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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Had Accumulated Pus, Necrotic Tissues. Had Chemotherapy. Taking Vancomycin, Ertapenem. Help?

5 days post head surgery for removal of accumulated pus and necrotic tissues from first surgery almost 2 years ago.Right temple surgical wound never healed,complicated by pseudomonas infection.Received chemo and radiation tx for 9 mos after first sx(cancerous tumor ).Discharged after 2 weeks hospital stay 10 days of Piperacillin .Noted pulsating sound and feeling of pressure in right temple with purulent drainage from temporal wound(old,recently debrided) cat scan showed gas formations and was given 100% O2,they said to counter balance the gas formation by the infection. Vancomycin and Ertapenem antibiotic started still waiting for culture and gram stain results .No fever but temperature always below 36. Also diabetic.Are these the right interventions... worried and scared...
Tue, 2 Apr 2013
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Pathologist and Microbiologist 's  Response
Hello and welcome to HCM,

You have mentioned that you have had a head surgery for cancer. Necrotic tissue and pus were removed from the wound site. After few days there was pulsations, gas formation in the subcutaneous tissue and discharge of purulent material from the wound site.

During your hospital stay you developed pseudomonal infection. Piperacillin was the appropriate drug for pseudomonal infection.
After that the gas formation in the tissues indicates an infection called gas gangrene caused by a bacteria called Clostridium welchi.
Vancomycin and Ertapenem are appropriate drugs for this condition.
Since, you are diabeteic chances of developing these infections is more as compared to general infections.

Thanks and take care.
Dr Shailja P Wahal
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Had Accumulated Pus, Necrotic Tissues. Had Chemotherapy. Taking Vancomycin, Ertapenem. Help?

Hello and welcome to HCM, You have mentioned that you have had a head surgery for cancer. Necrotic tissue and pus were removed from the wound site. After few days there was pulsations, gas formation in the subcutaneous tissue and discharge of purulent material from the wound site. During your hospital stay you developed pseudomonal infection. Piperacillin was the appropriate drug for pseudomonal infection. After that the gas formation in the tissues indicates an infection called gas gangrene caused by a bacteria called Clostridium welchi. Vancomycin and Ertapenem are appropriate drugs for this condition. Since, you are diabeteic chances of developing these infections is more as compared to general infections. Thanks and take care. Dr Shailja P Wahal