Hi there.

Your fiancee tested positive for blood culture means she needs antibiotics in her treatment. Recently due to acute renal failure (road accident and the subsequent need of dialysis), and malaria her immunity has gone for toss and she needs appropriate antibiotic treatment against the blood infection. She must be taken to a very good physician for this without any delay.
Bleeding from the nose might be due to the infection spreading in the blood (sepsis) or due to dengue kind of hemorrhagic fever itself. Other possibility- Headache and nose bleeding happen when BP reading goes very high. In this case, her kidney functions must be checked again to make sure that it is not causing uncontrolled BP and hence the bleeding.You please do not wait for any second opinion and take her for hospital treatment right away.
After she comes out of this infection etc , she must take enough rest and very good nutrition to build immunity to avoid such infections again.
Please let me know what does the physician say. Come back here for any further query.

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If the bleeing is there and she also has purplish patches over skin suggestive of bleeding below the skin then it is very serious to consider immediate treatment. Also checking renal (kidney) functions and blood pressure is of immediate importance. In case she has any sepsis or renal failure again she'll need 2 to 3 weeks to recover. But honestly I cannot comment with confidence over this period unless the patient is seen clinically by myself. You can discuss these questions with the treating doctor.
Take care.

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XXXXXXX the report which says Leucocyte count is 90,000 is itself suggestive that she might be having sepsis. Yes, tentatively she might need 2/3 weeks to recover from what you have described here.
We are not talking about possibility of sepsis only on the basis of one time bleeding from nose, but we are suspecting it on the basis of various conditions you have described here.
If you or her close family members take care of her and take her to hospital right away for treatment then she'll recover fast. there is no point in wasting 24 hours of questioning over this. I hope if not you, at least her other family members have taken her to the hospital and she's already been started on proper treatment by now. Good luck. Get back for any further query.

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Oh good, XXXXXXX that she's been taken care by somebody. The blood investigation can be of blood malignancy (cancer) nature as you have written here polymorphs are lower but other white cells are in higher percentage. To be XXXXXXX it may not be just sepsis as the Total Leucocyte count is also too high, the picture is said to be suggestive of Chronic Myeloid Leukemia.
Do not worry about your questions. You can ask as many questions as you want. I was wondering if you were still waiting for an online consultant to answer your doubts before taking her for treatment to an actual physician.
The CML referon is Interferon alpha used in the treatment of Chronic Myeloid Leukemia (a cancer of blood cells).
I understand your concern may be likely because she's your fiancee and not your wife yet, but please make sure you are supportive to her during her treatment, irrespective of your future relationship with her. You can talk to the physician about her prognosis as he/ she would be able to comment better after seeing her personally and judging clinically.
Get back for any related query. Take care.

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No, XXXXXXX I said it is mostly CML as the count is too high to call it only a sepsis case. I really cannot say anything on her prognosis. The prognosis depends on how she responds to the treatment and if she suffers from the untoward side-effects too much. Unfortunately CML has bad prognosis compared to other types of leukemias. You can hope for miracles because they do happen. It is your duty to do your best you can as per the medical advice and as per your faith on the almighty.
wish all the best.

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You are welcome, XXXXXXX Get back for any related query. Take care.

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She's got infections incidently when she met with an accident and couldn't recover normally but the infection lead her to sepsis, subsequent renal failure and need of dialysis. Then she got infection of Malaria. If she's from Bangalore, this area is very less prone for P. Malaria infection, but she got it due to very less immunity. and now headache, bleeding with fever of unknown origin. This means she's got 'blast form' of CML where very few normal cells (polymorphs) are functioning against the infection and she's having very low immunity. The Polymorphs you mentioned are 10% and rest of the cells, or in fact, blast cells are more than 50% and this stage is honestly bad. I am very sorry to say this.

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Blast cell form is, as I told you, the worst. Certainly the doctor treating her will do Oncologist control it to make it look like a chronic form. If they can then there are medications to keep this kind patients survival as high as 95% for minimum five years. But if this form can be treated to make it clinically and histologically look like chronic form is unknown to me and the answer you will get only from the Hemat-oncologist treating her.
Thanks.

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