Have you ever heard of this? Post # 173 Test results, she is better!

[booger73]

Mono Test - Negative (not a perfect test, but probably good enough)

Spinal Fluid Culture
Specimen Desc. Cerebroospinal Fluid
Gram. Stain No Organisms Seen (i.e. no bacteria)
Culture Pending
Report Status Pending

2. Opening pressure 16 cm of water in left lateral decubitus position.
Closing pressure is 12 cm. of water. (i.e. not elevated, which is good/normal.. certain organisms/things can increase it and increase pressure in the brain which can cause headaches from increased ICP)

Cerebrospinal Fluid
SP FL Glucose 61 mg/dl (normal - i.e. bacteria stuff not using it up probably)
SP FL Protein 20 mg/dl (would think higher usually if viral, etc, but not necessarily)

Cerebrospinal Fluid Tube 4
Spinal Cell CT
Appearance Clear
WBC 3 / CMM (good!)
SP FL RBC 1 / CMM
Neutrophils 0
Lymphocyte 0
Mono 0
No WBCS seen on smear

Cerebrospinal Fluid Tube 1
Spinal Cell CT
Appearance Clear
WBC 6
SP FL RBC 3
Neutrophils 0
Lymphocyte 100 --> suggests viral or non-bacterial things Mono 0
Other 0

Cerebrospinal Fluid (i.e. bacterial meningitis)
SP FL Strep B AGG Neg
N. Menin GRP A/Y, CSF Neg
N. Men GRP B/E. Coli,C Neg
N. Men GRP C/W, CSF Neg
SP FL Hemo INF GP B Neg
SP FL Strep Pneu Neg

Hemogram
WBC 7.0 (can be low in tick disease, but not always)
RBC L 3.55
HGB L 10.5 (was 11.7 Wed) (probably low due to lab draws)
HCT L 30.0
MCV 84.4
MCH 29.5
MCHC 35.0
RDW 14.9
PLT 175 (a little low normal..)

DIFF
SEG ABS 3.2
LYMPH ABS 3.1
MONO ABS 0.6
EOS ABS 0.1
BASO ABS 0.0
SEG 45.5
LYMPH 44.1 (usually suggests non-bacterial)
MONO 9.2
EOS L 0 .8
BASO 0.4

Sodium 137
Potassium 3.8
Chloride 104
Glucose 83
BUN L 6
Creatinine L 0.6
SGOT H 144
Calcium L 8.7
ALK PHOS H 141
TOTAL PROTEIN 7.0
T. BILI 0.5
ALBUMIN L 3.2
CO2 26
SGPT H 156 ---> this is VERY interesting.. also known as the ALT..

Given that her liver enzymes are elevated (i.e. a transaminitis/hepatitis) this brings in some interesting things to the picture... very often viral issues or certain bugs cause your LFT's to go up (in this case, SGPT and SGOT). Some people brought up some tick diseases (lyme, erlichiosis, RMSF, etc) before and they do that often.. Hepatitis A, B, C all do it of course, but usually they don't cause HA/photophobia.. they can cause fever, but usually people have liver symptoms and jaundice.. the Bilirubin (0.5) being normal says she's not primarily having that.. I would place a bet that it's liver inflammation due to whatever "systemic" thing is going on with her.. throwing a mild hepatitis, HA/fever/photophobia and a little bit of the "lymphocytes" that we're predominantly seeing makes you think more and more viral..

There are of course some weirder diseases (non-viral) that could do the same thing - doxycycline covers a lot of the Tick borne diseases so that's why that was chosen and is a very good choice... Tamiflu probably won't do anything 3 weeks out now, but I don't think it'll exactly "hurt"

A hepatitis panel (acute) needs to be drawn if it hasn't.. should also think about CMV (cytomegalovirus) - certainly a possibility!, EBV (epstein barr) titers.. I know you said no obvious exposures to animals/ticks, but those titers and WNV titers should be sent as I'm sure they've done (i.e. lyme, erlichiosis, rmsf).. i would still put a bet on enterovirus/arbovirus, etc though..

They are treating her as if she has West Nile. Put her on Doxycycline HYC 100 MG Tab and Tamiflu 75 MG Gelcap. (sounds good)

We live in a small town but other than her kitten she hasn't been around any animals (cat scratch fever usually has a bunch of lymph nodes so that should/would have been obvious i think)

Hope she feels better soon and hope some more information comes in...

 

[lucyanna girl]

Thanks for looking at this and explaining it a little better. She feels no better today, in fact we were up the entire night because she started feeling nauseous.

