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Suggest Treatment For Staphylococcus Infection
Question: Current Lab results
WBC = 12.3 x 10 power 9 L
Creatine = 2.8
Neutrophils = 20%
Eosinophils = 2%
Basophils = 0%
Lymphocytes = 50%
Monocytes = 28%
A heavy growth of staphylococcus
Sensitive to tanvid, streptomycin, augmetin, cefotacixime, nitrofiratron, oflocicutis
Resistant to erythromycin, tetracycline, gentamicin,
CHEST X-RAY
Marginal cardiac enlargement with CTR =0.54
There is aortic arch is unfolding
There is elevation of the right hemi-diaphragm (Hepatomegaly)
Increased hilar node markings
No obvious effusion
WBC = 12.3 x 10 power 9 L
Creatine = 2.8
Neutrophils = 20%
Eosinophils = 2%
Basophils = 0%
Lymphocytes = 50%
Monocytes = 28%
A heavy growth of staphylococcus
Sensitive to tanvid, streptomycin, augmetin, cefotacixime, nitrofiratron, oflocicutis
Resistant to erythromycin, tetracycline, gentamicin,
CHEST X-RAY
Marginal cardiac enlargement with CTR =0.54
There is aortic arch is unfolding
There is elevation of the right hemi-diaphragm (Hepatomegaly)
Increased hilar node markings
No obvious effusion
Brief Answer:
should treat infections
Detailed Answer:
there are rather a lot of choices for treating the staph. the ofloxicin has lower side effects, not sure if streptomycin is useful in malaria (it is never used for it generally due to potential kidney disease).
The elevated creatinine is quite a concern so, streptomycin is ruled out but the other medications are not that dangerous to the kidney.
Even milder UTI's cause mental confusion in the elderly.
You will likely ask more information and we will be happy to go on from here.
should treat infections
Detailed Answer:
there are rather a lot of choices for treating the staph. the ofloxicin has lower side effects, not sure if streptomycin is useful in malaria (it is never used for it generally due to potential kidney disease).
The elevated creatinine is quite a concern so, streptomycin is ruled out but the other medications are not that dangerous to the kidney.
Even milder UTI's cause mental confusion in the elderly.
You will likely ask more information and we will be happy to go on from here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
So those antibiotics that laboratory test results show that she is sensitive to are among the antibiotics to be given to her except the streptomycin that you mentioned could be harmful to the kidney? So being sensitive to an antibiotic means that the antibiotic can cure an infection that one has?
And those shown that she is resistant to should never be given to her at all?
Elevated creatine level is suggestive of what?
Mental confusion still persist (loss of recent memory)
Abdominal enlargement
Lower limb edema that comes and
Pressure sore on the buttocks and back
Blood pressure fell to (90/40)
Pt is talking now
Dry mouth and feeling thirsty
Difficulty swallowing
Difficulty opening her mouth very well
Custard is being given with complan milk
Pt has been constipated for the 4th day now
Earlier treated for ulcer with antacid liquid)
Also treated for typhoid with (ceproflaxacin)
Malaria therapy begun today = antisonate
And those shown that she is resistant to should never be given to her at all?
Elevated creatine level is suggestive of what?
Mental confusion still persist (loss of recent memory)
Abdominal enlargement
Lower limb edema that comes and
Pressure sore on the buttocks and back
Blood pressure fell to (90/40)
Pt is talking now
Dry mouth and feeling thirsty
Difficulty swallowing
Difficulty opening her mouth very well
Custard is being given with complan milk
Pt has been constipated for the 4th day now
Earlier treated for ulcer with antacid liquid)
Also treated for typhoid with (ceproflaxacin)
Malaria therapy begun today = antisonate
Brief Answer:
yes, exactly
Detailed Answer:
several points sensitive means the germ is sensitive. Resistant means the germ is never going to be affected by it. BUT that doesn't mean that is the right antibiotic. there are always many other considerations. First if kidney function is low, the amount give has to be adjusted if the antibiotic would go out by the kidney. Next, you might target specific locations of infection with specific antibiotics. Streptomycin is only good for blood infections and not so good anywhere else (including urine).
