Oct 17, 2019 09:58AM GlobalGal wrote:
A battalion of physicians, including primary care, neurologists, cardiologists, hematologists, and ER doctors, all failed to diagnose my spouse's severe back pain, originally lumbar with excruciating sciatica, then horrendous thoracic pain. They ran every test under the sun.
While hospitalized, an internal medicine PA was on the phone with radiology trying to figure out what additional scans to order when an infectious disease doctor, completely unrelated to this case, happened to walk by, heard the PA on the phone, and commented, "If there are splenic infarcts (my spouse's spleen was enlarged with some microscopic dead spots), then assume infectious disease until proven otherwise."
That off-hand comment, dear reader, saved my spouse's life!
No one had even considered infectious disease because my spouse was not running a temperature and his white blood cells were not elevated. But he did have a replacement biologic heart valve, which are prone to endocarditis (heart infection).
They finally ran blood cultures and did a trans-esophageal ultrasound which showed bacterial vegetation growing on his replacement aortic heart valve, which then showered tiny septic emboli (blood clots with bacteria) to his spleen and left kidney, along with the development of discitis (bacterial inflammation) of both the thoracic and lumbar spine.
He's now on 12 weeks of IV antibiotics.
Apparently, some 10 percent of endocarditis patients do not run a fever.
Untreated endocarditis is always fatal.
Bottom Line: Sometimes severe back pain is due to something else going on in the body.