Doctor's Miss a Diagnosis of Leukemia in Young Boy; Patient Dies Within Three Weeks

Case Overview

This case involves a young boy who originally presented to the hospital with complaints of abdominal pain and fever. The patient was never given a proper workup and was discharged home that same day. He was brought back to the hospital a week later with a high fever, intractable diarrhea, and seizure-like activity. The patient was transferred to a tertiary care center where they finally diagnosed him with end-stage leukemia. The boy died several weeks later without ever receiving a full medical workup or disease intervention plan.

Questions to the Hematology expert and their responses

What basic tests should have been ordered to rule out malignant disease?

At a minimum, I would consider a complete blood count and urine studies to assess for infection or other inflammatory disorders. Serum chemistry would help define the degree of dehydration the patient might be suffering from as well as identify any metabolic derangement.

About the expert

This extremely qualified, board-certified hematology/oncologist has been appointed to several major administrative positions at among the top ten medical institutions in the country. He also has a wealth of grant-funded research experience and publications in his field, and is a member of several national hematology societies. Furthermore, he is also involved with research at a major cancer center.