Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Persistent Fever And Night Sweats
Question: My husband a 71 yr old retired MD has had fevers of unknown origin X 3, over the past 7 weeks. The 1st 2 episodes were while we were on a Balkan cruise 7 weeks ago. The ship MD gave him some IV fluids ( his fever was 104.5 & he had rigors) Levoquin, steroids and I believe Tylenol. The next day he was ready to go sightsee but 48 hours later his symptoms returned. The ship MD gave him Z-pak then. We are from California and he loves to garden. ? Lymes?
So...my husband said we need to go home so we came home and he consulted with an ID Specialist but because he was on so many drugs, they advised him to wait to run tests & he was feeling somewhat better, but still had night sweats.
I forgot to mention that 14 days before we left home to fly to Scandinavia, he developed a golf ball sized abscess above his thyroid and another in his let axillae. Cx revealed heavy growth of MRSA so he was treated with Bactrim
6 days ago we were in the ER and he had blood cxs done because his fever was 103 and he had chills. I believe they are negative because they have not reported the results to us. He saw a pulmonologist to look at the CT scan of his lungs and he feels XXXXXXX did have some infection/inflammation due to some small nodules. He also had an echo to see if he could have endocarditis. If that report is negative...I think we should see an ID specialist...right???
So...my husband said we need to go home so we came home and he consulted with an ID Specialist but because he was on so many drugs, they advised him to wait to run tests & he was feeling somewhat better, but still had night sweats.
I forgot to mention that 14 days before we left home to fly to Scandinavia, he developed a golf ball sized abscess above his thyroid and another in his let axillae. Cx revealed heavy growth of MRSA so he was treated with Bactrim
6 days ago we were in the ER and he had blood cxs done because his fever was 103 and he had chills. I believe they are negative because they have not reported the results to us. He saw a pulmonologist to look at the CT scan of his lungs and he feels XXXXXXX did have some infection/inflammation due to some small nodules. He also had an echo to see if he could have endocarditis. If that report is negative...I think we should see an ID specialist...right???
Brief Answer:
Disseminated MRSA infection
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
Basically he has Methicillin-resistant Staphylococcus aureus (MRSA) infection which caused cervical abscess above thyroid gland and abscess in left axillae giving rise to high grade intermittent fever with chills.However he had been only partially treated (oral antibiotics) and it has caused now small nodules (again likely to be localized abscess ) in the lung.The primary source of MRSA might be cardiac valve (infective endocarditis).Has he got any pre-existing valvular heart disease (say Aortic stenosis or prosthetic heart valve )? What are the co-morbidities (they are common at his age-group) he is having like Diabetes(DM type 2) or any chronic renal disease? Please let me know.A course of parenteral antibiotic of newer generation will cure him of disseminated MRSA infection.Steroid was uncalled for.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Disseminated MRSA infection
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
Basically he has Methicillin-resistant Staphylococcus aureus (MRSA) infection which caused cervical abscess above thyroid gland and abscess in left axillae giving rise to high grade intermittent fever with chills.However he had been only partially treated (oral antibiotics) and it has caused now small nodules (again likely to be localized abscess ) in the lung.The primary source of MRSA might be cardiac valve (infective endocarditis).Has he got any pre-existing valvular heart disease (say Aortic stenosis or prosthetic heart valve )? What are the co-morbidities (they are common at his age-group) he is having like Diabetes(DM type 2) or any chronic renal disease? Please let me know.A course of parenteral antibiotic of newer generation will cure him of disseminated MRSA infection.Steroid was uncalled for.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Thank you for getting back to me! I appreciate your quick response.
As far as we know he has no co-morbidities...No AODM or renal disease.
He is very healthy.
The MD on board the ship gave him steroids to
'package him up" to send him home.
XXXX
As far as we know he has no co-morbidities...No AODM or renal disease.
He is very healthy.
The MD on board the ship gave him steroids to
'package him up" to send him home.
XXXX
Brief Answer:
MRSA
Detailed Answer:
In absence of known co-morbidities including Adult-Onset Diabetes Mellitus (AODM),immuno-senescence is possibly predisposing to Methicillin-resistant Staphylococcus aureus (MRSA) infection.
Tedizolid, a second generation oxazolidinone ( available as both oral and parenteral preparations) is administered once a day and effective against MRSA.
Ceftaroline , a fifth-generation cephalosporin with bactericidal
activity against MRSA is approved for use in lung infections and for skin & soft tissue infections but is given IV only.
ID specialist should be the correct person to deal with MRSA.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
MRSA
Detailed Answer:
In absence of known co-morbidities including Adult-Onset Diabetes Mellitus (AODM),immuno-senescence is possibly predisposing to Methicillin-resistant Staphylococcus aureus (MRSA) infection.
Tedizolid, a second generation oxazolidinone ( available as both oral and parenteral preparations) is administered once a day and effective against MRSA.
Ceftaroline , a fifth-generation cephalosporin with bactericidal
activity against MRSA is approved for use in lung infections and for skin & soft tissue infections but is given IV only.
ID specialist should be the correct person to deal with MRSA.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
