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What Causes Cellulitis Tuberculosis?
Question: Hi , i have been diagonsed wit some soft tissue track in my mri post cesarean surgery.it is being suspected as cellulitis or abdominal TB.
Pls guide the diagnostic blood tests relevant for identification of cellulitis on abdomen and abdominal tb
Pls guide the diagnostic blood tests relevant for identification of cellulitis on abdomen and abdominal tb
Brief Answer:
Admit. Blood culture,chest X-ray, Mantoux test. Diagnostic laparoscopy
Detailed Answer:
Hi,
Welcome to Healthcare magic.
I am Dr Ramadevi wani. I will be answering your concerns today.
I read through your notes.
From the notes I can think of two possibilities.
1. You had very severe soft tissue infection which has been incompletely treated. Since the infection is still there you are feeling the pain. The weird symptoms are caused by the infection.
Very rarely with such long standing lingering infection the cesarean scar on uterus can partially give way continuing this cycle of infection. However your MRI report only says that there is triangular altered intensity. It does not say that scar on the uterus has given way.
2. The second possibility of tuberculosis is only based on ultrasound. You do not have lymph node enlargement or other findings.
If you were in my clinic I would first admit you. I would do full blood count, ESR liver and renal function tests, urine culture and blood culture as baseline. Based on the result of tests I would start antibiotics. I would request Chest X-ray and Mantoux test which if positive would favor tuberculosis diagnosis. I would take opinion from internal medicine specialist/chest physician as regards the possibility of tuberculosis due to the track found on ultrasound. If it is opined that it could be tuberculosis I would start antitubercular treatment. With this in two weeks time you should feel better. I would also take opinion from surgeon as symptoms you had earlier are of severe cellulitis.
I am of the opinion that if your symptoms are worsening day by day. you should have a diagnostic laparoscopy done. This will give a clear picture of the condition of uterus, allow us to take peritoneal fluid for cytology and culture. This also gives us the opportunity to take biopsy of the skin track mentioned in ultrasound.
Biopsy would help us to confirm or refute the diagnosis of tuberculosis.
It is important that you should bring in your relatives to help you. You need to take rest.
Eat healthy protein rich food.
I hope I have answered your concerns. If you have any further queries do write to me through Healthcare Magic
Admit. Blood culture,chest X-ray, Mantoux test. Diagnostic laparoscopy
Detailed Answer:
Hi,
Welcome to Healthcare magic.
I am Dr Ramadevi wani. I will be answering your concerns today.
I read through your notes.
From the notes I can think of two possibilities.
1. You had very severe soft tissue infection which has been incompletely treated. Since the infection is still there you are feeling the pain. The weird symptoms are caused by the infection.
Very rarely with such long standing lingering infection the cesarean scar on uterus can partially give way continuing this cycle of infection. However your MRI report only says that there is triangular altered intensity. It does not say that scar on the uterus has given way.
2. The second possibility of tuberculosis is only based on ultrasound. You do not have lymph node enlargement or other findings.
If you were in my clinic I would first admit you. I would do full blood count, ESR liver and renal function tests, urine culture and blood culture as baseline. Based on the result of tests I would start antibiotics. I would request Chest X-ray and Mantoux test which if positive would favor tuberculosis diagnosis. I would take opinion from internal medicine specialist/chest physician as regards the possibility of tuberculosis due to the track found on ultrasound. If it is opined that it could be tuberculosis I would start antitubercular treatment. With this in two weeks time you should feel better. I would also take opinion from surgeon as symptoms you had earlier are of severe cellulitis.
I am of the opinion that if your symptoms are worsening day by day. you should have a diagnostic laparoscopy done. This will give a clear picture of the condition of uterus, allow us to take peritoneal fluid for cytology and culture. This also gives us the opportunity to take biopsy of the skin track mentioned in ultrasound.
Biopsy would help us to confirm or refute the diagnosis of tuberculosis.
It is important that you should bring in your relatives to help you. You need to take rest.
Eat healthy protein rich food.
