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Headache, High BP, low heart rate, low grade fever, elevated WBC. H. pylori positive, has rectal fissure. Any ideas?

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My father-in -law has is in the hospital and no one seems to be able to figure out what is wrong as all test come back negative. It started out that he had headaches bordering on migraines for 2 weeks. He went to the ER and had a BP of 70 over 60. He had low sodium so they treated that. 4 days later my wife (an ICU nurse) who has been keeping track of his BP found his heart rate was at 40 and upon going to the ER it still was only 48. They drew fluid from his spinal and did test and everything was negative. They did an MRI yesterday and it came back normal. His BP and pulse have been low to low normal the entire time he has been in the hospital. Even the neurologist is scratching his head on this one. They are sending him to a infectious disease specialist next since they don't have a clue. Any ideas? So far they have done 4 blood panels, a CAT scan, MRI, Lumbar puncture to no avail. He does have a low grade fever and slightly elevated WBC. H.pylori is positive and he does have a rectal fissure which he has been under treatment for.
Posted Mon, 23 Apr 2012 in Hypertension and Heart Disease
Answered by Dr. Aparna Kohli 13 hours later

Thanks for posting your query.

It is possible that your father-in-law is suffering from sepsis. This refers to an infection of the blood stream. This condition can lead to a low blood pressure, fever and an elevated WBC count.

However, as I believe that more information can help a physician arrive at an accurate diagnosis, I would request you to answer the following questions:
a. How long has he been suffering?
b. Are there any records which document his blood pressure and pulse rate prior to this episode?
c. Has he any other complaints like confusion, dizziness and agitation?
d. Has he developed any rash on any part of his body?

The diagnosis of sepsis is made when blood cultures are positive for a particular organism. Cultures are usually incubated for 24-48 hours and in some cases upto 1 week also.

I would request you to upload all his reports so that I can have a closer look.

Awaiting your response.

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