Erythromycin (which is not going to work since there is resistance) happens to accumulate in the ear.
different germs will have different resistance patterns. each infection you have to check and the pattern of which drugs will work will change each time.
yes, exactly
Detailed Answer:
several points sensitive means the germ is sensitive. Resistant means the germ is never going to be affected by it. BUT that doesn't mean that is the right antibiotic. there are always many other considerations. First if kidney function is low, the amount give has to be adjusted if the antibiotic would go out by the kidney. Next, you might target specific locations of infection with specific antibiotics. Streptomycin is only good for blood infections and not so good anywhere else (including urine).
Erythromycin (which is not going to work since there is resistance) happens to accumulate in the ear.
different germs will have different resistance patterns. each infection you have to check and the pattern of which drugs will work will change each time.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Present statuses of the pt
1. Abdominal scan shows liver is tender and enlarged
2. Legs are still swollen
3. Abdomen is still swollen (right side of the abdomen is bigger than the left side of the abdomen)
4. Rigor comes and goes
5. Constipation has persisted
6. Rectal exam done yesterday after which hard stool was passed. No more bowel movement after that.
7. Liver affect found (pus accumulation)
8. Chest x-Ray shows OK
9. 2 kidneys are OK
10. Malaria, typhoid, UTI, ulcer treated, but the effective of the treatments given have not been ascertained through retesting
11. Pt can be transferred from bed to wheelchair
12. Pt cannot stand or ambulate
13. Swallowing difficult
14. Can take custard with complan milk
15. Fasting blood glucose checked today read 119
16. pressure keeps flauctuating: 90/60 Tuesday afternoon, 100/50 on Tuesday evening, 100/60 yesterday, 110/45 today,
17. Face changed and mouth seems closed
Could the liver affect be responsible for recurring blood decrease, persistent abdominal enlargement, persistent swollen legs, ...?
What should be done at this time to get her back to health?
What can be done to get her liver to normal size and texture?
What can be done to get her abdomen to be sizable?
How about getting her limbs sizable and back to ambulating statuses?
What treatment options and medications will put her on the path of wellness?
Please tell me something Dr. XXXXXXX ... Your expertise advice and guidances have been so honorable. I am anticipating your usual prompt responses.
1. Abdominal scan shows liver is tender and enlarged
2. Legs are still swollen
3. Abdomen is still swollen (right side of the abdomen is bigger than the left side of the abdomen)
4. Rigor comes and goes
5. Constipation has persisted
6. Rectal exam done yesterday after which hard stool was passed. No more bowel movement after that.
7. Liver affect found (pus accumulation)
8. Chest x-Ray shows OK
9. 2 kidneys are OK
10. Malaria, typhoid, UTI, ulcer treated, but the effective of the treatments given have not been ascertained through retesting
11. Pt can be transferred from bed to wheelchair
12. Pt cannot stand or ambulate
13. Swallowing difficult
14. Can take custard with complan milk
15. Fasting blood glucose checked today read 119
16. pressure keeps flauctuating: 90/60 Tuesday afternoon, 100/50 on Tuesday evening, 100/60 yesterday, 110/45 today,
17. Face changed and mouth seems closed
Could the liver affect be responsible for recurring blood decrease, persistent abdominal enlargement, persistent swollen legs, ...?
What should be done at this time to get her back to health?
What can be done to get her liver to normal size and texture?
What can be done to get her abdomen to be sizable?
How about getting her limbs sizable and back to ambulating statuses?
What treatment options and medications will put her on the path of wellness?
Please tell me something Dr. XXXXXXX ... Your expertise advice and guidances have been so honorable. I am anticipating your usual prompt responses.
