One of the most difficult cases that I worked on was a case of Crohn’s Disease (CD) where we had to contend with a patient who was experiencing abdominal pain, fever, nausea, and diarrhea. This was definitely an emergency room situation, but the patient was sent home with some blood cultures to be tested for other illnesses. At the hospital, we learned that this Crohn’s patient had a very strong group of streptococcus bacteria in his mouth which had infected his lungs, and these bacteria traveled to his liver, heart, spleen, and colon. These bacteria then produced symptoms similar to those of an acute infection.
A few days later, he presented with extremely high fevers, a sore throat, and a cough which produced significant amounts of mucus. On further examination, we discovered that his liver and spleen contained extremely high counts of streptococcus, which were characteristic of an acute infection. The patient was treated with intravenous hydrocortisone (IVH), antibiotics, and piroxicam. At one week, the symptoms had completely disappeared.
The patient did not have any evidence of infection, even though his temperature was high. He also did not have a fever during the fourteen days from the time he received the IVH until he was discharged. Although the symptoms improved during the last week of the hospital stay, recurrence was observed, and he was readmitted. Throughout the next seven weeks, no new symptoms appeared, and he remained symptom free. When asked if the patient had ever been treated for streptococcus, he said he had not; but was sent home with a prescription for penicillin and a decongestant to aid him through the post-antibiotic phase.