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Is There Any Other Infection Which Has Led To E.coli And What Is The Treatment For UTI And Gall Bladder Adenomyomatosis?

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Posted on Fri, 10 Jan 2014
Question: Present age 77yrs, male.4 problems : 1). Very Low body immunity, 2) Urinary Tract Infection (detected E.Coli 1 week ago ). As per sensitivity report, started taking Martifur MR 100 twice daily, now fever gone and general condition has also improved. 3) Gall Bladder adenomyomatosis, (bilirubin (total) 6 weeks before was 3.5, 1 week before 1.6, now 0.8 ; 4) Mild pleural effusion beneath lung (detected in abdomen ultrasonography), advised chest PA XRay. Lung fields found clear in chest PA xray. OBSERVATION : Medical examinations showed no lung abnormalities (chest pa xray), no brain abnormalities (ct brain scan), no abnormality in ultrasonography of upper & lower abdomen except gallbladder adenomyomatosis, total blood count presently 14600 ( from 18000 1 week back), ESR presently 66 ( from about 45 1 week back), CRP presently 3.5 (from about 3.3 1 week back), All other blood parameters, kidney patameterd normal. PREVIOUS HISTORY was a repitition of the whole scenario (except e.coli was not detected), when augmentin followed by livofloxacin was given which normalised every blood parameter ( TC 26100 reduced to 7500, ESR 50 reduced to 10, CRP 14 reduced to <0.5 ).But whole thing replapsed when medicine was stopped, probably relapsed due to E.coli. Is there any other infection which has led to e.coli, which the previous medication very effectively normalised all parameters, so after medicine withdrawal, present e.coli treatment having partial effect ? Also ESSENTIAL THAT BODY IMMUNITY BE BOOSTED UP to fight and cure any infection. Please advise on treatment and cure. (NOTE: He is allergic to Azithromycin . He also has parkinsonism & previous COPD, COPD now seems cured. He is nondiabetic) Thanks.
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Answered by Dr. Ram Choudhary (5 hours later)
Brief Answer: a physician referal, investigation and follow up Detailed Answer: Hi Welcome to health care magic. There is no proven effective treatment to boost the immunity but good amount of aerobic exercises and balanced nutritious diet may help build your immunity. The UTI with E.Coli infection is a real problem and must be treated urgently, you have already started the treatment as per the culture and sensitivity report of the organism. Martifur is a good entry-level urinary antiseptics drug but there is problem of fast development of resistance if used for prolonged periods. Anyway you seem to have got benefited by the present regime. The gallbladder adenomyomatosis is a troublesome finding on ultrasound this indicates a problematic mucosa of the viscera that is liable to be more commonly infected leading to cholecystitis or it may develop malignant changes; so you have to be watchful about this finding and should review ultrasound at regular periods say about 6 monthly. Another troublesome finding in your case is the pleural effusion on ultrasonography. The chest X ray has shown bilateral angles clear but as a rule ultrasound is more sensitive in detecting pleural effusion than the chest x ray. It may be a part of the inflammatory syndrome that has resulted from the urosepsis that you are already getting treated and the bilirubin levels which were increased may also be the part of generalized sepsis recently that you have got treated with the initial antibiotic regimen of levofloxacin. You should get reviewed by a local physician and it will be advisable to you that you should get blood culture, urine culture and a CT scan of whole abdomen and chest to detect any locus of brooding infection or malignancy which may be the root cause of a depressed immunity. I hope the advice will be helpful for you.
Note: For detailed guidance on genetic screening consult a genetics specialist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ram Choudhary

Internal Medicine Specialist

Practicing since :2001

Answered : 2270 Questions

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Is There Any Other Infection Which Has Led To E.coli And What Is The Treatment For UTI And Gall Bladder Adenomyomatosis?

Brief Answer: a physician referal, investigation and follow up Detailed Answer: Hi Welcome to health care magic. There is no proven effective treatment to boost the immunity but good amount of aerobic exercises and balanced nutritious diet may help build your immunity. The UTI with E.Coli infection is a real problem and must be treated urgently, you have already started the treatment as per the culture and sensitivity report of the organism. Martifur is a good entry-level urinary antiseptics drug but there is problem of fast development of resistance if used for prolonged periods. Anyway you seem to have got benefited by the present regime. The gallbladder adenomyomatosis is a troublesome finding on ultrasound this indicates a problematic mucosa of the viscera that is liable to be more commonly infected leading to cholecystitis or it may develop malignant changes; so you have to be watchful about this finding and should review ultrasound at regular periods say about 6 monthly. Another troublesome finding in your case is the pleural effusion on ultrasonography. The chest X ray has shown bilateral angles clear but as a rule ultrasound is more sensitive in detecting pleural effusion than the chest x ray. It may be a part of the inflammatory syndrome that has resulted from the urosepsis that you are already getting treated and the bilirubin levels which were increased may also be the part of generalized sepsis recently that you have got treated with the initial antibiotic regimen of levofloxacin. You should get reviewed by a local physician and it will be advisable to you that you should get blood culture, urine culture and a CT scan of whole abdomen and chest to detect any locus of brooding infection or malignancy which may be the root cause of a depressed immunity. I hope the advice will be helpful for you.