I hope I have answered your concerns. If you have any further queries do write to me through Healthcare Magic
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
how is tb or endiometeriosis of abdominal wall identified?and if it is the case whose the doctor that wil deal with this issue a general surgeon ,physician or a gynae ,infectious diaease specialist i m taking zinase d for 12 days for howmany days can it be taken.will ct scan help me in identifying my problem.. can this be coverted into cancer if i will wait. whatbis the use of progestrone pills in my case.can this be cellulitis ..as per my radilogist it is cellulitis tuberculosis .pls guide.
Brief Answer:
Laparoscopy with peritoneal biopsy. Ct scan may help
Detailed Answer:
Hi XXXXXXX
How are you feeling now? How is your pain now? is it worsening?
Relax XXXXXXX What you are having is either cellulitis (infection) or Tuberculosis. It is not cancer and is not going to become cancer if you wait.
Now let me answer your questions one by one.
In my opinion it is not Endometriosis. Abdominal wall endometriosis does not appear as hypoechoeic tract. The pain of endometriosis usually is increased during periods. It does not usually start as acute pain as it happened in your case.
Tuberculosis of the abdominal wall can be diagnosed by following tests.
1. Abdominal wall tuberculosis is secondary. Usually chest X-ray will show some lesion. Mantoux test is positive in 70%of cases of abdominal tuberculosis. So if both these tests are positive it indirectly supports the diagnosis of tuberculosis.
A negative test is inconclusive though.
2. CT scan of the abdomen also helps. SInce it is more than 50 days from your MRI , get a CT and MRI done. This helps in comparision.
3. Peritoneal biopsy obtained through laparoscopy is the most effective way of diagnosing abdominal tuberculosis. Histopathology examination under microscope shows caseating granulomas ( diagnostic of tuberculosis) in almost 100% of cases. Laparoscopy also allows for abdominal wall inspection. If miliary tubercular nodules are seen, then it helps in diagnosis. Laparoscopy also helps in collecting ascitic fluid which can be used to culture for TB bacillus. The drawback of this test is it takes about 8 weeks for the culture result. The biopsy from the track like lesion also helps in diagnosing or refuting endometriosis. I don't think it is endometriosis. But I am writing it for your information. Laparoscopy also helps in assessing the state of uterus and to detect cellulitis/any small pockets of pus/endometriotic lesions in the abdominal wall.
In my opinion Laparoscopy is a must if your pain is worsening.
If tuberculosis found consult chest Physician.
I still feel it is basterial cellulitis. Not necessarily due to tuberculosis.
You can take Zinase D once daily for another two weeks.
Why do you want to take Progesterone? I don't see any reason for it to be prescribed.
I hope I have answered your concerns.If you have any further queries do write to me. I will be happy to answer.
Keep me posted about your progress.
I wish you fast recovery.
Laparoscopy with peritoneal biopsy. Ct scan may help
Detailed Answer:
Hi XXXXXXX
How are you feeling now? How is your pain now? is it worsening?
Relax XXXXXXX What you are having is either cellulitis (infection) or Tuberculosis. It is not cancer and is not going to become cancer if you wait.
Now let me answer your questions one by one.
In my opinion it is not Endometriosis. Abdominal wall endometriosis does not appear as hypoechoeic tract. The pain of endometriosis usually is increased during periods. It does not usually start as acute pain as it happened in your case.
Tuberculosis of the abdominal wall can be diagnosed by following tests.
1. Abdominal wall tuberculosis is secondary. Usually chest X-ray will show some lesion. Mantoux test is positive in 70%of cases of abdominal tuberculosis. So if both these tests are positive it indirectly supports the diagnosis of tuberculosis.
A negative test is inconclusive though.
2. CT scan of the abdomen also helps. SInce it is more than 50 days from your MRI , get a CT and MRI done. This helps in comparision.
