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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Could Cause Severe Debilitating Back Pain, Tremors, Uncontrollable Spasms, Nausea And Vomiting?

After being unable to get answers in the states and months of pain I went to Mexico 2 weeks ago for testing due to severe dibilitating back pain, shaking and tremors uncontrollable spasms,nausea pain and vomiting as various MRIs, ultrasounds with no apparent organic cause. Results showed: tiempo parcial de tromboplastina 23.7*, reacciones febriles- Tífico “o” positivo 1:320**, Brucella Abortus positivo 1:320**, Proteus OX-19 positivo 1:320**, albumina 5.1*, globulina 2.7* I don’t know what this means, and my doctor did not want to accept these test results and did not even want to see them to help me. I am now in the process of switching doctors. Is there any way you can help tell me what this means?
Tue, 8 Jan 2019
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Neurologist 's  Response
Hi,

I am very familiar with the meanings of these results, The parcial De tormboplastina or PTT in English is a measure of coagulation factor activity (i.e. how fast the blood clots) and your case appears roughly normal though you did not provide the laboratory normal values to know for sure.

It could possibly be slightly low but I don't believe it's clinically significant since it is so close to the "textbook normal" numbers.

The albumin and globulin are measures of protein content in your body. They appear to be within normal limits.

The positive Typhoid O protein of 1:320 is part of what is referred to as a WIDAL agglutination test used to diagnose typhoid fever.

However, though it was widely used as clinical evidence to treat people with typhoid fever it is no longer recognized as acceptable because of the very low sensitivity and specificity of the test.

What is considered the gold standard for diagnosing a patient with typhoid fever is the isolation and culturing of the organism which means that blood, urine, and other secretions, as well as bone marrow biopsies, are obtained if clinical suspicion for this infection is high.

I suspect this is the likely explanation as to why your doctor didn't want to look at the test results.

However, under the circumstances, if I were involved in the care of a patient with your symptoms and all tests were negative to explain your symptoms and if the patient did have a recent history of travel to a 3rd world country or may have been contaminated by food or water supplies where they live then, I would consider the possibility of an enteric or other type of infectious process and either culture the patient myself or send them to an infectious disease specialist who is known for working with patients with these sorts of traveler's infections. However, the test for brucellosis you present does appear to peak my attention a bit since it is in a significant range of 1:320. If your blood, stool, or urine were to be cultured positive for the Brucellosis organism then, together with the titer results you would more likely than not have a case of HUMAN Brucellosis which could be treated successfully with an antibiotic.

Once again, I understand why your doctor may be hesitant to accept the results of the Typhoid O titers but I think attention could be paid to the Brucellosis titers since lab studies detecting antibodies are still considered to be quite valid to make a diagnosis, even more so when combined with positive culture results.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Dariush Saghafi,
Neurologist
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What Could Cause Severe Debilitating Back Pain, Tremors, Uncontrollable Spasms, Nausea And Vomiting?

Hi, I am very familiar with the meanings of these results, The parcial De tormboplastina or PTT in English is a measure of coagulation factor activity (i.e. how fast the blood clots) and your case appears roughly normal though you did not provide the laboratory normal values to know for sure. It could possibly be slightly low but I don t believe it s clinically significant since it is so close to the textbook normal numbers. The albumin and globulin are measures of protein content in your body. They appear to be within normal limits. The positive Typhoid O protein of 1:320 is part of what is referred to as a WIDAL agglutination test used to diagnose typhoid fever. However, though it was widely used as clinical evidence to treat people with typhoid fever it is no longer recognized as acceptable because of the very low sensitivity and specificity of the test. What is considered the gold standard for diagnosing a patient with typhoid fever is the isolation and culturing of the organism which means that blood, urine, and other secretions, as well as bone marrow biopsies, are obtained if clinical suspicion for this infection is high. I suspect this is the likely explanation as to why your doctor didn t want to look at the test results. However, under the circumstances, if I were involved in the care of a patient with your symptoms and all tests were negative to explain your symptoms and if the patient did have a recent history of travel to a 3rd world country or may have been contaminated by food or water supplies where they live then, I would consider the possibility of an enteric or other type of infectious process and either culture the patient myself or send them to an infectious disease specialist who is known for working with patients with these sorts of traveler s infections. However, the test for brucellosis you present does appear to peak my attention a bit since it is in a significant range of 1:320. If your blood, stool, or urine were to be cultured positive for the Brucellosis organism then, together with the titer results you would more likely than not have a case of HUMAN Brucellosis which could be treated successfully with an antibiotic. Once again, I understand why your doctor may be hesitant to accept the results of the Typhoid O titers but I think attention could be paid to the Brucellosis titers since lab studies detecting antibodies are still considered to be quite valid to make a diagnosis, even more so when combined with positive culture results. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dariush Saghafi, Neurologist