unexplained lower abdomen infection, increase Prednisone?

[AliD23]

I’ve had a sore tender lower abdomen, temperature, shivers since Thursday teatime, which resulted in a trip to A&E (England). Admitted due to high CRP (267 instead of around 20), and high white cell count (20 instead of 10). Day 2 and CRP is now 277 but white cell count down to 15.

So far they have found an ovarian cyst which can be dealt with as an outpatient and doesn’t seem to,be the cause of the infection. I am being kept in due to the unexplained original symptoms, and on antibiotics via a Cannula (Saturday evening, and 3 doses so far today) I’m still feeling awful and nauseous. Negative Covid.

I am currently on 2mg Pred a day and wondered if I should suggest increasing my dose to the ward staff/consultant, or just crack on and do it (brought my own in, as apparently it’s a specialist med and they’d have to order some in, which surprised me!)

Your thoughts would be appreciated, many thanks

[DorsetLady PMRGCAuk volunteer]

Maybe suggest the sick day rules and see what a reaction you get, stating that you are concerned that current situation may cause a flare. They might be more inclined to raise Pred if they see this -

medicinehealth.leeds.ac.uk/...

Hope you soon feel better 🌸

[piglette]

I should talk to the consultant or whoever is looking after you and see what they say. My CRP went up to 414 in hospital, no one ever seemed to know why!

[PMRpro Ambassador in reply to piglette]

If it was when you hip was done - muscle tissue damage ...

[PMRpro Ambassador]

If you are unwell enough to require abx and stay in bed - that would qualify for Sick Day Rules, even at such a low dose which some might suggest shows your adrenal function is fine (I wouldn't though!)

[AliD23 in reply to PMRpro]

Thanks for all comments, just an update that the ward Pharmacist nodded wisely when I mentioned sick day rules and agreed to 10mg for 4 days. I was expecting a bit of a battle but it didn’t happen!

[DorsetLady PMRGCAuk volunteer in reply to AliD23]

Good.. glad we suggested it, and sensible pharmacist.

Again, hope you soon feel better…

[Greensleeves]

I would absolutely ask for an increase in steroids.

From experience, horrendous nausea stopped almost instantly after being put on IV steroids. Your infection markers are coming down but this infection, wherever it is , could be too much for your adrenals.

My Mum had sepsis several times and the source never determined, could be this or that ! Have they checked urology?

I’d show them the link from DL , you should have the consultants back in today .

Feel better soon . x

[2013mayo]

I too had sudden severe abdo pain plus projectile vomiting which was every 15 minutes that went on for 14hours, I eventually went to a/e, I ended up with bowel obstruction and was in hospital for a week and then a few weeks later had severe abdo pain, high crp and high white cell count, kept in for another week on iv antibiotics . It turns out it was diverticulitis which I’d never had before. Hope you feel better soon

[darkred in reply to 2013mayo]

I just returned home after being hospitalized for diverticulitis with abscesses. My condition had not progressed to what you have gone through. So sorry for what you went through. This is my first diagnosis of diverticulitis. I read that prednisone can predispose to the condition, as we can more easily get an infection. I'm now on amoxicillin/clav plus metronidazole . The latter is to prevent a colon infection called c. difficile. I'm not happy with needing these meds but have no choice. I guess I should feel lucky to have been diagnosed early.

[2013mayo in reply to darkred]

diverticulitis is a horrible disease, I hate those antibiotics they put you on, the metronidazole is really awful, makes me feel so ill, I had to have 2 more treatments of these drugs when I got back home as I refused to go back to hospital . It all seems to have calmed down at the moment but I don’t allow myself to get constipated, if I don’t go to the loo one day I take a laxative the next day, I never want to get bowel obstruction again. I did have bowel obstruction many years ago just after I had my appendix out, I’d forgotten all about it until this time round. I don’t think you get much help regarding diverticulitis, it just seems they give you the antibiotics when it’s very bad.

[darkred in reply to 2013mayo]

Thank you for the helpful hints. Now it's time for me to take my probiotic. Pils. pills, pills. I just hope they do the job. Then, of course, there's also the mandate to take these meds with food. Pills, food, pills, food, etc. And, of course, the probiotic can't be taken in close proximity to antibiotics. Mental gymnastics to do everything right. I hope all my pills (including prednisone 8 mg), "play well together."

Again, I shouldn't complain, as you had bigger diverticular challenges than I've had.