3. Peritoneal biopsy obtained through laparoscopy is the most effective way of diagnosing abdominal tuberculosis. Histopathology examination under microscope shows caseating granulomas ( diagnostic of tuberculosis) in almost 100% of cases. Laparoscopy also allows for abdominal wall inspection. If miliary tubercular nodules are seen, then it helps in diagnosis. Laparoscopy also helps in collecting ascitic fluid which can be used to culture for TB bacillus. The drawback of this test is it takes about 8 weeks for the culture result. The biopsy from the track like lesion also helps in diagnosing or refuting endometriosis. I don't think it is endometriosis. But I am writing it for your information. Laparoscopy also helps in assessing the state of uterus and to detect cellulitis/any small pockets of pus/endometriotic lesions in the abdominal wall.
In my opinion Laparoscopy is a must if your pain is worsening.
If tuberculosis found consult chest Physician.
I still feel it is basterial cellulitis. Not necessarily due to tuberculosis.
You can take Zinase D once daily for another two weeks.
Why do you want to take Progesterone? I don't see any reason for it to be prescribed.
I hope I have answered your concerns.If you have any further queries do write to me. I will be happy to answer.
Keep me posted about your progress.
I wish you fast recovery.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
thanks doc.i went to my gynae today and she has now reffered me to physician.my physiacian is in the opinion of getting a ct scan of abdomen done and usg guided fnac.pls guide me of both in terms of safety and radiations involvement as per my health
for how long trial of att is given .my concern is that if i dont have that tb prob,i will still need to take so many med for at least 6 months,how to confirm whether i really reuired this as i have already been on so many amtibiotics for so long..will this att treatment will not make seroius side effects on my body.
i have got some blood work done tday.attaching all my reports.also i was on antibiotic for last 5 days,will these affect my blood work andESR.my chest x ray and tb gold test was negative too.
how is bacterial cellulitis identified.are there any test for thesame..its been three months of my surgery.will ct scan cause any harmful radiations that may hamper my healing futher.does it damage tissue.what does that hypoechoic track that is avasvular means..mri was repeated ii time already
IS There ny other test that i can get done to know about actual bactetial growth
PLS GUIDE
for how long trial of att is given .my concern is that if i dont have that tb prob,i will still need to take so many med for at least 6 months,how to confirm whether i really reuired this as i have already been on so many amtibiotics for so long..will this att treatment will not make seroius side effects on my body.
i have got some blood work done tday.attaching all my reports.also i was on antibiotic for last 5 days,will these affect my blood work andESR.my chest x ray and tb gold test was negative too.
how is bacterial cellulitis identified.are there any test for thesame..its been three months of my surgery.will ct scan cause any harmful radiations that may hamper my healing futher.does it damage tissue.what does that hypoechoic track that is avasvular means..mri was repeated ii time already
IS There ny other test that i can get done to know about actual bactetial growth
PLS GUIDE
Brief Answer:
Do the CT scan. Treat vitamin D deficieny. Laparoscopy/FNAC
Detailed Answer:
Hi XXXXXXX
First tell me how are you feeling now? Is the pain worse? Last time also I asked you about the pain.
I am happy to hear that Chest X-ray and tuberculosis gold test are normal.
If there has been no improvement so far, I definitely recommend you to go for CT scan. CT scan is safe. It does not hamper the healing process. It definitely does not damage the tissues. So don’t worry about it
Ultrasound guided FNAC is a very safe procedure again. You may go for it.
I am suggesting diagnostic laparoscopy as I am not convinced about the diagnosis of tuberculosis. I am afraid sometimes the tissue obtained by FNAC may not be sufficient for diagnosis. Laparoscopy allows us to inspect the whole abdominal cavity and take necessary biopsy. If there is any other cause it can be seen. If you do not want any surgical procedure, then go ahead with FNAC. Again I repeat, CT and ultrasound guided FNA do not have serious side effects
If you are on antibiotics it may bring the neutrophils to normal. Does not affect ESR so fast.
Cellulitis is seen as oedematous tissue. There are no specific tests other than biopsy. If you are having any episodes of fever, blood culture taken during that time will be helpful.
I saw your reports. Please consult your doctor and take treatment for vitamin D deficiency. THIS VITAMIN IS VERY IMPORTANT FOR GENERAL WELL BEING. Where is the second MRI report?
For all you know the hypoechoeic avascular tract seen could be the scar tissue.
