AboutNeha Dahiya MD Expertise I can help patients understand their lab report results, help them with queries regarding what pretest preparation is required. How often a follow up test needs to be done. What does a particular tissue biopsy report mean in everyday English. I can explain the biopsy or cytology procedure. I can deal with Histopathology / cytology / clinical pathology and clinical chemistry queries. Helping in this manner will be my contribution to the community.
Experience I am a pathologist and director of clinical laboratory services. I have been a practicing pathologist for last 9 years in a 350 bed multi specialty hospital laboratory.
Organizations Indian association of pathologists and microbiologists.
MIAC - Member International Academy of Cytology
International association of Pathologists - indian division
Indian association of Cytology
Question Awhile ago I developed severe right face pain. The dentist saw no infection. For many months I suffered, then finally an infection revealed itself in my mouth, forming a fistula in the gum (it had eaten through the bone) where it drained right into me . I had a dental root canal, but I have been very ill ever since. I get repeated oral candida, have now had shingles twice, and urinary tract infections. I have had painful if not very enlarged lymph nodes/glands all on the right side of face and neck and around right ear. Now too I feel pain under the arms and in the right and left groin. I developed much chest pain and burning, but my heart itself has checked out ok via ekg/echo/stress tests. Most of my blood tests have been ok, EXCEPT for the lymphocytes. Please look at the abnormal ones, on the Feb. '09 and now May '09 blood tests:
Feb. '09 Abs Lymphocytes 1188.187 (normal range 1200-3265)
May '09: Abs Lymphocytes 836.798
Feb. '09: CD3: 786.10 (normal range 828-2328)
May '09: CD3: 574.55
My fear is that I have a persistent infection relating back to the dental infection that was NEVER treated with antibiotics. It could have entered the bone and body and given me Osteomyelitis which maybe could spread into the glands or blood. AND/or I fear I have diffused candida in me. For quite awhile my lungs showed "small opacities" during the time I had much chest pain. In these last few months I've developed a lot of heat --- inflammation -- in the upper chest, face, head area, even getting reddish flushing on the upper chest and neck. I am currently taking an anti-inflammatory which helps, but is no cure. My doctors have done NOTHING in terms of forming diagnosis, or treatment. I have been given no antibiotics at all, they have not sampled the glands/nodes as I have begged them, and only give me liquid Nystatin for oral candida every time that appears yet again. Please offer your opinion. I go to a big and well-known hospital, University of Chicago, but for some reason they have continuously down-played both my symptoms and even some of these clear clues in tests. I have been to the ER about 15 times this year. I have reported low fevers (about 100-100.02) many times, weakness, various breathing problems (that improved when now taking anti-inflammatory Celebrex), but continue to get the oral candida infections. What must my doctors DO? HOW do they LOCATE what may have started as an oral infection if it is now outside the face? SHOULD they not sample some lymph glands ?
Answer Hello Karen:
Thanks for the detailed history and information. There is definitely chronic pathology involving the gums / bone in the oral cavity (mouth)
Ideally you should have culture and sensitivity of the material which drains out of the fistula and have treatment based on that.
In addition a FNAC ( fine needle aspiration cytology of the neck glands will also help establish a diagnosis.
There is a decrease in lymphocytes even though mild and needs to be looked into. Once the tests are done and if there is infection you could consult and infectious diseases specialist.
