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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Abdominal Pain, Had Diverticulitis, WBC Abnormal, Fever, Pressure Sensation In Clavicle. Prescribed Flagyl And Levaquin. Help

I don't have the labs in front of me because the doctor had to use my copies so I will try and give the best answers I could. About two months ago I started having intermittent pain in my lower left abdomen. One day it became constant and more severe so I checked my temp and it was 100.4. I was sure I had diverticulitis again but a CT showed it was not there. My white count was at 19.1 and my neutrophils were in the 84% range and lymphocytes were about 12%. Everything else was good except my platelets were a little high at 440. I was prescribed Flagyl and Levaquin, a 10 day supply of each with instructions to come back if symptoms persisted. 4 days later it was back to the hospital because I was maybe a little worse, but this time my WBC was 14.3 and everything else back in the normal range. They gave me IV of each and extended my regimen to 17 days. 3 weeks later, still a low fever at about 99 when I wake, up to about 100 during the day, and dropping off at night to near or at normal levels. Pain is now in many different places. It had gone from lower left quadrant, to over naval, sometimes lower right quadrant, up to left clavicle where it feels like there is a pressure almost at times. This time white count was 11.1 but the neutrophils and lymphocytes were beginning to raise and lower respectively. I have had two more CBC since then and both times the WBC has been 11.1 and the as of a week ago the neutrophils and lymphocytes are near their original levels. At this point one of the doctors I was seeing, as my Primary was on vacation, is thinking infection still but doesn't want to go to more antibiotics because that would be the "shotgun approach". He seemed convinced that was the case until he did a physical exam. He didn't say much but when laid me on my back and sort of pushed my stomach towards the center of my ribcage he seemed surprised to hear it didn't hurt. I had told him the pain is now all over, rarely is it real bad and it is always at about 2-4 places at once. If I push on it in the abdominal area it actually relieves the pain. He seemed surprised to hear that as well. He sort of changed directions after that and ordered 4 new blood tests, one for EBV, and three others that test for inflammation or clues to an autoimmune disease. Has this become the favorite at this point? I know at one point infection, lymphoma or leukemia, or immune disease were all considerations.

As I type this I am waiting for results that I can take them to my Primary so he can take over the case. I still have a fever, rarely over 100, but everyday. I started having seizures about a year and a half ago, I don't think they are considering that as connected, but my neurologist wants the temperature under control because they can cause seizures. (The cause for the seizures was never determined) Tylenol or Ibuprofen don"t get rid of them, but if I take a lot I can go from 100 to 99.6 or something.

I guess I am kind of wondering if anybody can have a little insight to what they might be thinking. The pains have gone from mostly left side to almost as much right side now. They are sharp, mostly intermittent pains, usually not severe. The doctor said they could just be from my body fighting the infection so hard but it just doesn"t add up to me. They have continually gotten worse regardless of test results. Also, I have been having this pain/pressure feeling mostly everyday under my left ribcage. It is a lot to process, I know. Comments would be appreciated.
Mon, 30 Sep 2013
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General Surgeon 's  Response
Namasthe
Welcome to Healthcare-Magic
Greetings of the day
I would suggest that you get a Colonoscopy done , as CT scan may not pick up the things which are inside the lumen of colon. As your CT report is normal its unlikely to be abdominal lymphoma. Possibility of Tuberculosis has also to be considered depending on your geographic location.
Regards
Take care
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Abdominal Pain, Had Diverticulitis, WBC Abnormal, Fever, Pressure Sensation In Clavicle. Prescribed Flagyl And Levaquin. Help

Namasthe Welcome to Healthcare-Magic Greetings of the day I would suggest that you get a Colonoscopy done , as CT scan may not pick up the things which are inside the lumen of colon. As your CT report is normal its unlikely to be abdominal lymphoma. Possibility of Tuberculosis has also to be considered depending on your geographic location. Regards Take care