Had ablation. Blood culture showed positive for gram negative bacilli. On vancomycin and zosyn. Suggested hysterectomy. Guidance?
Thanks for posting your query.
After an ablation procedure, the blood circulation to the endometrial cavity is severely compromised which mainly helps in fighting off the infection.
Since the systemic antibiotics are not able to control the infection well even after a treatment for last more than 5 days, hysterectomy may need to be considered to save the life.
You must consider a transfer to level 1 facility under these circumstances.
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Dr. Rakhi Tayal.
Could this be the start of recovery, or a worsening condition being masked by the antibiotics?
Thanks for writing again.
The absence of fever and a good appetite are favorable symptoms. The total WBC count of 14.9 is also not very high.
The mild distension of abdomen is not worrisome as long as her bladder and bowel movements are normal, urine output adequate and there is no foul smelling discharge from vagina. The symptoms that you have described are indicative of the beginning of recovery.
If the infection spreads then the symptoms cannot be masked by the antibiotics.
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There is still no fever: temperature has ranged 98.0 - 98.9. WBC from 4 hours ago is 10.0. Her urine output is very good, though has watery bowl movements, of which we are told is due to the antibiotics. Has very loud bowl sounds.
The drainage is consistent, though not heavy and considered serosanguinous (unsure of spelling) ... is lightly colored blood with clear fluid ... still no odor.
The watery bowel movements can be due to the antibiotics she is taking. Taking probiotics will help in controlling this after consulting with her gynecologist.
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