the American Board of Family Practice. 2001 ; Vol. 14, No. 1. pp. 46-50.
@article{bc7ee4a49b5241fc9fddded01ab3e391,
title = "Crossing diagnostic borders: Herpes encephalitis complicated by cultural and language barriers",
abstract = "Background: The patient who complains of vague mental status changes requires extra vigilance in that the underlying condition might itself affect the patient's ability to communicate well and relate a medical history. The differential diagnosis of delirium is broad, ranging from the benign to the potentially fatal. The diagnostic uncertainty inherent in primary care is compounded when language and cultural differences interfere with physician-patient communication. Methods: We undertook a MEDLINE-assisted review of the medical literature concerning herpes simplex encephalitis. Additionally, we performed an Internet search of several government Web sites to find current legal and federal guidelines concerning the use of medical interpreters. Results and Conclusions: We recount the case of a young Eastern European immigrant who complained initially of vague mental status changes and was found to have herpes simplex encephalitis. Diagnosis could have been made sooner had the physician been familiar with the patient's baseline mental status or had cultural and language barriers not stood between the physician and the patient and his mother. Herpes simplex encephalitis is a rare, but specific, cause of delirium for which prompt diagnosis and treatment with intravenous acyclovir can prevent death or serious sequelae.",
author = "John Muench and Alexandra Verdieck and Alfonso Lopez-Vasquez and Melinda Newell",
year = "2001",
month = "1",
language = "English (US)",
volume = "14",
pages = "46--50",
journal = "Journal of the American Board of Family Medicine",
issn = "1557-2625",
publisher = "American Board of Family Medicine",
number = "1",

}

TY - JOUR

T1 - Crossing diagnostic borders

T2 - Herpes encephalitis complicated by cultural and language barriers

AU - Muench, John

AU - Verdieck, Alexandra

AU - Lopez-Vasquez, Alfonso

AU - Newell, Melinda

PY - 2001/1

Y1 - 2001/1

N2 - Background: The patient who complains of vague mental status changes requires extra vigilance in that the underlying condition might itself affect the patient's ability to communicate well and relate a medical history. The differential diagnosis of delirium is broad, ranging from the benign to the potentially fatal. The diagnostic uncertainty inherent in primary care is compounded when language and cultural differences interfere with physician-patient communication. Methods: We undertook a MEDLINE-assisted review of the medical literature concerning herpes simplex encephalitis. Additionally, we performed an Internet search of several government Web sites to find current legal and federal guidelines concerning the use of medical interpreters. Results and Conclusions: We recount the case of a young Eastern European immigrant who complained initially of vague mental status changes and was found to have herpes simplex encephalitis. Diagnosis could have been made sooner had the physician been familiar with the patient's baseline mental status or had cultural and language barriers not stood between the physician and the patient and his mother. Herpes simplex encephalitis is a rare, but specific, cause of delirium for which prompt diagnosis and treatment with intravenous acyclovir can prevent death or serious sequelae.

AB - Background: The patient who complains of vague mental status changes requires extra vigilance in that the underlying condition might itself affect the patient's ability to communicate well and relate a medical history. The differential diagnosis of delirium is broad, ranging from the benign to the potentially fatal. The diagnostic uncertainty inherent in primary care is compounded when language and cultural differences interfere with physician-patient communication. Methods: We undertook a MEDLINE-assisted review of the medical literature concerning herpes simplex encephalitis. Additionally, we performed an Internet search of several government Web sites to find current legal and federal guidelines concerning the use of medical interpreters. Results and Conclusions: We recount the case of a young Eastern European immigrant who complained initially of vague mental status changes and was found to have herpes simplex encephalitis. Diagnosis could have been made sooner had the physician been familiar with the patient's baseline mental status or had cultural and language barriers not stood between the physician and the patient and his mother. Herpes simplex encephalitis is a rare, but specific, cause of delirium for which prompt diagnosis and treatment with intravenous acyclovir can prevent death or serious sequelae.

UR - http://www.scopus.com/inward/record.url?scp=0035235972&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035235972&partnerID=8YFLogxK

M3 - Article

C2 - 11206692

AN - SCOPUS:0035235972

VL - 14

SP - 46

EP - 50

JO - Journal of the American Board of Family Medicine

JF - Journal of the American Board of Family Medicine

SN - 1557-2625

IS - 1

ER -