F.U.O.-need any and all possible suggestions

  1. A friend's father has been battling lymphoma for about 2 years. In Oct 2001 he got stem cells and within 3 weeks of transplant was discharged b/c his counts were fantastic. He was doing well, other than general fatigue that goes with recovery, until 9 days ago when he developed a fever. He was admitted to the hospital and is now on a vent and receiving abx to treat something they haven't dx'd yet. They've done bld cx, spinal taps, bld work, xrays. Friend reports they can't do MRI b/c they would have to remove all metal - I'm not quite sure what metal he's talking about. Should be able to do MRI on vented pt's,right? Can't even do CT b/c pt in so much discomfort/pain when he is moved slightest bit. How is a fungal infxn detected? Is it with MRI/CT? He's been in the hospital x 9 days and fever has been ranging from 99-105. CSF cx should be back tonight. Apparently every specialty has been consulted, Onco, Resp, ID, Neuro, Card, Heme. Other than possible fungal infxn or brain ca, does anyone have any insight?????

    I realize the info is limited. My friend is asking if I know any oncologists or other specialists I could run this past or if I know any specialists that wouldn't mind talking with him. I told him my resources at work are limited but that I would post this and see what my colleagues had to offer.

    My friend had Wilms about 30 yrs ago and to watch his father go thru tx was extremely difficult. Now he is absolutely beside himself.

    If anyone can share any tid bits of info or any experience with a similar senario as to other possibilities it would be GREATLY appreciated.
    Thank you very much!!!!!!!!!!!!!
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  2. 5 Comments

  3. by   ChemoRN
    Bless you for trying to help your friend.

    I work in a BMT/stem cell unit, so I've had plenty of experience with what you're describing.

    Usually, a fungal infection isn't likely unless the patient is still immunocompromised. You didn't say if he got his own cells or if he had a donor for his transplant. If he had a donor, then he is probably on some sort of immunosuppressant (Cyclosporin, Prograf, etc). If not, then he is likely only mildly immune suppressed secondary to the transplant process. it takes about 6 months for an auto to recover completely in most cases. Your friends dad is right on the cusp of that. Either way, a fungal infection is a possibility.

    They can see fungal infections on MRI/CT scans most of the time. If they are in the lungs (most common site), they can frequently be seen on a chest xray. They can also do a bronchoscopy or biopsy.

    Hopefully, if fungus is a true concern, they are treating him for it whether they've proven it or not.


    Hope this helps. Keep us updated.
  4. by   KeniRN
    Thank you very much, ChemoRN. I believe he was auto. He's being tx'd w/abx, I'm hoping with fungal infxn being assumed. I (and my friend) really appreciate you taking time to reply

    (I was on a peds onco floor for about 10 months after I graduated. I really enjoyed working there -just couldn't handle the rotating shifts )
  5. by   KeniRN
    Just an update.
    I just received a call from my friend and his father passed away this afternoon. He asked me to again thank you for the information. (I forwarded your posting).

    I like this web site more and more every day- actually, its the people. The friendship, concerns and generosity are present in (most of) the postings I read. Its very heartwarming.
    Thank you.
  6. by   ChemoRN
    KeniRN:

    I haven't been on the board in a while, and just saw your post.

    I am so sorry to hear about your friend's dad. I hope everyone is doing well.

    You are a good friend.
  7. by   KeniRN
    Thank you
    The family is doing well.

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