My wife is 37 and has been hospitalized since 9/7/2011, she has Cystic Fibrosis and is diabetic, she drove herself in for antibiotics and ended up with a small bowel obstruction, renal failure from Colistin IV (which her kidneys recovered from) they was released on 10/30/2011. During that time she became clinically malnurised and ended up back in the hospital on 11/1/11. She was they transferred to a transitional care unit to help get stronger to come home and they did not feed her and over medicated her on oxycodone and oxycontin. She was then transferred again back to the hospital where she ended up with candida glabrata and candida albicans in her blood. Since 12/6/11 the candida has not cultured in her blood.
She als cultured psuedomonis, stenotropomonis and asprigilis in her lungs. She has been on IV Cipro, IV Tobramicin, Micafungin, IV Voreconozol, IV Vancomicin, IV Bactrim and oral Vancomicin. She has never cultured for C-Diff but the oral Vanco seems to help anyway. In the last 2 weeks her WBC has come down but only to around 25,000 (from a high of 35,000), the doctors were thinking there was an abscess in the liver but after numerous CT scans and Ultra Sounds (going back as far as mid November) they all come back as fatty liver. She is currently on CCRT dialysis since her kidneys have not recovered as of yet. They are not sure if there is another infection other then the lungs or if the WBC is completely due to the lungs. Her BUN is around 8 (when on CCRT) and her creatinine is 0.2, here AlkPhos is around 900 (has ranged from 500-1500), her Bili is around 9 (ranged from 6-12).
Since she is on a vent right now, due to ending up in ICU we cannot ask her many questions. My question is does anyone have any ideas where else to look, she has had issue with arthritis in the past and was scheduled to see a RA before she was admitted. She is alert, she is not running a fever and her stats are good (HR 95-110 (was 130-140), BP 98/43 (63) when not on dialysis 110 range, O2 sat. 97% on 40%, resp rate 25-30) She is currently on TPN to help with nutrition, she is getting stronger but the WBC still bothers everyone.
I tried to condense the story a little but if there is more information needed, please let me know. I have all of the lab results and records if there is anything specific. I appreciate any help you may be able to give me. Thank you all for your time in advance.