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Suffering from high fever and low potassium levels - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: General Health
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General & Family Physician
Practicing since : 2005
Answered : 2407 Questions
User :   my step mother went to doctor with high fever and flu like symptoms. Blood tests showed her white blood cells were 1.1, her blood pressure was low and low potassium. She's been in hospital for four weeks and doctors are stumped. Theyve done bone marrow biopsies and have ruled out lukemia and tb. Any idea? Shes gotton pnuemonia since being in hospital and has had two blood transfusions.
Doctor :   Hi
User :   hi
Doctor :   Ok.
Doctor :   I have gone through your query.
Doctor :   How is the complete blood picture ?
Doctor :   platelets ?, etc. ?
User :   Hmmm, Let me call my dad and double check
Doctor :   Ok.
User :   He doesn't know..... he said she had two blood transfusions because her hemoglobin was down
User :   last blood transfusion was last week
Doctor :   Ok.
Doctor :   If you have alow platelet count associated you can suspect , Dengue, Gunya or other viral fevers ?
User :   She lives in Canada
User :   however, she went to Mexico earlier in the year
Doctor :   Did she travel anytime recently to asia or africa
Especially if there is any parasite it can be malaria or filaria ?
User :   Mexico is the only place.
Doctor :   Ok, Mexico , yes can be a cause
Doctor :   Lets look into it.
Doctor :   Is the fever there since more than 3 weeks?
User :   They did have a vaccine last year for various things as they went to Dominican last year. Her fever was at least three weeks and now since shes been in hosptial it is up and down
Doctor :   Ok.
Doctor :   Does he have any stiffness in the neck ?
User :   no
Doctor :   It could be encephaltis or meningitis ?
Doctor :   Ok.
Doctor :   Variations in FUO, as found in the literature, reflect the populations and periods studied. In children, infections are the most common cause of FUO, whereas neoplasms and connective-tissue disorders are more common in elderly persons. FUOs that persist for more than one year are less likely to be caused by infections and neoplasms and much more likely to be due to granulomatous diseases (the most common cause in these cases).
Doctor :   Diagnostic advances continuously modify the spectrum of FUO-causing diseases; for example, serologic tests have reduced the importance of HIV and numerous rheumatic diseases (eg, systemic lupus erythematosus [SLE], juvenile rheumatoid arthritis [JRA], rheumatoid arthritis [RA]) as causes of FUO. Modern imaging techniques (eg, ultrasonography, CT scanning, MRI) enable early detection of abscesses and solid tumors that were once difficult
Doctor :   I would advise her to get tets for folowing : Doctor :   1. Polymyalgia rheumatica
User :   She had CT scan
Doctor :   2. RA - Rheumatoid arthritis
Doctor :   Ok.
3. temporal arteritis
Doctor :   4. Still's disease
Doctor :   5.Systemic lupus erythematosus
User :   Not in any pain, not nausious, oxygen level is good, just heavy feeling
Doctor :   oK.
User :   fast heart rate 125 - 140
Doctor :   Could you please let me know if she has been tested for these that i have advised
Doctor :   Ok.
User :   she hasnt been tested for any of the five that you mentioned.
Doctor :   How about any uterine fibroids , etc ?
User :   I don't think they tested for that. They mentioned that she had nodes in her lungs
Doctor :   Ok.Thta it is big finding .
Doctor :   Could you elaborate on that ?
Doctor :   As nodes in the lungs suggest anything from a simple infection to malignancy.
Doctor :   Sorry to say that, have they found any tumor markers ?
User :   They said there were nodes in her lungs and they were planning to go in through her neck to access them as they werent surface nodes but are in her lungs. They haven't down this yet
Doctor :   I can help you better , if you can spare more time
Doctor :   i would advise for a FNAC
Doctor :   Test
Doctor :   for nodes
Doctor :   to help find out what is underneath
User :   So basically it could be lung cancer? Why is it taking doctors so long to diagnose? Why don't they test for this right away instead of doing two bone marrow tests/
Doctor :   I advised for a FNAC of the nodes
User :   i will mention the FNAC to my dad to tell the doctors.
Doctor :   Yes, they can directly go for this test and it would be much easier to diagnose
User :   Makes me think its not lung cancer though as four doctors consulted each other and they told my dad they are stumped.
Doctor :   Ok.
Doctor :   I would suggest the 5 probabilities that I have told you
Doctor :   which are very common in geriatric age group.
User :   Ha. It could be....Im just saying that I don't know why they didn't test for it right away. Thank you so much for your help. I will get ahold of my dad.
Doctor :   Please do not worry, and hope it gets diagnosed soon.
Doctor :   Let them know of mexican travel too/
User :   Thank you. Have a great night.
Doctor :   thank you for ocnsulting me
Doctor :   Take care , bye for now, you too
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