Orioles closer Jim Johnson remained hospitalized Wednesday as doctors tried to determine what is causing flu symptoms and an infection that has dogged him for more than a week.
"They want to identify it, and [with] bacteria, you're talking about some things you've got to be careful with," manager Buck Showalter said. "But he's in great hands … and at some point, he'll rejoin us and then we'll start talking about baseball. Right now, he's about getting the body healthy. We'll figure the baseball part of it out later."
Johnson, who has converted 15 straight save opportunities, including seven this season, had been suffering from flu symptoms during the road trip. His case worsened overnight Monday in Baltimore, and he went to the hospital about 2 a.m. He has been under observation since.
"[Doctors are] running tests, eliminated some things, haven't completely identified it," Showalter said. "He's getting a little frustrated. I texted back and forth with him a little today."
With Johnson out, Showalter used Pedro Strop in a one-run save situation Tuesday against the Toronto Blue Jays, and the right-hander converted it for his first save in 53 big league games.
Wada seeing Dr. Yocum
Left-hander Tsuyoshi Wada will seek a second opinion on his left elbow from renowned surgeon Dr. Lewis Yocum in California.
A MRA taken in Baltimore on Tuesday showed ligament damage, but a course of action won't be determined until Wada receives the second opinion.
"No one's definitively said this is what has to happen. He could rehab this thing and be back," Showalter said. "[There's] always the potential of surgery, and if that happens, the way things are nowadays, he could be pitching for us again. Either way, I'm going to stay positive on it."
Yocum, the Los Angeles Angels' team doctor, did the initial physical on Wada before he signed with the Orioles. He also was the one who removed bone chips from Wada's elbow in 2007, Showalter said.
"It'll be good, too, because [Yocum] did the original physical and obviously there's some changes there from the original physical," Showalter said.
The 31-year-old Wada, who signed a two-year, $8.14 million deal in December, pitched in just two major league games during spring training because of elbow soreness. He made one rehab start last week for Triple-A Norfolk — allowing six earned runs in 22/3 innings — and later complained of elbow pain in a different area from the previous soreness. Wada dealt with elbow injuries in 2007 and 2009.
Berken returns to majors
Right-hander Jason Berken, who didn't make the club out of spring training partially because he was limited by a hamstring injury, was promoted from Norfolk on Wednesday when Robert Andino was placed on the paternity list.
"I am excited. I suppose I pitched pretty well in Triple-A, and I am excited about doing the same here," said Berken, who allowed just one earned run in 15 innings (0.60 ERA) in three starts for the Tides. "It's great to be back. I'm just excited to see all the guys. That's the biggest thing, you miss the teammates. You miss the guys that are here."
Berken, who had a 5.36 ERA in 40 games as an Orioles reliever last year, said a combination of using his changeup more at Norfolk and being healthy allowed to pitch so well this month.
"I feel like my spring training kind of started when the season started in terms of getting my innings in and pitching," he said. "In the last game, I threw six [innings] and it felt good."
Berken, 28, will pitch out of the bullpen while he is with the Orioles. He could be sent down when Andino returns this week.
"Whenever I get the opportunity to pitch, I am going to take full advantage of it," Berken said. "Timewise, I don't worry about that stuff."
Reimold improving, still out
Left fielder Nolan Reimold was out of the starting lineup Wednesday for the fifth time in six games because of neck spasms. However, he took swings in the indoor batting cage and during batting practice. He hasn't thrown yet but said he feels he is improving.
"Right now, it's just frustrating that I'm on the sidelines and in the training room, and I want to get this over with and get back on the field," said Reimold, who visited a chiropractor in Baltimore on Tuesday.
Reimold, who is batting .370 with five homers in 46 at-bats, said he feels better than he did Friday night and Saturday morning in Anaheim, Calif., when he couldn't move his neck up or down and barely left to right. Now, he says, he really feels discomfort only when stretching his neck downward. He expects to avoid a trip to the disabled list.
Endy Chavez again replaced Reimold in left and at the top of the order Wednesday.
Around the horn
Catcher Taylor Teagarden (back) is not progressing, and doctors are considering giving him a third epidural injection. Showalter said if that doesn't work, then another course of action will have to be pursued. Teagarden has remained in Sarasota, Fla., since the team left in April. … Andino's wife, Renee, had the couple's third child and first girl Wednesday afternoon, Amarise Hazel. She was 8 pounds and born on her dad's 28th birthday. Andino is the second Oriole with a child who shares his birthday. Pitcher Jason Hammel shares a birthday with his son Beckett William. … Lefty Zach Britton (shoulder) is progressing with his rehabilitation in Sarasota and is nearing a return to throwing from a regular mound, according to Showalter. … The Orioles have nine players on their 25-man roster with flu symptoms or upper-respiratory issues, Showalter said. … Mark Reynolds was in the starting lineup at designated hitter Wednesday after getting the day off Tuesday. He was in a 0-for-16 slump and was batting .125 heading into Wednesday night. ... The first 10,000 fans age 15 and older to attend Thursday's game will receive a "Gold Glove" Orioles T-shirt featuring silhouettes of Nick Markakis and Matt Wieters, the club's 2011 Gold Glove winners, on the back.