there is no chlamydia virus. There is however, commonly "coinfection", especially in pneumonias where both viruses and bacteria are causing infection. In any case, Im not sure how she got diagnosed with chlamydia pna--chlamydia pneumonia's are not cultured out of sputum often. They are more commonly grown from bronchoscopy (scope into lungs) samples when it is tested for chlaymdia PCR. Also, if she has this pneumonia she should have gotten a course of azithromycin( macrolide) or levaquin (quinolone) If she hasnt then this makes no sense.
As far as the endocarditis/pancarditis? Chlyamydia endocarditis is quite rare--you would suspect many other more common organisms to cause endocarditis first. And she would be treated in hospital. Libman-Sacks endocarditis is an autoimmune cause of endocarditis in Lupus and in a woman is a possibility. Also, "pericarditis" can be seen in lupus as well.
Another syndrome which could make sense is viral myocarditis. These people can get dilated hearts with poor ejection fraction, seemingly out of nowhere except they recently had a after viral infection. This syndrome can affect all aspects of the heart--pericardium, myocardium, endocardium--whereas bacteria usually only cause endocarditis.
As far as the low Tcells, I think its most likely she has some autoimmune problem--or CVID causing her problems. (with limited info at hand) All of these rare findings in a young to middle aged woman ---indicates autoimmune or genetic diseases are at play. She would usually have a past history of infection if CVID (ear infections, pneumonias, sinusitis, etc) is to be considered--although as the name states--it can be variable.
For autoimmune diseases--any combination of aches/pains/rashes---but not necessarily infections-- should be part of the history.
And for the Diflucan--i have no idea. They must have cultured yeast from somewhere--sputum, mouth, urine, blood. (if they cultured it from blood she'd be in the hospital)
(nicedream) said:
Ok finally got a call back from the secretary at the Drs office today. Apparently there is no mycoplasma infection, but a chlamydia infection (not the STD) and 2 other viruses. To which I responded "but chlamydia is a bacterium not a virus, why isnt she being treated with abx?" Secretary: "no it is the viral type of chlamydia" Me: "im pretty sure theres no viral type, chlamydia is a bacterial organism" Her: "Dr. XXXX says its viral" Me: "well that doesnt make sense" Her: "Have you done an IM residency and 3 year AI fellowship and practiced AI for 40 years?" Me: "no" Her: "well Dr. XXXX knows what hes doing"
Ok, so has anyone heard of a Chlamydia virus???? All she's on is diflucan because apparently her normal flora is "out of control" - and painkillers for her chest pain caused by the infections. She "will get a lot worse before she gets better"