I advise you to take anti tubercular treatment only if all these tests done do not provide a clear answer and you still have this pain. Trail of Anti tubercular treatment may need to be taken for 6 weeks. The medications do have some side effects. If there is tuberculosis then they are the best drugs.
I hope I have answered your queries.
If you have any further concerns, do write to me. I will be happy to answer.
Do the CT scan. Treat vitamin D deficieny. Laparoscopy/FNAC
Detailed Answer:
Hi XXXXXXX
First tell me how are you feeling now? Is the pain worse? Last time also I asked you about the pain.
I am happy to hear that Chest X-ray and tuberculosis gold test are normal.
If there has been no improvement so far, I definitely recommend you to go for CT scan. CT scan is safe. It does not hamper the healing process. It definitely does not damage the tissues. So don’t worry about it
Ultrasound guided FNAC is a very safe procedure again. You may go for it.
I am suggesting diagnostic laparoscopy as I am not convinced about the diagnosis of tuberculosis. I am afraid sometimes the tissue obtained by FNAC may not be sufficient for diagnosis. Laparoscopy allows us to inspect the whole abdominal cavity and take necessary biopsy. If there is any other cause it can be seen. If you do not want any surgical procedure, then go ahead with FNAC. Again I repeat, CT and ultrasound guided FNA do not have serious side effects
If you are on antibiotics it may bring the neutrophils to normal. Does not affect ESR so fast.
Cellulitis is seen as oedematous tissue. There are no specific tests other than biopsy. If you are having any episodes of fever, blood culture taken during that time will be helpful.
I saw your reports. Please consult your doctor and take treatment for vitamin D deficiency. THIS VITAMIN IS VERY IMPORTANT FOR GENERAL WELL BEING. Where is the second MRI report?
For all you know the hypoechoeic avascular tract seen could be the scar tissue.
I advise you to take anti tubercular treatment only if all these tests done do not provide a clear answer and you still have this pain. Trail of Anti tubercular treatment may need to be taken for 6 weeks. The medications do have some side effects. If there is tuberculosis then they are the best drugs.
I hope I have answered your queries.
If you have any further concerns, do write to me. I will be happy to answer.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thanks for the detailed reply doctor.
The pain in abdomen is tolerable,but yes i feel it is now extending to left side too as i feel heaviness over there,more till the time i dont get fresh.i do feel very tired ,with blurred vision and feeling of not well being.i dont know it is the side effects if taking so many antibiotics for so long or not taking them gives me this
I have srarted devloping low back pain and swelling in my left nose and behind the left ears,with numbness in my head left side also.wen i recently started the treatment of cefi xl d five days back ,all symptoms were settled,but now i left so again its resurfacing,though doctor has asked me for a course of 10 days,but i could not take antibiotics since they trouble me..
i m hsving pain in right side of rib cage also for so many days..was my lft normal what does the higher value indicates
Mam,isnt there any test to confirm as u said severe cellulitis or soft tissue infection..any blood test that can help me to identify the proper bacteria so thst proper antibiotic for that particular infection be given.till now i feel hit and trial is going on.pls help
I m attaching my the ist usg ,mri report and then iind usg in chronologicall order..had it been tb would the track have reduced to this almost half extent,.is it becoz of serratopeptidase or zinase d.what should i do..15 days back i have had urine culture ,stool culture done with expert plusvtest for tb also,i m attaching that report too..pls guide
I m also feeling thumping sounds wen i lie and pass motions and tremors in my body.why can they be so.
Can amikacin pipzo and orni tht were given to me have caused me ringing in my ears..what should i do
The pain in abdomen is tolerable,but yes i feel it is now extending to left side too as i feel heaviness over there,more till the time i dont get fresh.i do feel very tired ,with blurred vision and feeling of not well being.i dont know it is the side effects if taking so many antibiotics for so long or not taking them gives me this
I have srarted devloping low back pain and swelling in my left nose and behind the left ears,with numbness in my head left side also.wen i recently started the treatment of cefi xl d five days back ,all symptoms were settled,but now i left so again its resurfacing,though doctor has asked me for a course of 10 days,but i could not take antibiotics since they trouble me..
