As you were first learning about the differential diagnosis process, you were likely
exposed to the maxim, “When you hear hoofbeats, think horses, not zebras.” In other
words, when diagnosing patients’ signs and symptoms, remember that many diagnoses
(horses) are common, and the chance that a patient has a rare diagnosis (a zebra)
is small. This wise phrase is attributed to Theodore Woodward, MD (1914-2005),
1
a respected physician, researcher, and teacher at the University of Maryland who
also was a charter member of the Infectious Diseases Society of America. His work
greatly advanced the science and care of many serious infectious diseases (IDs), including
cholera, typhus, bacterial meningitis, dengue fever, and Rocky Mountain Spotted Fever.
2
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References
- Lesser-spotted zebras: Their care and feeding.Can Fam Physician. 2016 Aug; 62: 620-621
Mackowiak PA. Theodore E. Woodward, 2014-2005. Trans Am Clin Climatol Assoc. 2006; 117: lxviii–lxxi.
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