Doctors Lounge - Chest Answers
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Forum Name: Pneumonia
|jb03530 - Sun Mar 25, 2007 9:43 pm||
59 year old male/ diagnoses small cell lung cancer- right lung/ four inconclusive diagnosis/ 2 needle (ct scan guided) tissue biopsies, 1 plueral effusion biopsy/ 1 bronchial scope biopsy - 1 year in treatment - 3 different chemo treatments/ 1 series of radiation/ little to no change in the mass, no mestatisizing to any other area of the body/ unresolving pneumonia and daily fevers, constant chronic cough, weakness on the right side of the body/ trembling right hand. Many blood cultures for the fevers- all return a negative result, have been given levequin on a regular basis - no positive results, avelox - no positive results, fluconazole - no positive results/ recently hospitalized for 9 days - fever of 103, fungus growth in mouth and throat, open seeping lesions on the back, massive doses of IV fungal and antiobiotic medication/ low red count - white count - 0 -four units of blood and 1 unit of platletts administered at this time. Currently I have a temp of 102, and a bumpy rash has developed subcutaniosly on the palm of my hands. Have had two right lung collapses. At the occurance of the second one a catheter was placed on the right side to allow daily plueral effusion drainage, approx 300 ML daily for 3 weeks. I have had two strokes while hospitalized 1 year ago, pulmonary embolism in the lung and blood clots in the right arm. A filter was placed in the artery above the right lung to prevent additional clots from moving in the lung. I also have afib, controled with digitox. Mother had luekemia, and a staph infection contracted while nursing. I was a smoker for 30 years and also have mild emphysema. I use spriva daily and albuteral inhaler daily. Not on oxygen, oxygen levels have been in the 95 to 98 percentile range. Blood pressure - 102/70. I will be starting another new chemo treatment in two weeks.
|Dr. Chan Lowe - Mon Mar 26, 2007 5:10 pm||
If I understand your post correctly, your WBC count is very low (zero?). In this circumstance, the diagnostic possibilities completely change. One must always consider typical infections; however, at this point the body is immunocompromised, so the opportunistic infections must also be considered.
On top of this, the inflammation from your cancer may also be triggering the fevers.
I would strongly suggest you continue with very close follow up with your oncologist and consider requesting an Infectious Disease specialist consultation.
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