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CML patient w/PCP
Aug 28, 2000

Dear Dr. Feinberg, My husband has had CML for 8 years. We had no idea his immune system was so weakened. 24 days ago he was hopitalized, 21 days ago he was put on a vent and diagnosed with PCP. He has 5 chest tubes, trac was moved to his neck on 3/18 and feeding tube to his stomach and he is in an induced "coma-like" state since 8/7. He is currently running a temp of 101, has an infection at the site of the trac and as of last night he has other positive blood cultures. His bp is low, he is currently at about 60 percent vent, as of this morning his left side started leaking again. He was changed from bactrim to pentamatine on 8/16 and is on vancomycn and zozysn as well. I'm not really sure what I'm asking other than an opinion from an objective resource. I have never seen someone so sick. My mother survived a traumatic car accident 7 years ago (5 1/2 weeks in a coma, infections,etc.) and I thought then I had seen very ill but I know differently now. I'm trying not to lose hope but seeing all these complications makes it very difficult. Your reply is very much appreciated. Sincerely, Heart broken in Virginia

Response from Dr. Feinberg

people with CML are very prone to infections, and your husband's immune system must be severely weakened to have come down with PCP. Sometimes, the damage done to the lungs by PCP prevents people from getting better, even though they have ben adequately treated for the infection. It sounds like this may be the case with your husband. PCP doesn't cause low blood pressure and it sounds like he is now septic (bacteria in his blood). He should probably also get beefed-up coverage for Pseudomonas, a germ that needs 2 antibiotics, not just Zosyn (vancomycin is for different germs).

Realistically, it sounds like he has a very uphill road to get better. But he needs your full support to do this, so try to keep your hopes up. Good luck!

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