A male family member age 52 diagnosed with MS approximately 15 years ago. Over the last two years he has not been ambulatory, but has had an adequate quality of life until last November '08. He was admitted emergently and found to have TTP...Platelets were at 19....he eventually improved on Plasmaphoresis and discharged to a skilled nursing unit for continued therapy. He then returned home to the care of his wife with what was a Stage III decubitis ulcer....Five days ago he was re-admitted emergently with a core body temperature of 90 deg f. Blood cultures were all negative as was all other labs...platelets stable at 100. He returned home last evening and his temperature has not gone above 92F since all this began last week. His ulcer is now a stage IV and he is receiving outpatient debridements...and on po antibiotics....What could be causing his low body temperature?
Hypothermia and a severe decubitus ulcer?? My overriding fear would be sepsis - the same thing that killed Christopher Reeves. This would presume that the oral antibiotics are not appropriate for whatever the real infection is. They should be repeating blood cultures regularly for a while. Sometimes they don't catch the bug right off.
If not, failure of temperature regulation is an autonomic problem - small unmyelinated fibers. While autonomic neuropathy does occur in MS it is VERY rare. I'm inclined to believe that all this is not a direct effect of MS, but either unrelated or secondary (like the ulcers).
Has he been seen by both hematology and infectious disease. I find it all very worrisome.
Thank you for your thoughts regarding my concerns Quix. Yes, he is being followed by hematology (because of his TTP) and infectious disease docs. He was on IV Vanco while hospitalized this past week...but since the blood cultures were all negative they sent him home on oral meds that are for the staph infection of his wound (not MRSA thank goodness)....thank you for responding to my question...I appreciate it... Patty
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