A Jaundiced Eye

A CLINICAL PROBLEM-SOLVING article by John Amory from University of Washington, Seattle and colleagues.
A previously healthy 27-year-old man presented to his primary care physician six days after the onset of a nonproductive cough, sore throat, and a feeling of being “run down.” During the preceding week, he had also noted fever and diffuse abdominal pain that was mild to moderate in intensity. Two days before presentation, he noticed dark-colored urine and that his eyes were red and itchy, with a clear, thick discharge.
Three days after the initial clinic visit, the patient began to have nausea and vomiting, jaundice, and worsening cough. He had a temperature of 39°C.
Two days later, the patient returned to his primary care physician with dyspnea, worsening cough, and a pruritic rash on both arms. A chest X ray revealed bilateral pulmonary infiltrates. The patient had scleral icterus with mild conjunctivitis. In addition, shotty anterior cervical lymphadenopathy was noted.
In this case, some atypical features may have increased the difficulty of finding the correct diagnosis of a severe multisystem disorder in a previously healthy host. In making the diagnosis, the discussant places weight on the most important features of the patient's presentation, and is not overly distracted by anomalous findings.

"jaundiced eye"には、「偏見の目を持った見方」という意味があり、この場合、jaundicedは、prejudiced, biased, distortedなどと同義。