She isn't eating well at all, most food just turns her stomach when she sees it. Last night she got me back up just as I started to dose off because she felt as if she would be sick, said it was like acid reflux. She spent the rest of the night dozing in a big chair. I know she didn't rest much because I stayed up with her.

Today her temp has been over 102 slightly. It is down now thanks to Tylenol. She still feels nauseous. I have some finagrin that you rub on your wrists and she is using a little of that.

Seems to me that whatever she has is evolving a little. Earlier in the week her headaches were very bad but her fever was mostly low grade in the morning and higher at night. Now the headaches are still with her but not as intense while the fever seems to be going up earlier and staying later at night.

Penny

 

[Disney Doll]

The antibitoic could be making her feel nauseated. Make sure she has a little food in her stomach.

We usually start to see the effect of antibiotics 36-72 hours after the 1st dose.

 

[booger73]

doxycycline is very well known for causing 'pill esophagitis' - i.e. problems with the swallowing/irritation (just as if you would have reflux/etc/heartburn) if you take it.. probably causes lots of nausea for some people also..

like DD says, lots of food.. lots of h2o.. do NOT lay down or other things after you take it for about 30 min

althought she shouldn't need it (and it's just 'another drug'), some otc prilosec/omeprazole for heart burn/stomach symptoms might help if it gets too bad

 

[java]

Penny I am so sorry to read all this. It must be so terribly scary for both you and her.

(((penny)))
Here's hoping those test results provide the doctors with the information they need. And that your dd is on the mend soon.

 

[lucyanna girl]

Well, she couldn't think of any food that sounded good except for Olive Garden salad. Fever was down for a while so DH and I took her for some. She ate (just some salad) then went and threw it up. Drove home and threw up again.

I gave her half a fenagin tablet to settle her stomach. She is dozing off now. I'll let her sleep on the sofa a while so I can keep an eye on her then wake her and maybe try a little soup so that she can take her prescribed medication.


Penny

 

[chell]

Goodness, your poor daughter. I'm sorry they still haven't figured it out. I hope they do figure it out soon. When I had bad headaches like that it was because I had too much fluid on my brain, but that isn't her case since there wasn't too much pressure when they did her spinal tap.

Antibiotics will really mess up your stomach. If she can handle it, have her eat some yogurt every day so she doesn't get a yeast infection and so it will help keep her intestines from getting too messed up.

I hope you guys get an answer soon.

 

[Buckalew11]

Penny,
Lots of hugs and prayers for you both. I can't imagine how helpless you, as a mom, are feeling. Knowing you are doing everything you can and they will find out what this is, I hope!
Your poor DD, she's been through so much already. I'm sure she is sick of being sick right now and wants to know what is wrong with herself. God bless her. Tell her we are praying for her and hoping she gets relief soon.
Much love to you both.

 

[CJ's Mommy]

Oh my, I just read your whole thread and want to say how sorry I am and hope everything turns out okay. I really hope you get some answers quickly! I can't imagine feeling like that for 3 weeks! Your poor DD, and you must be worried sick! Your family will be in my thoughts. Sorry I can't offer any advice/help.

 

[Liberty Belle]

Well, she couldn't think of any food that sounded good except for Olive Garden salad. Fever was down for a while so DH and I took her for some. She ate (just some salad) then went and threw it up. Drove home and threw up again.

I gave her half a fenagin tablet to settle her stomach. She is dozing off now. I'll let her sleep on the sofa a while so I can keep an eye on her then wake her and maybe try a little soup so that she can take her prescribed medication.


Penny

You know, it's sounding more and more like when I had CMV and liver inflamation.

I hope the antibiotics help her and she gets well fast.

 

[lucyanna girl]

Thank you all for caring. I am scared and frustrated that I can't seem to help her. She is really tired of feeling bad. She starts her senior year of high school Thursday and has all Honors classes so she needs to be able to concentrate. At this point I honestly don't know how she can go if she isn't a lot better.

Penny

 

[christiane]

So sorry to read about your daughter.

I would ask for a referral to an infectious disease specialist. She should be tested for toxoplasmosis. Headaches, light sensitivity, lethargy, fever & liver changes are all seen with this disease. Often associated with exposure to cats, but usually contracted by eating undercooked meat.

The diagnostics you posted rule out many diseases. Only mild anemia & subtle liver changes are noted.

I hope she is much better soon.
Christiane.

 

[disneymarie]

Did they consider a blocked bile duct, that can cause the fever, the reading in the liver as a infection from a blockage.

DD had this and this threw a mild hepititis. meaning inflamed liver.

I remember my dd having some tenderness to a spot under the rib cage. When it got to the point that she had color changes in sking, and peeing redish finally figured out what is wrong.

