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- Apr 6, 2013
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Guy I did a permanent on is three weeks out.
He said in the last two days he is having weakness fatigue, headaches, vomiting, neck stiffness, the shakes etc.
He does not have a fever in the office today.
The sites are good, although there is some tenderness around the battery site. The smallest bit of redness pretty typical post op around the sites but no fluctuance or fluid or anything. Neuro exam non-focal. I did not do a proper Kernig's and Brudzinski's in office as I just wasnt thinking meningitis initially, but then got worried thinking about the neck pain/headaches.
I am sending him for a stat CT thoracic and lumbar with contrast. They are pending for later today.
WBC is up from 10.8 preop to 11.5 with neutrophils up from 8.4 to 9.2. ESR and CRP are normal.
He is not that reliable generally, has been a drinker at times, and is being weaned from opioids from someone else. No big changes recently but I wonder if some of it is subtle withdrawal type symptoms? Or just a flu?
What do you think? Seems aggressive just take it out at this point...LP? Send to ER? Call a spine surgeon to try and get him in STAT?
Have you ever seen a deeper type infection this early even though the sites looked good?
Thanks for your help in advance.
He said in the last two days he is having weakness fatigue, headaches, vomiting, neck stiffness, the shakes etc.
He does not have a fever in the office today.
The sites are good, although there is some tenderness around the battery site. The smallest bit of redness pretty typical post op around the sites but no fluctuance or fluid or anything. Neuro exam non-focal. I did not do a proper Kernig's and Brudzinski's in office as I just wasnt thinking meningitis initially, but then got worried thinking about the neck pain/headaches.
I am sending him for a stat CT thoracic and lumbar with contrast. They are pending for later today.
WBC is up from 10.8 preop to 11.5 with neutrophils up from 8.4 to 9.2. ESR and CRP are normal.
He is not that reliable generally, has been a drinker at times, and is being weaned from opioids from someone else. No big changes recently but I wonder if some of it is subtle withdrawal type symptoms? Or just a flu?
What do you think? Seems aggressive just take it out at this point...LP? Send to ER? Call a spine surgeon to try and get him in STAT?
Have you ever seen a deeper type infection this early even though the sites looked good?
Thanks for your help in advance.
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