I've been hospitalized five times since the end of January. 2016 for recurrent Sepsis. The offending bacteria include E. Choli, Enterococcus, and others that live happily in the bowel. Admissions have ranged from 4 to 9 days. After the 4th admission, doctors said they didn't know what the underlying problem was, and suggested I might have better luck at Mayo Clinic or elsewhere.
After two visits to Mayo in MN, where nothing was found, I was admitted the 5th time back home. There were no significant tests done that hadn't been conducted previously, so after treatment with Vancomycin and other antibiotics, I was sent home with a script for Levaquin & Flagyl. Levaquin is a powerful drug, but side-effects were slightly similar to Sepsis symptoms - chills and malaise.
Prior to my first admission, the onset of full-blown symptoms (fever, uncontrollable, shaking chills, rapid pulse, etc.) followed 3-4 days of feeling increasingly ill and sleeping a lot. That precursor has reduced significantly. The last onset of full-blown symptoms occurred 10 minutes after I noticed feeling slightly chilled.
Not long after the last admission in July, an Infectious Diseases doctor started me on a preventive program using three different antibiotics - the 1st (Amoxicillin) for 30 days, the 2nd for 30 days, the 3rd for 30 days, then repeat the cycle. That will hopefully prevent the antibiotics from becoming ineffective while keeping the Sepsis from gaining a foothold. I've also been told to carry Levaquin with me when traveling, and at the first sign of symptoms, start taking it and get a blood draw to confirm or rule out Sepsis/Bacteremia. Additionally, I have a standing order to have blood cultures drawn if I'm feeling symptomatic.
At times, it feels like the Sepsis and daily antibiotics are at war. I'm sometimes easily chilled, lack energy and sleep a lot. I also have blood drawn semi-monthly to evaluate my status. Doctors have said that continued Sepsis outbreaks will eventually result in resistance to antibiotics, leading to Septic shock and death. They've also began talking in terms of 'when' I'm next admitted, not 'if'.
Doctors suspect a miniscule break in the mucosa of my bowel allowing bacteria into the blood stream, but apparently the technology to find it isn't available. How do you examine the inside of 30 feet of small intestine? A colonoscopy found nothing, as did a white-cell-tag scan.
Final notes: 1) I've been on an immunosuppressive (Remicade) for 3 yrs for Rheumatoid Arthritis, which keeps it under control. Other meds aren't being considered as they're also immunosuppressives, and RA severity has gradually increased; 2) hospitalizations began in late January due to a plugged common bile duct. However, night sweats and minor chills were occurring 6 months earlier; 3: An MRCP at Mayo was unremarkable; 4) latest labs show significant increases: CRP: 2.84; ALP: 205; SGOT: 93; SGPT: 83. Other components are normal/near-normal. ALP has historically been slightly elevated.
My doctors and I are open to suggestions.