Brief Answer:
Life depends on the liver.
Detailed Answer:
So, I cannot comment directly on this patient since I am not there, but only on the information given. Information has characteristics of fitting with itself and fitting with the larger body of knowledge in medical literature.
People with severe illnesses especially the elderly take a long time to recover after everthing is fixed. Ambulation, physical therapy, etc are especially important.
90 to 110 systolic would be a normal blood pressure if no organs are suffering from lack of blood flow. Kidney function is the most sensitive to that effect and if it is improving that indicates the pressure is, indeed, adequate. Blood count, urine output are other relevant features. They seem fine in the description.
A liver with an infection has problems. This can enlarge the liver and will usually make it and the abdomen at least somewhat sore. This will lower bowel motility and cause constipation. The liver function if impaired will cause edema. the liver if blocked will have fluid back up behind it. Generally in the abdomen. These will cause leg swelling constipation, abdominal distention, painful liver. It may IF AMMONIA IS ELEVATED cause a variety of mental effects including rigor. THIS IS TREATABLE WITH LACTULOSE. If ammonia is elevated. And in someone without muscles, the ammonia level doesnt have to be very elevated.
Covers topic and fixes everything.
Life depends on the liver.
Detailed Answer:
So, I cannot comment directly on this patient since I am not there, but only on the information given. Information has characteristics of fitting with itself and fitting with the larger body of knowledge in medical literature.
People with severe illnesses especially the elderly take a long time to recover after everthing is fixed. Ambulation, physical therapy, etc are especially important.
90 to 110 systolic would be a normal blood pressure if no organs are suffering from lack of blood flow. Kidney function is the most sensitive to that effect and if it is improving that indicates the pressure is, indeed, adequate. Blood count, urine output are other relevant features. They seem fine in the description.
A liver with an infection has problems. This can enlarge the liver and will usually make it and the abdomen at least somewhat sore. This will lower bowel motility and cause constipation. The liver function if impaired will cause edema. the liver if blocked will have fluid back up behind it. Generally in the abdomen. These will cause leg swelling constipation, abdominal distention, painful liver. It may IF AMMONIA IS ELEVATED cause a variety of mental effects including rigor. THIS IS TREATABLE WITH LACTULOSE. If ammonia is elevated. And in someone without muscles, the ammonia level doesnt have to be very elevated.
Covers topic and fixes everything.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Pt transferred to another hospital as par the doctor that has been treating her since her hospital admission
1. Heart races fast and abnormally upon assessment
2. Heart failure suspected upon listening to the heart
3. Pt feels Feverished
4. Feaces has been manually removed
What treatments should options should be administered considering her heart status, liver status, swollen abdomen and edematous limbs?
1. Heart races fast and abnormally upon assessment
2. Heart failure suspected upon listening to the heart
3. Pt feels Feverished
4. Feaces has been manually removed
What treatments should options should be administered considering her heart status, liver status, swollen abdomen and edematous limbs?
Brief Answer:
several points
Detailed Answer:
as mentioned, there are several types of heart failure and anemia is certainly one, not having enough fluid (dehydration) is one. Then, an echo can look at how well the heart is pumping. Some types of heart failure have the heart pump very well and most have the heart pump poorly. Those types can be suspected on examination.
The faeces also came out spontaneously. and the patient is also described as weak. These imply NOT a huge blockage. Narcotics can make more constipation and laxatives (including lactulose) make the bowel more active.
several points
Detailed Answer:
as mentioned, there are several types of heart failure and anemia is certainly one, not having enough fluid (dehydration) is one. Then, an echo can look at how well the heart is pumping. Some types of heart failure have the heart pump very well and most have the heart pump poorly. Those types can be suspected on examination.
The faeces also came out spontaneously. and the patient is also described as weak. These imply NOT a huge blockage. Narcotics can make more constipation and laxatives (including lactulose) make the bowel more active.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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