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Thursday, July 24, 2014
What`s Next, Been Sick for Almost a Year
My daughter is 17 and has been sick for 11 months. Initially, she had chronic sore throats, swollen glands, blisters in her throat, nausea, fatigue, depression and ongoing low grade fever. She has been test seven times for strep and mono and come negative everytime. Her tonsils were removed five months ago. She hemorrhaged, diagnosed with Von Willebrands Disease, but none of her symptoms have gone away. Doctor didn`t do pathology on tonsils so we don`t know those results. She has tested negative for lupus and sed rate is 4. She has lost 1/5 of her weight. Does it make sense to take her to immunologist or infectious disease specialist next?
I think an infectious disease specialist is an excellent idea. She may be having one of the prolonged fever-of-unknown-origin (FUO) syndromes that are best evaluated and treated by a pediatric infectious disease specialist. I would not seek care by an adult infectious disease specialist because they are less familiar with the FUO syndromes common among children. There has certainly been plenty of time for a more common illness to make its presence clear, even if the initial presentation was unusual as in your daughter's case.
I hope you have an answer soon!
Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University