When Boston Mayor Thomas Menino ended his vacation in Italy short this fall and checked into a Boston hospital complaining of a respiratory infection, it led doctors to find and treat a blood clot in his leg, a fracture in his back, an infection around the fracture and type 2 diabetes.
Cold and flu symptoms from respiratory infections can be a hassle, but sometimes that fever and cough can be good for just getting people to the doctor.
"That's why every patient needs a careful evaluation because every once in a while, what the patient thinks is the flu or reports as the flu is not," said Dr. William Schaffner, chairman of preventative medicine at Vanderbilt University in Tennessee. "I would say 99 percent of people who present to the emergency room and doctor's office with symptoms of influenza - that is cough, fever and the like - are certainly going to have influenza."
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Menino, 69, arrived at Brigham and Women's Hospital on Oct. 25, complaining of fatigue and a cough, and doctors described him as "extremely washed out" with some "malaise." In addition to the respiratory infection, doctors found a blood clot that traveled from Menino's leg to his lungs.
Respiratory illnesses, like the one that initially drove Menino to seek medical attention, can often range from mild to severe, Schaffner said.
"He was feeling poorly enough to end what was supposed to be a very pleasant vacation, and when he got here, he was very weak and very washed out," Dr. Dale Adler, Menino's doctor, said during a press conference in mid-November.
Doctors can usually tell whether flu-like symptoms are the result of a respiratory infection or something else soon after the patient is admitted. If not, they can perform a series of tests to find out.
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(The flu can lead to other ailments, the most common of which is pneumonia, or an infection of the lungs, Schaffner said.
About 1.1 million pneumonia patients were hospitalized and discharged in 2009, according to the latest data from the Centers for Disease Control and Prevention. On average, they stayed in the hospital 5.2 days.)
Weeks later, Menino was still in the hospital. Although his illness and clot had been resolved, he was complaining of back pain, which doctors discovered was the result of a compression fracture and an infection around the fracture.
Finally, doctors discovered that Menino had underlying type 2 diabetes, which may have contributed to the infection, Menino's doctor said during a press conference on Monday.
It's not clear how Menino's initial flu-like symptoms tied into his other ailments, but doctors said they are positive about his prognosis. The mayor relocated to a rehabilitation center on Monday.
"It is a run of bad luck," Morris said of Menino. "He will rebound from this."