I have a severe sore throat, fever, and rash. Doctors couldn't help. It hurts so much! What should I do?

Question

I have a severe sore throat, fever, and rash. I've recently had a kidney transplant. I am on a lot of anti-rejection meds. I've recently switched to RAPAMUNE when I got this sinus infection; I was seen by 2 doctors (infectious disease doctor and a nephrologist, but all the lab tests they've done on me came back negative. They don't know what's causing the infection. It hurts so much even when I try to swallow liquids! I am now in the hospital because I cannot eat/drink. It's been more than 8 days. What should I do? HELP!!!

Answer 1

What is Rapamune used for?

Rapamune or Sirulimus is used together with cyclosporine and a steroid medication to prevent your body from rejecting a kidney transplant.



Special Warnings Concerning Rapamune:

In order to prevent transplant rejection, Rapamune suppresses the body’s immune system. This also decreases the ability of the body's immune system to protect against other diseases. While taking Rapamune there is an increased risk of infection and possible development of lymphoma (cancer of the immune system).



General Precautions with Rapamune:

Rapamune can increase your blood cholesterol and triglyceride levels, which may require treatment.

Your doctor will monitor your kidney function and may adjust the dose of some of your immunosuppressant medications based on the test results.


Avoid sources of infection. Rapamune weakens your body's immune system and increases your risk of infection. Notify your doctor at the first sign of fever, chills, or a sore throat

What are some possible side effects of Rapamune? (This is not a complete list of side effects reported with Rapamune. Your health care provider can discuss with you a more complete list of side effects.)

Rapamune is an immunosuppressant drug. Immunosuppressant drugs weaken your body's immune system and increase your risk of developing infection and possibly lymphoma. (See "Special Warnings").

Other side effects may include:

increased cholesterol level
increased lipid level
high blood pressure
rash
acne
anemia
joint pain
diarrhea
decreased potassium level
decreased blood platelets

So, the rash you have might be an adverse reaction to Rapamune. The sore throat and the accompanying fever and chills could be some type of bacterial or vrus infection. Ask your physician for an EENT specialist consultation. They should do some Blood culture to determine the bug causing the infection. and a C&S ( culture and sensitivity) to determine the exact type of antibiotic that the bug is sensitive to - to combat the infection.

Maybe, your surgeon who most likely is following you up for the success of the kidney transplant. And the oncologist or immunologist who's responsible for your antirejection therapy, would suggest another antirejection drug aside from Rapamune .

Unfortunately, you are in a Catch-22 state. With the cyclosporin drugs, your immune system is suppressed- making you susceptible to infection. But w/o them, your new kidney doesn't stand a chance against. rejection. Some health experts on this suggest some pancreas cells transplant too( PKT- stem cells are also considered). This way, rejection is less likely.

I'm going to suggest a lot of natural foods to boost up your immune system.

Answer 2

You and your treating physicians is now face a difficulty situation.Because you are taking immunosuppressive medicine for your newly received kidney .your resistant to infections is very low despite it is bacterial,virus,fungus infection.Although some infection could be control easily by antibiotic in normal people but will have hard time for you.to fight off it.Your sever sorthroat with difficulty to swalling possible due to bacterial infection;strep.or staph with possible tonsillitis(with abscess),other visual infection with sorthroat such as mon.infection.Since you are in hospital and under care by infectious disease specialist they should have find out the etiology.Only I suggest is beside present doctor you shoud ask for ENT specialist to take a look or ask for second opinions.If you stop or change the present immunosuppresive drug you will risk to lost you kidney.Don't forget that many test for identify of the bugs are base on antigent and antibody reaction and due to your present immu situation will not react normal.

Answer 3

Renal patients are immunocompromised that is the reason why even a simple infection can lead to a very disturbing event.

Number one, trust your nephrologist (kidney spcialist). Do healthy lifestyle, watch for your renal diet (low salt diet),and treat yourself more carefully compared to other persons having no kidney disease. Control of blood pressure and blood sugar as well are important.