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Endocarditis or not?
My girlfriend is 38 years old and 9 weeks post fulkerson osteotomy surgery. Just over a week ago she woke one morning with numb lips on her mouth, over the next day or so this spread to numbness in the left side of her face going to halfway along the top of her head.
1st visit to the doctor suggested possible Bells Palsy. A few days later she remained concerned and saw another doctor who didn' think it was Bells Palsy. When he called the hospital for advice they asked him to check for nail splinters, which he did and her nails did not show any.
At some point in this period she awoke one night ran to the toilet and vomited but did not feel unwell or have anystomach pains or diarrhea.
A few day later she is now very tired, still has the numb face and remains worried so she sees another doctor. He tests her facial nerves, receives advice from the hospital and she is admitted for investigations to look for possible stroke or space occupying lesion.
On admission, blood test shows high levels of white blood cells indicating an infection. ECG is normal and she is given IV antibiotics.
When visiting her I asked why did the 2nd doctor look at her nails and she said she didn't know but she now had some small splinters on three nails in her hands. I went home googled it, read about endocarditis and panicked. She showed the nail splinters to the hospital doctor who reassured her that she did not have endocarditis.
CT scan showed no abnormality so she was discharged and asked to come back two days later for an MRI scan which took place 2 days ago. Yesterday she was called back for another (2nd) more detailed scan of her head and we are now waiting to hear back from them.
Last night she complained of feeling cold despite the room being over 20c, she slept very well, woke at 8am but has now gone back to sleep.
From what I have read sudden appearance of nail splinters is not common and can be a good indicator for endocarditis? Added to that her identified infection markers and facial numbness we are extremely worried she is being misdiagnosed or perhaps not being treated as fast as required?
1st visit to the doctor suggested possible Bells Palsy. A few days later she remained concerned and saw another doctor who didn' think it was Bells Palsy. When he called the hospital for advice they asked him to check for nail splinters, which he did and her nails did not show any.
At some point in this period she awoke one night ran to the toilet and vomited but did not feel unwell or have anystomach pains or diarrhea.
A few day later she is now very tired, still has the numb face and remains worried so she sees another doctor. He tests her facial nerves, receives advice from the hospital and she is admitted for investigations to look for possible stroke or space occupying lesion.
On admission, blood test shows high levels of white blood cells indicating an infection. ECG is normal and she is given IV antibiotics.
When visiting her I asked why did the 2nd doctor look at her nails and she said she didn't know but she now had some small splinters on three nails in her hands. I went home googled it, read about endocarditis and panicked. She showed the nail splinters to the hospital doctor who reassured her that she did not have endocarditis.
CT scan showed no abnormality so she was discharged and asked to come back two days later for an MRI scan which took place 2 days ago. Yesterday she was called back for another (2nd) more detailed scan of her head and we are now waiting to hear back from them.
Last night she complained of feeling cold despite the room being over 20c, she slept very well, woke at 8am but has now gone back to sleep.
From what I have read sudden appearance of nail splinters is not common and can be a good indicator for endocarditis? Added to that her identified infection markers and facial numbness we are extremely worried she is being misdiagnosed or perhaps not being treated as fast as required?
After three MRIs my girlfriend was discharged and sent home with antibiotics. 3 weeks later she started vomiting, felt dizzy and had vision problems as well as loss of coordination of her left arm.
She was admitted again and 6 days later has been discharged with a diagnosis of stroke caused by arterial dissection.
She was admitted again and 6 days later has been discharged with a diagnosis of stroke caused by arterial dissection.
Thanks for the reply.
2nd MRi showed white mass between left ear and base of skull / brain?
Going for 3rd MRI tomorrow.
2nd MRi showed white mass between left ear and base of skull / brain?
Going for 3rd MRI tomorrow.
While I know that rare cases of endocarditis may present with a bell palsy, yet such an happening is seen in case of IV drug users in the form of a Gram-ve endocarditis. Fever,tachycardia, and murmur would be cardinal presentations.
It is most unlikely we are dealing with an endocarditis here.
It is most unlikely we are dealing with an endocarditis here.
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