A horse or a zebra?
Many medical students will be familiar with the concept of the “zebra” of diagnoses. Yet at some point in our careers we might come face to face with a large, hoofed, black and white striped disease. At what point should we stop believing rare diseases are impossible to contract and start performing those weird and wonderful tests that we would normally never consider?
Six weeks after returning from my elective in Malawi I developed flu like symptoms: with a cough, diarrhoea, and a fever I went to see my GP. I suggested that, after having swum in the waters of Lake Malawi, I could have contracted schistosomiasis and now have acute Katayama fever.
He calmly informed me that I was the third medical student he had seen that morning who thought they had contracted a disease while on elective. Despite this, he dutifully performed a full examination, humoured my delusions