Evelyn had an okay night last night, although her fevers have returned and she had a “toxic” reaction after her antibiotics were given last night. We are so glad we brought her in when we did! The hospitalists and Infectious Disease doctors strongly feel after having 5 days of very strong antibiotics that the chances of clearing Ev’s line of infection is slim. They are willing to try adding on a second antibiotic as well as “locking” her line with the strongest one (they leave the antibiotic sitting in her line for at least 4 hours, so this will be tricky with her TPN needing to run over 22 hrs in a day). They do not like to wait too long while they are actively sick, since this means we are only losing ground, so if this does not show significant improvement in a reasonable amount of time, they will need to remove the line. The bug that is growing is called coagulase-negative staph, a relatively reasonable bug to treat through in a line infection, but after finding that the bug she is growing is the same bug she was infected with 3 weeks after the onset of her foot pain back in May, this makes us wonder if it is a bone infection, and in that case the two sites of colonies (line and bone) will likely feed each other. The line will most likely have to go. She also has the worry of her fresh vascular stent (from January) being a potential area of growth, since a new sheath of vascular cells is created over top of it that heals in the months after it is placed, thus a perfect breeding ground for bacteria as well. This is less likely, since scans showed it was fine during May’s infection. They performed an Echo on her last night to check this out; they hope to have results sometime this morning. She will also have an aspiration of her knee and ankle sometime today to culture the fluid and test for white blood cells and other markers that would indicate infection.
She was made much more comfortable after receiving IV Tylenol & Toradol (ibuprofen) last night.
Thank you all for your encouraging words, thoughts and prayers. We can surely feel them! Will update as we can.