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Q. My father is in ICU with high sugar levels and WBC values. Please suggest further treatment plan.

Answered by
Dr. Zubayeralam
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Dec 11, 2020

Hello doctor,

My father is in ICU under ventilation for a week now. His oxygen level was low, and now the level is 94. He is a diabetic patient, and his sugar level is above 300 and fluctuating. His TLC count was 16.5 but again jumped today to 22000. I wanted to consult with a doctor for advice and a treatment plan urgently. I have all my father's reports, which I can forward as well.

#

Hi,

Welcome to icliniq.com.

According to your statement, the patient has been in the ICU and has uncontrolled DM.

According to the investigation reports (attachment removed to protect patient identity), WBC has increased, other parameters show no abnormalities. His oxygen saturation level is 94%, and his ongoing treatment is in the correct way. Continue his current treatment protocol.

Thank you doctor,

In the hospital, they were giving the antibiotics for the last two weeks. They even gave the antibiotics through the neck vein, but the TLC count is still not decreasing. Last night they gave medicine for the fungal infraction. They are not able to find out the exact cause of the infection. Can you advise me on that? Also, he is on ventilation for the last one week. How long should he be on ventilation?

#

Hi,

Welcome back to icliniq.com.

Persistent high lymphocytes count may result from various reasons such as viral infections, hepatitis, COVID-19, tuberculosis, Toxoplasmosis, cytomegalovirus, brucellosis, vasculitis, acute lymphocytic leukemia, chronic lymphocytic leukemia, HIV and AIDS, chronic inflammation like arthritis, severe medical illness like trauma, a reaction to a new medication, history of spleen removal, any type of fungal or bacterial infections, etc.

A ventilator helps get oxygen into the lungs of the patient and removes carbon dioxide from the body. Some conditions like pneumonia, COPD (chronic obstructive pulmonary disease), brain injuries, stroke, etc. With impairment of lung functions need those ventilators.

Patients on a ventilator are more prone to develop pneumonia as viruses, bacteria, or fungus easily enters through the breathing tube. If the patient begins to breathe on his own, then the ventilator should be removed. Fluid collection or biopsy from his bone marrow, HRCT (high-resolution computed tomography) of the chest, test for COVID-19, etc., can be done to exclude the causes.

As he is on a ventilator, antiviral medications should be introduced for better coverage.


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