Andrew Fenves, MD; David Windus, MD
To the Editor: A recent article by Moskowitz and colleagues (1) that dealt with uncertainty, risks, and tradeoffs in clinical decision making was very interesting. The patient who was selected for presentation was particularly fascinating. A 63-year-old man had preleukemia and was transfusion-dependent and received 44 units of packed erythrocytes over a 6-month period. Deferoxamine therapy for iron overload state was started. One month later, the patient developed classic rhinocerebral mucormycosis infection, which was treated with amphotericin B. At the time of this infection, the patient had not yet had chemotherapy.
A review of the literature shows two similar patients
Fenves A, Windus D. Uncertainty in Clinical Decisions. Ann Intern Med. ;109:347–348. doi: 10.7326/0003-4819-109-4-347_3
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Published: Ann Intern Med. 1988;109(4):347-348.
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