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Dr. Andrew Rynne

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Can uncleared actinomycetes cause vomiting?

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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 1999 Questions

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Posted on Wed, 10 Oct 2018 in Digestion and Bowels
Question: I had a Vertical Gastric Sleeve surgery in 2016. I had complications,including having to have a pleural effusion d/t a large hematoma irritating my diaphragm, lesions on my liver and lungs, but scans showed that "wait and see." 3cm hiatal hernia. It was discovered that I developed actinomycosis infection in my GI tract during one of my complication stays in the hospital. I saw an infectious disease doc and was tx w/Pcn for 6 weeks and then he said I was ok, but I was never retested. The past 3 months, I have been vomiting 6-8 times a day. No wt loss, no fever. I went to the ER and was admitted for a potential MI, had a stress test, everything tested ok. EGD showed Barretts, some erythemia. Catscan of lungs d/t elevated D dimer, lung lesions showed no growth, no evidence of PE. LE Doppler showed no evidence of DVT. I am still having sx, but no one can figure out what could be wrong. I am wondering if perhaps actinomyces never cleared up all the way-sx are consistent. I haven't had CRP tested yet. Current sx are chest pain, rapid HR(110-129 at times) , low bp (is always normal when i go to MD, but at home is often 70/55 on calibrated machine), vomiting 6-8 times a day(tried many different combinations of food and eating strategies-working with dietician), fatigue, brain fog, low libido, muscle aches, right flank aches, combo diarrhea/constipation. Labs came back fine. Can provide copy if you want to see them. Current meds are Cymbalta, Omeprazole, multivitamin. Have f/ups with Cardiologist and Pulmonologist. PCP is perplexed. Saw GI and he said he did not notice anything GI related. Will f/up with infection doc, but am looking for any answers or clues. I am tired of vomiting and feeling horrible. I just got a TSH, free T3 T4 lab drawn 2/9. No results posted yet.
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Answered by Dr. Ramesh Kumar 1 hour later
Brief Answer:

Few more tests required

Detailed Answer:

Hello,

Actinomycetes is a gram positive bacteria and to know if you still have this infection or not is very easy get a culture and sensitivity test done.

If the sensitivity test is negative then there is no residual infection.

In most of the cases, post-antibiotic therapy culture and sensitivity test are done to follow up.

Now, let's move to heart rate. Whenever blood pressure is low heart rate would be high this is the initial reflex action of our body to maintain optimum cardiac output.

However, most of your symptoms are suggestive of a long-term chronic infection. Therefore few test to rule out infection should be done.

They are:

stool routine and microscopy
stool culture and sensitivity
Urine routine and microscopy
Urine culture and sensitivity
Blood routine and microscopy
Blood culture and sensitivity
A swab culture should also be done.

Your endoscopy suggests Barrett oesophagus which could be a cause of constant nausea and vomiting.

Omeprazole only covers the acid production part in the oesophagus. However, to control reflux and vomiting domperidone or any Prokinetic drug should be given to you.

I would suggest you take 4 mg of Zofran four times a day with antioxidants and a multivitamin and follow up with reports I

Hope I have answered your query.

Take care

Regards,
Dr Ramesh Kumar, Gastroenterologist
Above answer was peer-reviewed by : Dr. Prasad
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