i m hsving pain in right side of rib cage also for so many days..was my lft normal what does the higher value indicates
Mam,isnt there any test to confirm as u said severe cellulitis or soft tissue infection..any blood test that can help me to identify the proper bacteria so thst proper antibiotic for that particular infection be given.till now i feel hit and trial is going on.pls help
I m attaching my the ist usg ,mri report and then iind usg in chronologicall order..had it been tb would the track have reduced to this almost half extent,.is it becoz of serratopeptidase or zinase d.what should i do..15 days back i have had urine culture ,stool culture done with expert plusvtest for tb also,i m attaching that report too..pls guide
I m also feeling thumping sounds wen i lie and pass motions and tremors in my body.why can they be so.
Can amikacin pipzo and orni tht were given to me have caused me ringing in my ears..what should i do
Brief Answer:
there could still be minimal lurking infection
Detailed Answer:
Hi XXXXXXX
The infection must be slowly settling now and that is why the pain has become tolerable. But it has not fully gone.
Other possibility for this dull pain is that the infection has caused some adhesions and this is causing pain.
In case of cellulitis, if you develop fever , a blood culture taken at that time will be helpful.
I saw your reports. I saw the second ultrasound done on 28th Feb. Is the MRI taken on 18th Feb the second one. Other than this I did not see any MRI. I am of the opinion that the hypoehoiec track which has reduced in size now is scar tissue. As the healing process continues it reduces in size.
I saw your LFT result. Marginally high level don't mean anything. It is normal.
Are you taking adequate food? Did you take Vitamin D injection for deficiency. Please don’t neglect this. It is very important. If you don’t like injection, there are capsules of vitamin D 50,000 units available. Please take them once weekly for three months. Again I repeat for general well being this is extremely important. In addition take a multivitamin tablet daily.
Blurring of vision is a new complaint I am hearing from you. I am sure you have checked your blood Pressure. Do check your vision too along with fundus examination.
Ringing in the year and oedema of face can be due to the side effects of medications.
After reviewing all your management so far, I have two suggestions:
1. Considering that there could still be minimal lurking infection, complete the course of CIFI XI. Since while taking these tablets you were feeling good.
2. The infection may have caused adhesions and this is causing pain. Be positive and optimistic. If you are emotionally stressed the intensity of such dull pains doubles. What activity you are doing at home? Three months of sedentary life itself can start backache. Go for massage. In addition to vitamins (mentioned above) and good food please start doing postnatal yoga or some form of mild to moderate exercises. You can join a class. Or there are beautiful videos on the you tube. You can see and do. You may find this silly, but this is important.
Continue serratopeptidase for two more weeks.
I wish I could examine you.
Please keep me updated about your health
there could still be minimal lurking infection
Detailed Answer:
Hi XXXXXXX
The infection must be slowly settling now and that is why the pain has become tolerable. But it has not fully gone.
Other possibility for this dull pain is that the infection has caused some adhesions and this is causing pain.
In case of cellulitis, if you develop fever , a blood culture taken at that time will be helpful.
I saw your reports. I saw the second ultrasound done on 28th Feb. Is the MRI taken on 18th Feb the second one. Other than this I did not see any MRI. I am of the opinion that the hypoehoiec track which has reduced in size now is scar tissue. As the healing process continues it reduces in size.
I saw your LFT result. Marginally high level don't mean anything. It is normal.
Are you taking adequate food? Did you take Vitamin D injection for deficiency. Please don’t neglect this. It is very important. If you don’t like injection, there are capsules of vitamin D 50,000 units available. Please take them once weekly for three months. Again I repeat for general well being this is extremely important. In addition take a multivitamin tablet daily.
Blurring of vision is a new complaint I am hearing from you. I am sure you have checked your blood Pressure. Do check your vision too along with fundus examination.
Ringing in the year and oedema of face can be due to the side effects of medications.
After reviewing all your management so far, I have two suggestions:
1. Considering that there could still be minimal lurking infection, complete the course of CIFI XI. Since while taking these tablets you were feeling good.
