History of infections

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worriedson714
Posts: 49
Joined: Mon May 03, 2021 4:27 pm
Facebook Username: jasonbeck

History of infections

Postby worriedson714 » Tue Jul 13, 2021 8:24 pm

Hello ,
My dad has a history of infections UTI's and sepsis last month and since he has had sepsis his temp has spiked to 102 twice both times we give him tylenol and it goes down and seems to be gone . Because everytime a nurse checks it it has been back to normal doctors are acting like it's just one of those unexplained things . He will be starting chemo soon so this is concerning to me given his history . Has anyone heard of something like this before with rectal cancer maybe causing it ? Should I push the oncologist to look for cause of it ?
My Dad was DX - 3/19 stage 3 rectal cancer
Folfox - 6/ 2019 threw 10/2019
Rad - 4/ 2019 threw 5/2019
12/ 19 - Abdominal Perineal Resection - Cancer left and permanent colostomy
9/21- Removal of prostate and bladder- Permanent Urostomy still cancer left
5/28/21 - Positive Biopsy Mostly necrotic tumor
6/14/21 - Sepsis with obstructive uropathy needed nephrostomy tube
7/19/21 Kidney infection
7/28/21-Started folfiri
8/3/21 - Blood Clots in lungs and leg
10/13/21 Chemo stopped

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beach sunrise
Posts: 1027
Joined: Thu Mar 05, 2020 7:14 pm

Re: History of infections

Postby beach sunrise » Tue Jul 13, 2021 9:34 pm

What does his bloodwork look like; WBC, RBC, platelets ect?
Have they done any bloodwork to maybe see what is going on?
Is not, have them do do a complete CBC is my suggestion.
8/19 RC CEA 82.6 T3N0M0
5FU/rad 6 wk
IVC 75g 1 1/2 wks before surgery. Continue 2x a week
Surg 1/20 -margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24 post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
CEA
7/20 11.1 8.8
8/20 7.8
9/20 8.8, 9, 8.6
10/20 8.1
11/20 8s
12/20 8s-9s
ADAPT++++ chrono
CEA
10/23/22 26.x
12/23/22 22.x
2023
1/5 17.1
1/20 15.9
3/30 14.9
6/12 13.3
8/1 2.1
Nodule RML SUV 1.3 5mm
Rolles 3 of 4 lung nodules cancer
KRAS
Chem-sens test failed Not enough ca cells to test

catstaff
Posts: 177
Joined: Wed Mar 03, 2021 11:37 am

Re: History of infections

Postby catstaff » Wed Jul 14, 2021 8:18 am

My husband had this kind of pattern for some of his UTIs before surgery. Maybe take him in when he has the fever without trying to bring it down? Bloodwork isn't really of much use here other than a blood *culture* for possible bacteremia (bacteria in the blood). There are some blood markers of infection but they're not definitive. Have they done a urine culture? Some bacteria is normal from an ileal conduit, which makes it harder to diagnose a true infection, but some types of bacteria shouldn't be there.
D/H Dx 10/2019 RC age 61
Clinical T4bN2M1a (common iliac and para-aortic lymph nodes)
MSS KRAS G12D
CRT 11/19-1/20 FOLFOX 3/20-7/20
Pelvic exenteration w/LAR 8/20
ypT4bN0Mx G3 0/14 nodes LVI not seen PNI-
CEA 10/19:20, 1/20-11/20:1.6, 4.3, 3.4, 2.7, 2/21:9.0 3/21:18,40 4/21:28,19, 5/21:13.3,8.6
PET 3/21 recurrence in distal nodes, L5 vertebra, pelvis
FOLFIRI+bev 3/21-

worriedson714
Posts: 49
Joined: Mon May 03, 2021 4:27 pm
Facebook Username: jasonbeck

Re: History of infections

Postby worriedson714 » Wed Jul 14, 2021 11:57 am

beach sunrise wrote:What does his bloodwork look like; WBC, RBC, platelets ect?
Have they done any bloodwork to maybe see what is going on?
Is not, have them do do a complete CBC is my suggestion.


Last blood work was done the day after he got out of the hospital oncologist said WBC was a little high his hemoglobin and iron have been low for months at around 7 .
My Dad was DX - 3/19 stage 3 rectal cancer
Folfox - 6/ 2019 threw 10/2019
Rad - 4/ 2019 threw 5/2019
12/ 19 - Abdominal Perineal Resection - Cancer left and permanent colostomy
9/21- Removal of prostate and bladder- Permanent Urostomy still cancer left
5/28/21 - Positive Biopsy Mostly necrotic tumor
6/14/21 - Sepsis with obstructive uropathy needed nephrostomy tube
7/19/21 Kidney infection
7/28/21-Started folfiri
8/3/21 - Blood Clots in lungs and leg
10/13/21 Chemo stopped

worriedson714
Posts: 49
Joined: Mon May 03, 2021 4:27 pm
Facebook Username: jasonbeck

Re: History of infections

Postby worriedson714 » Wed Jul 14, 2021 11:58 am

catstaff wrote:My husband had this kind of pattern for some of his UTIs before surgery. Maybe take him in when he has the fever without trying to bring it down? Bloodwork isn't really of much use here other than a blood *culture* for possible bacteremia (bacteria in the blood). There are some blood markers of infection but they're not definitive. Have they done a urine culture? Some bacteria is normal from an ileal conduit, which makes it harder to diagnose a true infection, but some types of bacteria shouldn't be there.


Problem is my dad doesn't want to go in until he tries to get it down and they can't do a urine culture cause it's always " contaminated " from the illeal condult . Do you know what the blood markers are for infection ?
My Dad was DX - 3/19 stage 3 rectal cancer
Folfox - 6/ 2019 threw 10/2019
Rad - 4/ 2019 threw 5/2019
12/ 19 - Abdominal Perineal Resection - Cancer left and permanent colostomy
9/21- Removal of prostate and bladder- Permanent Urostomy still cancer left
5/28/21 - Positive Biopsy Mostly necrotic tumor
6/14/21 - Sepsis with obstructive uropathy needed nephrostomy tube
7/19/21 Kidney infection
7/28/21-Started folfiri
8/3/21 - Blood Clots in lungs and leg
10/13/21 Chemo stopped

catstaff
Posts: 177
Joined: Wed Mar 03, 2021 11:37 am

Re: History of infections

Postby catstaff » Thu Jul 15, 2021 8:35 am

High WBC, also the ratio of neutrophils to lymphocytes, sometimes disturbances in blood electrolytes. Often inflammatory markers are checked; they are not specific to infection but can be useful if infection is suspected.

If his iron is low have they recommended supplements? He's not on chemo yet, correct? That will drive hemoglobin down further. Was the hemoglobin 7? That's at the low end of "doesn't need a transfusion."
D/H Dx 10/2019 RC age 61
Clinical T4bN2M1a (common iliac and para-aortic lymph nodes)
MSS KRAS G12D
CRT 11/19-1/20 FOLFOX 3/20-7/20
Pelvic exenteration w/LAR 8/20
ypT4bN0Mx G3 0/14 nodes LVI not seen PNI-
CEA 10/19:20, 1/20-11/20:1.6, 4.3, 3.4, 2.7, 2/21:9.0 3/21:18,40 4/21:28,19, 5/21:13.3,8.6
PET 3/21 recurrence in distal nodes, L5 vertebra, pelvis
FOLFIRI+bev 3/21-


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