What are side effeects of YAZ that all the warnings are.
Anything about liver.
Everything goes through the liver, it is the waste cleaner of the body,. If the YAZ has issues and it is a last resort med, under advisement that all other treatments failed, then it may be the YAZ.

The slow dump from an opiate pain med made the bile duct block in my dd and caused they hep. The test went back to neg, after getting the med out of her system.

It was 7 months on it,...she was removed from one treatment of Oxycotin and placed on a methadone as it was less ex*****ve and did not cause the stomach issues....but it almost shut the liver down.

With the migrains, I especially think YAZ.
I am sending lots of prayers, Your family has its hands full and certainly going through this now is enough to just scream at a higher source.

My hugs to your family and you
di

 

[perdidobay]

For you and your DD. I hope they can find out what it is and cure her soon.

My sister had histoplasmosis when she was a teenager and the symptoms were similar.

 

[Pea-n-Me]

Another thing to consider given her elevated liver enzymes is continued use of tylenol.

http://www.webmd.com/news/20060705/study-tylenol-liver-effect-stronger

I would also question whether this had something to do with the elevated enzymes in the first place if she was taking lots of it during the weeks prior to this testing.

One of those things you might never know for sure, but looking forward, I would be very careful with subsequent dosing. (Actually, I prefer motrin to tylenol anyway for fever and aches.)

I would also - if it were me - stop the birth control pills given these can cause headaches and blood clots (we have seen some extremely serious cases in people her age in the hospital). It's possible the fever could be coincidental, who knows. But you could see how she does off them (and obviously help her find another form of bc. ) BTW, does your DD smoke?

I had an issue myself that was completely perplexing to my own medical team, and after much research on my part (and many months of symptoms, seeing many specialists and having tons of testing), turned out the medication I was on was causing a very rare side effect in me (which I discovered on my own when I went back and researched the original testing that was done for the drug when it was in the trial stage). Within days of my coming off the medication, the symptoms that had plagued me for months were gone. One of my docs said, verbatim, "Good thing you figured it out". LOL

Good luck.

 

[lucyanna girl]

Some of you may remember that three years ago Sarah was critically ill while she and I were in Orlando. Her hemoglobin dropped to 6.1. Emergency surgery was done in the middle of the night because they were so certain she had a gastric bleed. No bleed was found and they gave her four units of blood. She spent a day in ICU and the rest of the week in Sand Lake Hospital. We tried but were never able to find out what happened then. Since then her doctor has always told us not to give her aspirin, Aleve, or Motrin - just Tylenol, and no more than four Tylenol in a twenty-four hour period.

Sarah is like me. My parents always seemed to be taking a pill for something and I went the other way, I don't take one unless it is a dire need. She is the same way. She hasn't taken nearly as much medication as most people who have been sick this long would have.

I just took her temperature and it is 101.7. I hope they get the West Nile test results back soon so we will know if we have a diagnosis or if we need to keep looking.

Penny

 

[lucyanna girl]

West Nile test results back, negative.

Now what???

Her temperature spiked twice last night. Once at 102.9, broke and again a couple of hours later at 103.4. Her heart beat and respiration were very rapid.

I've got a call in to our ER doctor friend to ask if he thinks she needs to be admitted.

Penny

 

[ClarabelleCowFan]

Penny - just wanted to send big hugs to you and Sarah.

I can't imagine how helpless you are feeling right now but hoping they find out what is going on ASAP so the proper treatment can be started.

Sending prayers and pixie dust to you both!

 

[disneymarie]

West Nile test results back, negative.

Now what???

Her temperature spiked twice last night. Once at 102.9, broke and again a couple of hours later at 103.4. Her heart beat and respiration were very rapid.

I've got a call in to our ER doctor friend to ask if he thinks she needs to be admitted.

Penny

My God, with the fevers there has to be infection and they need to find it. Were you able to find a new PCP?

If not I would get her back to an ER. How long can a body handle fevers that high. She must need fluid IV, and IV antibiotics
Also find the source.

I am thinking of you aand praying for you all.
di

 

[Feralpeg]

West Nile test results back, negative.

Now what???

Her temperature spiked twice last night. Once at 102.9, broke and again a couple of hours later at 103.4. Her heart beat and respiration were very rapid.

I've got a call in to our ER doctor friend to ask if he thinks she needs to be admitted.

Penny

Penny, have you had her checked by en endocrinologist? Pituitary problems can cause similar symptoms.

My heart goes out to you. I can imagine how stressed you are over this. I've had a lot of health challenges with my daughter. We've yet to get a definitive diagnosis. Fortunately, my daughter's problems are not as bad as yours. I know how frustrating this can be. I'll keep her in my thoughts and prayers!