What causes a persistent bacterial sinus infection despite taking antibiotics?
May need intravenous antibiotics and work up for fungal infections.
Thanks for sharing your concerns with us. We will try to help you in best way possible. First of all it's sad to know what you had been going through lately.
Based on the history you have shared, such resistant infection will need intravenous antibiotics if orals have not been effective. Also the culture reports which suggested enterobacter cloacae would have shown the sensitivity spectrum of antibiotics it has been responsive to. If not a repeat cultures of nasal swab from secretions or blood cultures can be repeated after being off antibiotics for 3 days at least.
Empirical treatment can be with intravenous aminogylcoside antibiotics or gentamicin or amikacin and that all should be done with close liason to ENT specialist and if needed a CT scan of head and neck to see for exact extent if infection may be done. More broad spectrum antibiotics like carbapenim group may also be needed if first like treatment fails to respond.
Other causes of such extended infection or super infection with fungi should be ruled out as well. Sugar levels, ANA and HIV might also be needed to rule out any low immunity state.
Wishing you a speedy recovery. Hope this has answered your query.
Dr. Saddiq Ulabidin, General & Family Physician
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