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Suggest Treatment For Cold And Flu While On Immunosuppressive Therapy

Posted on Thu, 23 Mar 2017

Question: My wife had a liver and kidney transplant in 2014. She has been doing well but has been in the hospital for a urinary tract ecoli infection just before Thanksgiving. She hates hospitals because it is often hard for us to get discharged even when she is feeling better. Problem is she was bit by an insect on the eyebrow and there are 3 tiny puncture wounds from 7 days ago. The swelling is finally almost gone. 2 days ago a fever set in and went up to 103 and has held for the last 48 hours from 101 to 104.1. She is nauseous. I got an over the counter urine tester and it does not show a urine infection but she is urinating every 90 minutes or so and is unable to take in much water. She did take 2 tyelenol 500 mgs 2 hours ago and they stayed down. I know she should probably go to the ER but she won't go voluntarily unless it is life threatening. Is this a life threatening situation or just a virus that must run its course. She has no other cold or flu like symptoms.

Answered by Dr. Dr. Ivan Romich (1 hour later)

Brief Answer:
The ER visit is mandatory

Detailed Answer:
Hi and welcome.
In every patient who is recieving imunnospuressive therapy, each infection or suspicion of infection should be treated adequately. It is obvious that she receives immunosupressive therapy is she had organ transplantations in history...
Fever is sign of infection and it may be caused by simel flu or urinary infection but also, kidney infection with urosepsis or intrabaddominal abscess may be present as well. So it would be good to do at least basic lab findings to see the degree of inflammatory process. In transplanted people, antibiotic therapy may be requied more often than in other people. Of course this may be just temporary inflammation and probably wont be life threathening but you should not take the risk... WIsh you good health. Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr. Ivan Romich (1 hour later)

Thank you for your answer. The good news is that as a result of being on immunosuppressing drugs (prograf) she does regular lab draws that are then submitted to her hepatolgist and kidney doctor. She did one on Thursday AM so we should be able to call and see if there was any abnormalities present. And going in for a second lab is much less dramatic then a 4 day journey thru ER, ICU and the regular hospital floor. She is diabetic but because she is not eating I don't think that is a factor but I wil check her sugar. Thanks for your advice.

Answered by Dr. Dr. Ivan Romich (7 hours later)

Brief Answer:
You are welcone

Detailed Answer:
You are welcome. You should just be cautious and if her condition deteriorates or fever progresses,you should see doctor. her diabetes may just complicate possible urinary or any other infection so if blood sugar is higher than 10mmol then you should also see doctor.

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Above answer was peer-reviewed by : Dr. Kampana