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Interstitial Lung disease, high fever, low BP, chills, low WBC count, lung damage. Treatment ?

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Internal Medicine Specialist
Practicing since : 1998
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This is for my mother, she is 63years and weight is about 54kgs.My mother was diagnosed with an ILD(Interstitial Lung Disease) in XXXXXXX 2011 but the doctors did not prescribe any medicines as my mother had no symptoms. Recently we had to admit her to the hospital because of a high fever(103) and low bp, this was 10days back. After this the bp has stabalised but she is having recurring chills and fever. She continues to be in the hospital for this. The hospital has done all the blood/urine tests, blood/urine cultures, x-rays, ct scan, broncoscopy. All her tests came normal except for the WBC count(it is 0000 currently) and the ct scan shows significant right lung damage.She is not having any other symptoms except for the recurring chills and fever. Despite all the tests done the doctors are not able to figure out as to what exactly is wrong so they are not in a position to prescribe any specific medicines. My mother is still in the hospital(in Bangalore). Please help. She used to take meds for high bp for 10years and also has an elevated level of creatinine.
Posted Sat, 14 Apr 2012 in Infections
Answered by Dr. Jasvinder Singh 13 hours later

Thanks for posting your query. I can understand the pain and agony which your mother is going through.

The important causes of fever which need to be looked into are firstly, a lower ILD which increases the chances of a respiratory tract infection like a pneumonia, a total white cell count of 17,000 which occurs in a bacterial infection, the CT scan evidence of a damage to the lung, my first possibility is definitely a bacterial lower respiratory tract infection.

She will need antibiotics to take care of the infection. A fungal infection like aspergillosis/candidiasis and Tuberculosis=A0are other possibilities which need to be ruled out if the fever is not responding to the routine antibiotics. A fungal culture of the bronchoscopic alveolar lavage should be done.

A chills. A urine analysis and culture should always be done, especially in females, as this is an important cause of fever.

It makes sense to do a blood test for malaria (peripheral smear and malaria antigen) as malaria is another important cause of fever with rigors and chills.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.
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