Stay Up to Date! Like us on Facebook  and Twitter  for the latest news and announcements    

Reaction to Infection

During infections, the patient's baseline clinical symptoms may become more severe.  An exacerbation of myalgias, headaches or migraine, and/or sensory symptoms can occur.  Gut motility may worsen, and a reduction in calories and fluids under these conditions can further aggravate the patient's fatigue or trigger those symptoms commonly associated with poor intake (e.g., headaches, dizziness).  The reduced ability to tolerate fluids or food enterally may necessitate intravenous fluid therapy.  A reduced urine output may be due either to dehydration or urinary retention, a complication of bladder dysfunction. 

Other autonomic features may also become more prominent during infections.  Body temperature can become more fluctuant with wide swings.  Pallor or flushing or skin mottling is common.  Patients may feel chilled or very hot, but their skin (to touch) doesn't corroborate their perception.  Inappropriate sweating, i.e., not sweating with fever or in hot environments, or profuse sweating in otherwise comfortable temperatures.   Finally, brady- and tachycardia can occur, along with dizziness which might reflect orthostatic hypotension; these features can become apparent during an acute illness.  These symptoms are not unique to the mitochondrial patient but their intensity is impressive and duration more long-lasting. 

Most patients with mitochondrial disease have no underlying immunological issues and can fight off infections appropriately.  However, the process is associated with a significant degree of fatigue with or without lethargy.  Furthermore, while the symptoms of the infection itself improve within a reasonable period of time, the fatigue can often last much longer, perhaps days or even weeks, before the patient recovers to his/her baseline level of energy and/or mental function.  With severe infections (like influenza), profound muscle weakness may lead to obstructive apnea and even respiratory failure. 

In general, one can expect that once the infection clears and the post-infection weakness clears, the patient will return to his baseline level of functioning.  However, a particularly severe stress, a prolonged period of infection, or several recurring infections could produce a situation in which a patient does not fully recover and a new (lower) baseline is established.  Since even patients treated aggressively for infection can expect a prolonged period of recovery, whether or not a patient recovers to his baseline cannot be accurately predicted.

Finally, new clinical features of the underlying energy disorder may emerge with the stress of the infection.  For example, hyperglycemia requiring insulin therapy may develop, only to recede as the infection wanes.  However, the appearance of a new but transient symptom should raise concern that this feature might re-appear later as a permanent symptom.

Page Security: