Some Answers:

Finally...
we have some answers! 

 And all it took was:

3 pediatrician visits
3 emergency room visits
2 hospital admissions
20 days in the hospital
2 EKG's
2 ECHO's
4 x-rays
1 sweat test
3 abdominal ultrasounds
1 full body MRI
1 CT scan
1 bone marrow biopsy
1 endoscopy/colonoscopy
1 spinal tap
9 IV's
Countless blood draws
Cultures of everything possible
Consults by Infectious Disease, Rheumatology, Immunology, Oncology and Gastroenterology

and...29 days of high fevers!!!

Yesterday at 5:30pm Audra went under anesthesia for a CT scan of her abdomen/pelvis and a spinal tap.  Once again, she tolerated the anesthesia and procedures very well.  Strongest girl I know!  Poor, sweet girl had a nasty spinal headache last night though because they had to take a large volume of spinal fluid for all the tests they needed to run. 

Late last night the doctor eagerly came in to tell us that they found something on her CT scan....and boy, was it the talk of the hospital!  Really, no one could believe it.  Audra's left kidney is larger than her right one and had multiple areas of what they think are abscesses inside it, with evidence of inflammation around it. 

So...pyelonephritis (a kidney infection) with abscesses...most likely the result of a UTI.

The strange thing is...all of Audra's many urine samples in the past 3 weeks have shown no signs of infection.  So, very late last night, they got another catheterized sample of urine from Audra and sent it off to the lab.  Now we wait.  The doctors are very hopeful that it WILL grow a bacteria this time and then they will know exactly which antibiotics to give her...and she will get better VERY soon!

This diagnosis seems almost too good to be true.  How did it possibly take this long to figure this out?  Why haven't there been any other signs of this infection before yesterday...28 days into the illness!  For now, the doctors don't have answers to these questions.  What they DO know is that there are abscesses in her kidney right now that NEED to be treated.  So, today at 1:30pm she received her first dose of antibiotics.  If this really is the cause of her prolonged illness then in a couple of days the fevers should be gone, her bloodwork should start returning to normal...and she should feel BETTER! 

If she doesn't improve with antibiotics, then this is not the primary cause of her current illness, but just something else that has been identified along the way.  The only way to know for sure is to treat her with antibiotics and see if she gets better. 

Because of all the extensive testing that Audra has had, we have found out about some other health concerns:

Her bone marrow biopsy indicated that she isn't producing red blood cells properly.  Maybe this is because of the severe inflammation throughout her body right now.  Maybe not.  We will follow this and see if it improves as she gets better.

Her immune system seems to be a bit "quirky" and not functioning 100% properly.  Again, they will follow this and see if it improves.

The biopsies from her endoscopy showed that she has quite severe inflammation in her stomach and the first portion of her small intestine.  So significant that there is actually some atrophy (damage and destruction) of the tissues.  The pathologist is not sure what is causing this...but whatever it is, it has been going on for a long time.  This is not the cause of her current illness, however her current inflammatory response may be causing this condition to be exacerbated right now.  For sure, the condition of her GI tract is why she is so small.  There is no way that her body could absorb nutrition in that current state.  Also, she has H. pylori infection in her GI tract.  Not all that uncommon and very treatable.  So, for both of these conditions she is being given a strong acid blocker to protect her stomach lining and two antibiotics to treat the H. pylori.  There is talk of initiating a special diet to help her stomach/intestine heal.  More to come on this later probably.

So, for now, we wait and pray for bacteria to show up in her most recent urine culture...and for the antibiotics to work and for her to feel better.  Looking back, I cannot believe all that she has been through in the last 4 weeks.   So many uncomfortable, painful things...on top of nasty fevers that never give her a break.  But in between all of that she is still happy and playful.  She is one, strong, amazing, beautiful little girl who I love with all my heart...to the moon and back!

She has captivated all of the doctors here in the unit.  I can tell they truly care about her and WANT her to get better.  In fact, I think they all have been racing to beat each other out to "the diagnosis".  Earlier this week I warned them that there was a new doctor on Audra's case who was just as eager to figure out the diagnosis...

Thank you for your thoughts and prayers for our sweet, sweet girl...they HAVE been heard...and they HAVE been answered!!  We have had to face some very scary potential diagnoses for Audra, and thankfully they were all ruled out...one at a time.  Please continue to pray that this new finding in her kidney IS the primary source of her illness.  If so, we should be home by the middle of next week!