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Landed on lower back. Noticed swelling, bruise and developed fever. Any suggestion?

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My 31 year old wife was cycling at walking speed and knocked over by a car also traveling at walking speed perpendicularly to her path. She was knocked sideways from the car which hit her bicycle's front wheel and she landed on her lower back, luckily with no impact on her head. This was 48h ago.

She Initially reported local pain from bruised, swelling areas on lower back (muscles right of spine) and sacrum (a localized bruise on left side). She reported a mild stingy feeling in some poses between her lowest 2 ribs on her left side.
24h after accident, she reported increasing but well manageable pain (without painkillers) which she describes as feeling like super-strong muscle-ache. Bruised areas are very sensitive to the touch. Rib area symptom still unchanged.
48h after accident, she developed a mild fever (38.2 C), headache, slightly cold feet, a more widely spread mild body ache (including areas of her pelvis, which she considers normal from her experience with fever) and the above remaining symptoms unimproved. She just saw a physician. She requested an ultrasound exam, but was sent home to wait and see. They took blood samples, but the results won't be available before the next morning.

The fever might well be unrelated, as the season is prone to flus and colds here. However, we are getting a bit worried about the progression of the situation and would appreciate a balanced advice. We are both engineers and can deal with uncertainty.

Best,
XXXXXXX
Posted Thu, 1 Nov 2012 in Medicines and Side Effects
 
 
Answered by Dr. Jasvinder Singh 4 hours later
Hello,
Thanks for posting your query.
Given your wife’s symptoms, it looks like a viral fever but if her pain is persisting and increasing and rib symptoms remain the same, then it is advisable to get any rib fracture ruled out by getting an x-ray, ultrasound abdomen and blood culture (to rule out any infection) done.

Till the time you get these investigations done, I suggest you to apply cold compresses on the bruised area and give her some anti inflammatory pain killers like Ibuprofen or Diclofenac after prescription from your doctor as the pregnancy status needs to be cleared first. Your wife can also follow certain lifestyle measures which can help her with this pain. Give complete rest to the part and avoid doing any strenuous activity which causes any further damage.

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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Follow-up: Landed on lower back. Noticed swelling, bruise and developed fever. Any suggestion? 5 hours later
Thank you for your help Dr. XXXXXXX

she just has started to vomit and have diarrhea and we are up at this time of night (in California). However, the blood analysis came in and I have copied this for you below. Fever has stabilized around 38.5 C .

Let me know if you see any link between the accident and this flu-like condition, or if you think there is concern for XXXXXXX organ injury.

Best,
XXXXXXX


WHITE BLOOD CELL DIFFERENTIAL, MANUAL
Neutrophils %. Manual count 80 ; normal 50 - 70 %
Lymphocytes % manual count 6 ; normal 20 - 50 %
Monos %, man cnt 11 ; normal 1 - 11 %
Eosinophils % manual count 4 ; normal 1 - 5 %
RBC's, morphology NORMAL
Platelets,bld,ql, man ct ADEQUATE

CBC (COMPLETE BLOOD COUNT) WITHOUT DIFFERENTIAL
WBC COUNT 7.5 ; normal 3.5 - 12.5 K/uL
Red blood cells count 4.35 ; normal 3.60 - 5.70 M/uL
Hgb 13.3 ; normal 11.5 - 15.0 g/dL
Hematocrit 39.7 ; normal 34.0 - 46.0 %
MCV 91 ; normal 80 - 100 fL
RDW, RBC 12.8 ; normal 12.0 - 16.5 %
Platelets count 229 ; normal 140 - 400 K/uL
 
 
Answered by Dr. Jasvinder Singh 13 hours later
Hi,

I have gone through the reports.

There's an increase in the neutrophils. Neutrophils are the type of blood cells which tend to get increased when there's a bacterial infection. Hence, will suggest you to consult a physician as she'll likely need a course of antibiotics.

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.
Above answer was peer-reviewed by
 
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