Hello. A little history about me first. I am 36yrold f, with a hx of lupus dx 2012. Prior to recently being hospitalized for systemic infection d/t a tooth abscess; Ive been on cellcept 1500mg BID, plaquenil 200mg BID and prednisone 40mg daily. Other medications include: Neurotin 600mg bid, aspirin 81mg daily, protonix 40mg daily and lisinopril 20mg daily.

My tooth abscess came on very quickly. I felt thr pain wednesday night, I had gone to the dentist on a thursday morning to be pulled, only to be told that my bp was too high and they gave me antibiotics and told me to come back in a wk. I filled the prescription and started the meds. By friday i was running a fever. I went to my dr that handles my lupus meds with blood work and he told me to stop the cellcept that my wbc (15k at the time the blood work was taken) has been noticing an elevated trend. He was also concerned with how septic i looked and sent me to the er to be evaluated. Which I was admitted. (wbc 23k. Neutrophils 13.49 Neutrophil 59% Lymphocytes 7.78 Lymphocytes 34%)

11 days later I am being discharged. My doctor attempted to get an oral surgeon here to see me and take care of this abscessed tooth so i can finish the iv antibiotics at the hospital. But too no avail. So instead i have to have to be discharged and placed on orals. I have an appt with an oral surgeon now in a few days.

My concern besides being immunocompromised is that through out my stay my wbc dropped the 1st night i was on antibiotics to wbc 10.78k. Neutrophils 6.59 Neutrophil 61.1% Lymphocytes 2.99 Lymphocytes 27.7%.

Then from that point on they checked my counts every other day.
Day 5: wbc 12.66k. Neutrophils 6.50 Neutrophil 51.4% Lymphocytes 5.07 Lymphocytes 40%
Day 7: wbc 16.52k. Neutrophils 11.55 Neutrophil 72.3% Lymphocytes 3.26 Lymphocytes 19.7%
Day 9: wbc 17.98k. The neutrophil and lymphocytes hasnt been completed yet.

I have been placed on several iv Ntibiotics through out the stay azactam, cleocin, and vibramycin as well as diflucan and unasyn when the 1st three was d/c. The tooth infection itself seems to be resolving as the pain is slowly resolving however i feel like it isnt gone that it has just moved into my tissue or something. I am still running low grade temps. I have been wicked nauseated to a point that i feel like am getting sucker punched especially everytime I go to get up and walk to the bathroom. I know that this infection will not get resolved completely until this tooth is surgically removed however i feel like i am leaving here almost the same way as I came in here. Pain, fever, infection.

So my question is could the docs be missing something with the infection? Especially with my wbc continuing there trend upwards or is there something else they should be looking at?

Also forgot to mention i have never had any major problems with htn. But since this tooth abscess my bp has gotten to 180/130. It has come down to normal levels until 5 days ago i began having right quadrant pain and my bp has been back up into the 170/105 while on catpres 0.2 mg tid prn and increased my lisinopril to 40mg daily. They did ct and us of abdomen and it came back fairly unremarkable.

Would appreciate any imput and thank you for you time.