Question: Hi, you were kind enough to give me good advice here: http://www.healthcaremagic.com/AskDoctorYYYYId=00000

A radiologist has put numbers to the hyperintensities in the MRI from 27 Aug, about 20 on the right and 10 on the left. Very small, but too many. And more on the right side goes with the rest of my problems being mainly on the right - numbness in jaw, coldness inside eye, raised ridge on forehead. I will post a pic from two weeks ago of the ridge, still there and a bit larger, and a smaller one forming on the right. If I wanted to play a Klingon in Star Trek, increasingly I will need less make-up!

As per your advice to get tested, we had an LP performed, which cleared any antibiotic suspicion, however the viral cultures are not expected for another 9 days. I am on acyclovir now, since it was the recommendation in advance of the cultures, given in particular the blisters spreading across my back.

Unfortunately, after 7 days of acyclovir, during which the progression of squealing in my head seemed to slow, it has increased again. And the blisters are not slowed - they are worse than a week ago. I feel like I have a terrible flu, with everything except the coughing. Without ibuprofen, I have to lie down and rest.

So general question: any thoughts on the situation? Specific question: under the assumption it turns out to be a viral infection, and the acyclovir helped but is becoming ineffective, are there other antiviral medications or treatments we should be considering at this time?

Thanks for your valuable time,
XXXX

Hi, this was intended for Dr. Erion Spaho who answered the previous question. I hope it gets to him in particular?
Thanks,
XXXX

Very interesting, thanks.

Something else we are considering - interaction with my spine issues. When the abscess occurred, it was cm from a C7 fracture without union. We knew about an old C2 fracture. However, it has healed. The radiologist that read X-rays a couple weeks ago, comparing with four months ago, confirmed some changes ongoing, and more importantly this non-union fracture in C7. Most of my problems are related to nerves in the C6-C7 area, even index finger effects.

However, instead of this being a consequence of another cause, perhaps a process in this area is causing the inflammation and problems in other areas?

My GP wife has even suggested some effects are like CSF leaks, but she feels quite out of her experience comfort. Could this non-union fracture, or some other problems showing in C4-C5-C6-C7, be leaking fluid that causes the blisters, or in some other way be causing things like this widening welt on my forehead?

Your consideration greatly appreciated,
XXXX

Thanks. Wrt increased signal causing nasal drip, could you elaborate?

As input, in my previous question, you mentioned brain pan leak. I hope not, however must understand any possibility. I know from the April abscess, the pain head wide was level 8 and 9 for a week, 10 when I finally looked behind my ear. At the time, I describede the pain as in my head bones. Antibiotics fixed that episode. Could it have cracked areas like my brain pan, and not be visible in the MRI?

Administarively, please let me know if it would be best to close this question, and open a new one.

Thanks.

Thanks. I will open a different question re the cervical vertebrae issues.

For this potential left nasal cavity issue, something to factor in. At the beginning of August, a dark spot appeared on my left cheekbone, about 1.5 cm in diameter, and never left. It looks like just a discoloration, but closely more like a bruise, that never goes away.

Most of the problems have been felt on the right, then moved left later. However, this started on the left, and did show up at the beginning of this worsening phase. It is not centered, rather about 4 cm left of the nose, roughly the point of the cheekbone.

So the question - does this make sense with my bloodwork? That is, most recently my CRP was 3, then a few days later 5. My Sed was 12, then a few days later 10. Some evidence of inflammation, but not tremendous. And WBC is always normal. Therefore, could a bacteria or virus be driving me crazy from cheekbones, to jaw, to forehead, but produce those test results? Where would it be?

Finally, there are raised areas, can they be tested? This ridge on my right forehead is pretty visible. There is a similar, smaller area behind my ear. They do not look filled with liquid, more inflamed and puffed. Is there a way to test these? I can get my wife to make referral to a physician dermatologist for example, but don't want to ask if not useful. Do you think these areas, or even just the smaller blisters, could somehow have a sample taken. Data is always King.

Thanks so much,
XXXX

Thanks, I will close.

Would you be so kind enough to take a look at the new question I opened re the x-ray detail? My wife says the problems are much more visible on it than the MRI, so I will provide a link for it was well, in that question.