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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Had a septoplasty and turbinate reduction and taking amoxicillin and ibuprofen. Told as bacterial infection. What should I do?

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Dr. Michelle Gibson James

General & Family Physician

Practicing since :2001

Answered : 15822 Questions

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Posted on Thu, 21 Nov 2013 in Medicines and Side Effects
Question: Hello, I had a Septoplasty and Turbinate Reduction 20 days ago. I was given 10 days of Amoxicillin and 30 days worth of NORCO and Ibuprofen for pain. After the 11th day post recover, I started to get a fever. I followed up with my Surgeon and he stated that it could bacterial infection, but never did any bloodwork and prescribed me more antibiotics(Omnicef). 4days later, I still had a fever, I went and seen my PCM. They drew labs. Negative for Strep/FLU but my ALT and AST were elevated.. ALT was 128 and AST was 75. As of today, my fever went away(After 7 days) and I had my levels rechecked again. They came back ALT 136 and AST 75. Could the Viral illness I had after my surgery be contributed to this? Could the Antibiotics I took or Pain meds I took contribute to this? I am Male, 5'7 207 pounds, so I am slightly overweight. The last time my ALT and AST were drawn, I was 23 and 24 respectfully and that was 4 months ago. Any help would be greatly appreciated.
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Answered by Dr. Michelle Gibson James 1 hour later
Brief Answer: likely due to the medication Detailed Answer: HI, thanks for using healthcare magic It is possible that the medication used could have resulted in this increase in liver enzymes. Antibiotics in particular are commonly reported because they induce liver toxicity. In most cases when this occurs ,this reaction cannot be predicted from what is known about the profile of the drug. It is thought to occur as a result of an inflammatory reaction that may be stimulated by the drug. The first antibiotic that you used can rarely cause a hepatic reaction. There is a recent report of the second omnicef (cefdinir) causing hepatic injury. (In J Gen Int Med). IN the vast majority of cases, the hepatic enzymes return to normal and there is no lingering injury to the liver. This is normally seen after 4 to 6 weeks. In rare cases there is long term damage. IN terms of the pain killer, norco, it is possible , since this contains acetaminophen, that it could have also contributed to the increase in liver enzymes. Acetaminophen in known to potentially affect the liver. Again , if related to this drug, improvement should be seen in a few weeks. I hope this helps, feel free to ask any additional questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Michelle Gibson James 16 minutes later
Thank you very much for your response. I have a follow up with my PCM tomorrow morning to go over the Labs(I got the results already, as I work in the Medical Field in the Navy). I read that usually High Enzymes for liver follow up with an ultrasound. Is that true? Also, what type of diet should I start, so I do not injure the liver any further? I plan to stay away from Medication and Alcohol as well. When should I have my LFT's checked again? The Doctor also drew blood to test for Mononucleosis, but he doubts I have it because I do not have any swollen lymph nodes. I suffer bad from Health Anxiety and I know ill be worried until everything goes back to normal..
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Answered by Dr. Michelle Gibson James 6 hours later
Brief Answer: repeat the tests in 4 to 6 weeks Detailed Answer: Hi Yes, imaging of the liver with an ultrasound would be helpful. It would help to identify any changes. In terms of dietary changes, there are some suggestions for persons with chronic changes to the liver which is not the case for you but the suggestions may still be helpful. In the acute setting changes are not usually necessary. The recommendations generally center around preventing fluid retention by restricting salt and fluid intake. In the past , protein restriction was advised, but this is no longer thought to be necessary. You would need to consume a balanced healthy diet with the required 5 servings of fruits and vegetables. You should have the LFT's checked 4 to 6 weeks from the initial blood tests to give the body a chance to heal It is understandable to be concerned but the values return to normal in most persons. Please feel free to ask any additional questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Michelle Gibson James 10 hours later
Hello Doc, I have my follow up this morning..the Doc did call and say my Mono test came back negative. Also, i lost 7 pounds this week. I did cut back TREMENDOUSLY on what i ate the past 4 days. Just been eatting fruits and veggies..After my doctors appointment today, i will follow up one more time then i will close out and rate your services. Thank you again
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Answered by Dr. Michelle Gibson James 2 hours later
Brief Answer: ok Detailed Answer: HI Sure, no problem
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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