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What Causes Blotchy Skin And Sore Throat In Repiratory ALS Patient?
Question: Husband (74) is repiratory ALS patient with tracheostomy, ventilator and PEG. Has a mild fever, his normal is 98.4, presently 99.1-3. Good day, bad day pattern since Tuesday. Skin on face and chest is a little blotchy this afternoon. Very tired. Says he has a sore throat yesterday and today. Has more secretions than usual and needs suctioning more often. Doesn't want to go to be checked at emergency. What does the blotchy skin mean? How can I tell if this is a serious infection?
Brief Answer:
Require diagnostic tests to establish etiology.
Detailed Answer:
Thanks for your query at HCM.
I understand your concern and situation.
As your family member is suffering from Amyotrophic lateral sclerosis (ALS) which causes progressive neurodegenerative disease in which nerve cells in the brain and the spinal cord are affected. When voluntary muscles in patients become affected in the later stages of the disease they may become totally paralyzed with requiring tracheostomy and ventilatory support as in your case.Percutaneous endoscopic gastrostomy (PEG) as you told in your patient is an endoscopic medical procedure in which a PEG tube is passed into a patient's stomach to provide feeding when oral intake cannot be done. The patient whether has blotchy skin or rash due to infections has to be evaluated. I suggest you to visit your physician. The symptoms suggest that patient has upper respiratory tract infection due to viral etiology that is causing rash.These infections are self limiting but in patient with ventilator it can be life threatening. It is advisable to get blood culture, throat swab examination and suction fluid for gram staining microscopy and culture sensitivity test, fungal microscopy. Get complete haemogram and proper physical examination to rule out lower respiratory tract infection as it is quite common in such patients and can be life threatening. Keep the patient and surrounding clean. Patient will need analgaesics and antibiotics and for such patients it is advisable to take under guidance of the treating physician. Keep oral hygiene maintained use chlorhexidine gargle 6-8 times per day. Use 2% chlorhexidine body scrub to clean. Maintain tracheostomy and PEG care as advised. The suctioning is most important perform routine cleaning and care according to facility policies and procedures.Ventilator-associated pneumonia is a major complication of mechanical ventilation.Keep the head of the bed elevated 30 to 45 degrees at all times. Yes I suggest take all precaution and get your patient evaluation done.
Take care.
Best of health.
I hope I answered your query.
You can take a follow-up query.
If no clarifications then you can close the discussion.
Dr. Sheetal Verma
Infectious diseases Specialist
Require diagnostic tests to establish etiology.
Detailed Answer:
Thanks for your query at HCM.
I understand your concern and situation.
As your family member is suffering from Amyotrophic lateral sclerosis (ALS) which causes progressive neurodegenerative disease in which nerve cells in the brain and the spinal cord are affected. When voluntary muscles in patients become affected in the later stages of the disease they may become totally paralyzed with requiring tracheostomy and ventilatory support as in your case.Percutaneous endoscopic gastrostomy (PEG) as you told in your patient is an endoscopic medical procedure in which a PEG tube is passed into a patient's stomach to provide feeding when oral intake cannot be done. The patient whether has blotchy skin or rash due to infections has to be evaluated. I suggest you to visit your physician. The symptoms suggest that patient has upper respiratory tract infection due to viral etiology that is causing rash.These infections are self limiting but in patient with ventilator it can be life threatening. It is advisable to get blood culture, throat swab examination and suction fluid for gram staining microscopy and culture sensitivity test, fungal microscopy. Get complete haemogram and proper physical examination to rule out lower respiratory tract infection as it is quite common in such patients and can be life threatening. Keep the patient and surrounding clean. Patient will need analgaesics and antibiotics and for such patients it is advisable to take under guidance of the treating physician. Keep oral hygiene maintained use chlorhexidine gargle 6-8 times per day. Use 2% chlorhexidine body scrub to clean. Maintain tracheostomy and PEG care as advised. The suctioning is most important perform routine cleaning and care according to facility policies and procedures.Ventilator-associated pneumonia is a major complication of mechanical ventilation.Keep the head of the bed elevated 30 to 45 degrees at all times. Yes I suggest take all precaution and get your patient evaluation done.
Take care.
Best of health.
I hope I answered your query.
You can take a follow-up query.
If no clarifications then you can close the discussion.
Dr. Sheetal Verma
Infectious diseases Specialist
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Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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