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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 48803
Experience:  Board Certified Physician
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Tragically my mum died 3 weeks ago with bronchopneumonia at

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Hello, Tragically my mum died 3 weeks ago with bronchopneumonia at the age of 81. Mum had rheumatoid arthritis and was on methotrexate for several months. She also had an aortic stenosis and was on Ramipril, amlodipine, indapamide. Mum had regular blood checks for the methotrexate and her last test said her white blood cells were raised but I was only advised this when mum was ill a week later with a stomach upset and sickness, so I called the rheumatoid dept and also her GP. A few days later my mum died in hospital having spent two nights there. The HDU ward gave her antibiotics, fluids and steroids, but mum passed away. An HDU nurse also mentioned Sepsis. Did the blood check clinic miss a window of opportunity with mum's raised white blood cells six days before she died?

This is Dr. David

I am so sorry for the loss of your mother.

with her history of RA and methotrexate, if she was suspected of pneumonia and had elevated WBC counts coming to the hospital, she should have had a blood culture to check for infection in the blood stream.

methotrexate can suppress the immune system so the WBC count is not as high as it would be without the methotrexate.

if she had fever or consolidation or pneumonia on her chest xray, this can be a sign of infection.

yes, the clinic should have caught an elevated WBC count above 10.0 and called the doctor to notify and she should have been evaluated for infection at that point.

let me know if you have other questions.

Customer: replied 1 year ago.
Thank you Dr David for your quick response.
I am going to contact the RA dept at the Hospital to find out what my mother's last WBC was?
If a window was missed, I do not want this to happen to another person. The High Dependency Unit were excellent but my concern is that my Mother was handed over to their care too late!Many RegardsDebbie McNulty

you are welcome

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