Also known as: Midline deformity
Kenny has a severe congenital cranial facial deformity (frontonasal encephalocele with midline cleft) that causes significant facial disfigurement. He is scheduled for a reconstructive facial bipartition procedure but experiences multiple complications that delay the surgery throughout the episode.
Also known as: Second-degree infranodal heart block
Kenny experiences unexplained cardiac arrest just before his scheduled surgery, entering v-fib. He requires a pacing wire to keep his heart going. The heart block becomes a central diagnostic mystery throughout the episode.
Also known as: Tick-borne disease
The final diagnosis that explains all of Kenny's symptoms. The characteristic target-shaped rash was hidden in the acanthosis nigricans discoloration around his hairline, making it difficult to detect because no one looked closely enough at someone with his facial deformity.
Also known as: Liver failure
Kenny develops liver failure during his workup, which causes variceal bleeding when a scope is inserted. This becomes a key diagnostic clue, with debate over whether it's caused by intracranial pressure, acetaminophen toxicity, or the underlying infection.
Also known as: Skin discoloration
Darkened skin discoloration associated with Kenny's congenital deformity. Ironically, this condition masks the target rash of Lyme disease, preventing earlier diagnosis because people avoided looking closely at his face.