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Friday, August 1, 2014
Lack of Diagnosis for 72 year old
For 3 months my mother, 72, has been feeling faint and having night sweats. This has escalated in the last month to include severe upper body (torso, arms) pain, so intense it has caused her to faint. The pain worsens at night but does not ever go away without painkillers. She is currently in hospital undergoing tests but doctors have ruled out polymyalgia as she didn`t respond to steroid treatment. I`ve noticed that in the last week she has developed large hemetomas on her arms where they have extracted blood. Thsi didn`t occur until recently. She also has many pinprick sized blood marks on her lower legs. She has lost considerable weight, at least a dress size. Other points to note are that she visited South Africa (Cape Town) for two weeks 4 months ago. She had a cough about a month ago but that has gone away. There was no bloody mucous from the cough. The hospital is conducting tests very slowly and I`m concerned that they think as long as the pain in under control then they have as much time as needed to diagnose. Any advice on what tests to ask for would be appreciated.
On the basis of information given I am unable to give an opinion on this 72 yr old with multiple symptoms without proper examination and knowing the findings on blood tests and imaging (thoracic spine/chest and brain MRI) etc.
It seems she is in good hand being hospitalized and investigated. I am not sure about the cause of upper body pain if she has not responded to steroids, skin rash appears to be a bleeding (hematological) problem or a dermatological! It is unclear if there is a relationship to travel to South Africa and if any disease was acquired there via vectors or personal contact.
Arvind Modawal, MD, MPH, MRCGP
Professor of Family & Community Medicine, Geriatrics and Palliative Care
College of Medicine
University of Cincinnati