22-Year-Old Male with Septic Pulmonary Embolism and IVC Thrombus: Seeking Insights on Possible Fungal Infection
Greetings, I am a 22-year-old male standing at 6 feet 2 inches and weighing around 80 kilograms. Due to a diminished appetite that accompanies my frequent illnesses, I've dropped a couple of kilograms. I apologize if my thoughts are a bit disorganized; I've been struggling with significant brain fog, making it difficult to maintain coherent conversations lately. My first hospitalization occurred on May 28th, where I spent 11 days battling a fever that exceeded 39 degrees Celsius, often reaching 40 degrees and above. I experienced extreme shaking and a rapid heart rate that climbed into the 200s. During this time, I was diagnosed with a septic pulmonary embolism and IVC thrombus, though these conditions were only identified after I underwent a CT and CTPA scan about a week into my stay. Initially, I was treated for sepsis, and it was truly harrowing to feel so close to death during that undiagnosed week. The antibiotics I received failed to help, and I believe they may have worsened my condition. Despite extensive testing for various rare conditions, including Lemierre’s syndrome, the fundamental cause of my blood clots remains unknown. I’m fortunate to have a retired family doctor who continues to offer support. Given the progression of my symptoms, which included oral thrush, mild fevers, chills, escalating fevers with rigors, skin lesions, pleurisy, along with lingering confusion and skin peeling, he suspects there might be an undiagnosed fungal infection in my bloodstream. However, the medical team caring for me strongly disagrees with this assessment. While I do not wish to overstep and dictate the doctors' actions, I can’t help but feel that a fungal infection is the underlying issue. They argue that any fungi would have been detected in my blood cultures, but my continuous antibiotic treatment could interfere with the identification of fungal infections. From my research, it appears that Fusarium is the only fungus that commonly appears in routine blood cultures. I would like to hear your expert opinion on whether my concerns are misplaced. Although I am currently under the care of respiratory specialists, I feel a fungal infection specialist would be more appropriate. Unfortunately, I struggle to articulate my case effectively, but my concerns weigh heavily on my mind, particularly as I lay in bed each night contemplating my illness. Unfortunately, I was readmitted to the hospital on June 13th for an additional 7-day stay due to persistent high fevers and rigors, but this time, I experienced improvement within two days of antibiotic treatment. I had developed pneumonia and pleurisy again, alongside COVID-19. Thankfully, the antibiotics appeared to work against the bacterial and viral infections. I was discharged on June 20th, yet I began coughing up an alarming mix of fresh and clotted blood, plus mucus, particularly worsening after receiving enoxaparin injections. I believe this detailed account is crucial for understanding my situation. Just ten days post-discharge, I found myself back in the hospital due to low-grade fevers and alarming symptoms resembling heart failure: pink sputum, confusion, breathlessness, and swollen ankles, accompanied by a relentless cough. Though my oxygen levels seem stable, I was disheartened to learn that, despite a month of enoxaparin treatment, my pulmonary embolisms have actually increased in size. The fever returned, peaking at 39.7 degrees with accompanying rigors. Now, I’m back on antibiotics, and the familiarity of this experience feels disheartening. I want to suggest discontinuing the antibiotics in favor of testing for fungal infections multiple times until we can ascertain the true cause of my issues. Based on my history, do you believe this course of action is prudent? The doctors remain perplexed about the root cause of my situation, and I am currently waiting for results from brain scans. However, it strikes me as a significant oversight that, aside from routine blood cultures, I have not been tested for fungal infections—only viral and bacterial pathogens. I would greatly appreciate your insights on this matter. If you agree that the failure to test for fungi is a serious error, how does the absence of fungal treatment affect my health risks? Thank you for your time and expertise.
Answers (1)
7/3/2025, 4:01:56 AM
OpenHealth AI
Main Points: Your situation is complex, involving a history of serious infections, blood clot issues, and ongoing symptoms that are understandably distressing. It's important to ensure thorough investigation into all potential causes, including fungal infections, given your symptoms. Coordination between specialists is critical for your treatment.
Explanation: You’ve already faced significant health challenges, such as septic pulmonary embolism and IVC thrombus, and your symptoms of oral thrush, persistent high fevers, chills, confusion, and bleeding raise valid concerns about a possible underlying fungal infection. While your medical team has ruled this out based on blood cultures, it’s understandable to question whether fungal infections were adequately explored, especially considering the medications you've been on that may impact culture results.
Fungal infections can sometimes cause symptoms similar to bacterial ones, and certain fungi, like those from the Aspergillus or Candida families, might not show up in routine cultures. Your thoughts about testing for specific fungi, especially when common antibiotics haven't resolved your issues, are reasonable. Additionally, conditions like pneumonia alongside fungal infections can complicate diagnosis and treatment.
Next Steps:
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Discuss Testing Options: Consider bringing up the idea of specific fungal testing with your healthcare team, emphasizing the symptoms you've experienced and how they might align with a fungal infection or resistance to initial treatments. Mention the importance of thorough investigations for anything that could be causing your ongoing issues.
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Symptom Documentation: Keep a detailed record of your symptoms, including their intensity, what you were doing when they occurred, and any changes after treatments. This documentation can help your healthcare providers make informed decisions regarding further testing.
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Seek a Fungal Infection Specialist: If possible, ask your doctor about consulting an infectious disease specialist focused on fungal infections. Their insight may provide a new perspective on your health status. Explain that you would like a robust evaluation of all potential infectious causes.
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Monitor and Report Changes: Stay vigilant about any new or worsening symptoms, and immediately report them to your healthcare team. Given your history, quick adjustment in care is crucial should things change.
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Support and Advocacy: Don’t hesitate to lean on your family doctor for guidance. They can assist in advocating for your health needs when communicating with the medical team.
Remember that your concerns are important and deserve to be taken seriously. It's natural to feel overwhelmed, especially with the confusion and uncertainty surrounding your health. Finding a supportive team that listens to you and works collaboratively will be invaluable in your recovery journey.
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