update #3: seeing the light of the tunnel

this is the continuation of the report on hiking and illness near las vegas bbs.wenxuecity.com/health/456561.html

after transferred to regular room, dw was giving vancomycin by iv.  after 3 doses, she still had fever of 101 deg of f thus having to take ibuprofen every 6 hours; skin condition was continuing to spread though at a slower pace.  the hospital consulted an external id specialist (infecious decease doctor) who came in last night.  he looked at the leg, and immediately pointed out it's not "litis", it had to do with outdoor causes such as insect bites or snake attacks inspite unnoticed.  

he ordered to stop further using vancomycin instead iv doxycycline.  amazingly, since the first dose of it at midnight last night, her fever has not returned; and her skin condition seems to be improving... we were convinced the doctor was the guy...

later...

所有跟帖： 

• there are a lot of unknowns this is one of them :) -internuts- ♂ (0 bytes) () 07/09/2014 postreply 15:57:53

• good point. i asked the nurse last night for the culture but st -internuts- ♂ (209 bytes) () 07/09/2014 postreply 17:47:15

• 謝謝分享。咱跟著學習。 -欲千北- ♂ (0 bytes) () 07/09/2014 postreply 15:46:06

• no thanks. i am taking this as a case study :) -internuts- ♂ (0 bytes) () 07/09/2014 postreply 16:24:44

• 仍然是皮膚感染，更換了抗菌素，萬古黴素變成了強力黴素，抗菌敏感性增強了。效果明顯了。。。 -禦用文人- ♀ (0 bytes) () 07/09/2014 postreply 15:58:19

• yes, doxy is a broader spectrum one, like a shotgun vs handgun -internuts- ♂ (0 bytes) () 07/09/2014 postreply 16:15:24

• 祝福！選用抗生素是一門學問，感染病專科醫生這方麵還是很厲害的。 -viewfinder- ♀ (0 bytes) () 07/09/2014 postreply 16:10:05

• agreed. specialist has the edge on its particular area -internuts- ♂ (0 bytes) () 07/09/2014 postreply 16:22:13

• 我也覺得細菌培養怎麽還沒有結果有點奇怪，不過體溫下來了，說明抗生素有效。 -薛成- ♂ (0 bytes) () 07/09/2014 postreply 16:18:05

• i'll ask a copy of all blood/urine/xray as well as culture repor -internuts- ♂ (0 bytes) () 07/09/2014 postreply 16:39:33

• 還惦記著你太太呢，這回對症下藥了，祝她盡快地好起來。等你下一次的update。 -goingplace- ♀ (0 bytes) () 07/09/2014 postreply 16:26:06

• thank you... will do... -internuts- ♂ (0 bytes) () 07/09/2014 postreply 16:40:55

• Thanks for bringing us the update. All the best to your wife's r -這年頭誰怕誰- ♀ (0 bytes) () 07/09/2014 postreply 17:35:10

• thanks to above two of you!! -internuts- ♂ (0 bytes) () 07/09/2014 postreply 17:40:42

• 祝福！謝謝分享！蟲子嘴髒，不一定能培養出東西來。用抗菌譜廣的make sense。 -誌在千裏- ♀ (0 bytes) () 07/09/2014 postreply 17:06:15

• 不可能知道是啥蟲子，更不知道蟲子嘴裏有啥，毒素，細菌，酶。。。臨床上改善就好。上天保佑您太太！等她恢複了告訴我們她當時穿的是什麽 -誌在千裏- ♀ (245 bytes) () 07/09/2014 postreply 17:15:52

• Exactly that was how the id doc said, so he chose a wider spectr -internuts- ♂ (0 bytes) () 07/09/2014 postreply 17:39:46

• she wore walking shoes and open end trousers. about 1 inch above -internuts- ♂ (273 bytes) () 07/09/2014 postreply 17:57:58

• 有道理。就像被動物咬了一樣。 -薛成- ♂ (0 bytes) () 07/09/2014 postreply 18:43:02

• 蟲咬和身體的反應本身就可引起發熱和其他全身性反應，不一定需要細菌。當然細菌現在肯定有，而且剛剛被消滅了很多。 -誌在千裏- ♀ (3425 bytes) () 07/09/2014 postreply 17:49:26

• this is a good explanation. it looks like fitting my wife's sym -internuts- ♂ (0 bytes) () 07/09/2014 postreply 18:01:45

• 非常感謝你在百忙之中抽空貼出後續和反饋，漲姿勢啦！ -惡俗老狼- ♂ (0 bytes) () 07/09/2014 postreply 18:12:20

• 平時在健壇收益頗深，現在出了點事作為案例跟大家分享，應該的。謝老狼！ -internuts- ♂ (0 bytes) () 07/09/2014 postreply 18:49:36

• 以前沒經驗。有的真是蠻厲害的。吃一塹長一智了。 -internuts- ♂ (0 bytes) () 07/09/2014 postreply 18:57:36

• 複雜的問題必定有個簡單方法可以解決，有一樣尋常食物就可以解這毒 -醫者意也- ♂ (51 bytes) () 07/09/2014 postreply 19:36:15

• 算了，還是不說的好，否則壇子裏的人以後不斷的拿出來敲打幾句就沒意思了 -醫者意也- ♂ (0 bytes) () 07/09/2014 postreply 20:44:59

• 我願意向您學習，QQ 給我好嗎？ -禦用文人- ♀ (0 bytes) () 07/09/2014 postreply 22:09:09

• 排隊在禦醫之後 -隨意- ♀ (0 bytes) () 07/09/2014 postreply 23:30:53

• 已發QQH， -醫者意也- ♂ (0 bytes) () 07/10/2014 postreply 07:06:05

• 收到，謝謝！ -隨意- ♀ (0 bytes) () 07/10/2014 postreply 07:27:14

• 已發QQH， -醫者意也- ♂ (0 bytes) () 07/10/2014 postreply 07:04:34

• 這招有人已經使過了，老用就沒人信了，應該換個噘頭升級了 -指揮家- ♂ (229 bytes) () 07/10/2014 postreply 05:55:27

• 有些蟲子咬人時還inject了一點麻藥進皮膚。讓您根本不知道被咬。 不知道那看來的，但肯定不是我的原創。 -誌在千裏- ♀ (0 bytes) () 07/09/2014 postreply 19:07:00

• 再次謝謝您在百忙中寫的貼！祝福您太太早日康複！ -誌在千裏- ♀ (0 bytes) () 07/09/2014 postreply 19:08:56

• Possible RMSF -霧裏看花123- ♂ (0 bytes) () 07/09/2014 postreply 19:19:21

• 有可能，ID 醫師肯定考慮到這一點了。 打電話給CDC也應該和這些事情有關。可惜要事後才能靠血清學知道。 -誌在千裏- ♀ (31 bytes) () 07/09/2014 postreply 19:50:17

• 祝福她早日康複.ID醫生的介入很好. -閩姑- ♀ (0 bytes) () 07/09/2014 postreply 19:20:37

• Rocky Mountain Spotted Fever (RMSF) -誌在千裏- ♀ (2326 bytes) () 07/09/2014 postreply 19:53:43

• you all are a group of the most caring people i have ever met in -internuts- ♂ (0 bytes) () 07/09/2014 postreply 20:37:11

• oops just saw a typo on my post -internuts- ♂ (130 bytes) () 07/09/2014 postreply 22:26:02