Thursday, January 14, 2010

Case Presentation

Problem list - hematuria, elevated creatinine, elevated AST, hydronephrosis, huge kidneys, hydroureter, thickened bladder wall, high fevers, urinary retention, subconjunctival hemorrhages, weakness, and thrombocytopenia - thoughts? Sepsis secondary to a renal abscess and TB are 2 of ours, but the presentation doesn't really match up well. We are still trying to figure it out and treat as best we can. We may be dealing with both, but we will probably never know. Unfortunatley, the fevers continue despite antibiotics and tb tx, so we aren't winning yet. Surgery may be an option, but we don't enough evidence of it being an infection to have Jim open him up yet. So we keep looking.