2. The infection may have caused adhesions and this is causing pain. Be positive and optimistic. If you are emotionally stressed the intensity of such dull pains doubles. What activity you are doing at home? Three months of sedentary life itself can start backache. Go for massage. In addition to vitamins (mentioned above) and good food please start doing postnatal yoga or some form of mild to moderate exercises. You can join a class. Or there are beautiful videos on the you tube. You can see and do. You may find this silly, but this is important.
Continue serratopeptidase for two more weeks.
I wish I could examine you.
Please keep me updated about your health
Above answer was peer-reviewed by :
Dr. Shanthi.E
Thanks mam
I m sending u current pic of mine.the pain and heaviness is now radiating from right to left also, im scared the infection is spreading.
While taking cefi xl d i m having some kind of itching in my body,.why is dicloxallin used for..i m having feverish like fweeing all the time but wen i record it remains normal though feom inside i feel that.i cant do any exercise as my stomach is very flaaby.i fwwl discomfort whike walking sleeping and bending sidewards.i m also attaching my first mri..pls look if something is left to investigate which is giving ,me trouble..what doea that soft tissue track means and will it swttle of its own or further spread..
Can foe adheaions something can be done..pls guide
I m sending u current pic of mine.the pain and heaviness is now radiating from right to left also, im scared the infection is spreading.
While taking cefi xl d i m having some kind of itching in my body,.why is dicloxallin used for..i m having feverish like fweeing all the time but wen i record it remains normal though feom inside i feel that.i cant do any exercise as my stomach is very flaaby.i fwwl discomfort whike walking sleeping and bending sidewards.i m also attaching my first mri..pls look if something is left to investigate which is giving ,me trouble..what doea that soft tissue track means and will it swttle of its own or further spread..
Can foe adheaions something can be done..pls guide
Brief Answer:
The pain is probably due to adhesions.
Detailed Answer:
Hi XXXXXXX
Where is the current picture? I spent all this time looking for it in all your uploaded files. I did not find it. Henceforth if you upload any file, please label them with date.
Dicloxacin is antibiotic given for infections.
Did you start taking Vitamin D and Multivitamin?
Do you feel at least 50% better compared to the first month post cesarean?
XXXXXXX I feel probably the infection has caused adhesions and this is causing pain.
As I wrote earlier, the avascular soft tissue track in my opinion is scar tissue.
It will settle on its own.
You can start the exercises slowly. May be start with light yoga and meditation.
Finally, if you are not at least 50% better compared to the first month, in my opinion it is better to have diagnostic laparoscopy. If you decide to have diagnostic laparoscopy it should be done by well experienced endoscopic surgeon as there is a possibity of adhesions. If the adhesions are mild to moderate they can be released. If the adhesions are dense, there is no use releasing them as they reform again.
If you are feeling 50% better, then stop worrying, stop antibiotics. Take
vitamin D, multivitamin, healthy food. Start exercises. You will gradually achieve normalcy.
If you have any further concerns do write to me. I wish you fast recovery.
The pain is probably due to adhesions.
Detailed Answer:
Hi XXXXXXX
Where is the current picture? I spent all this time looking for it in all your uploaded files. I did not find it. Henceforth if you upload any file, please label them with date.
Dicloxacin is antibiotic given for infections.
Did you start taking Vitamin D and Multivitamin?
Do you feel at least 50% better compared to the first month post cesarean?
XXXXXXX I feel probably the infection has caused adhesions and this is causing pain.
As I wrote earlier, the avascular soft tissue track in my opinion is scar tissue.
It will settle on its own.
You can start the exercises slowly. May be start with light yoga and meditation.
Finally, if you are not at least 50% better compared to the first month, in my opinion it is better to have diagnostic laparoscopy. If you decide to have diagnostic laparoscopy it should be done by well experienced endoscopic surgeon as there is a possibity of adhesions. If the adhesions are mild to moderate they can be released. If the adhesions are dense, there is no use releasing them as they reform again.
If you are feeling 50% better, then stop worrying, stop antibiotics. Take
vitamin D, multivitamin, healthy food. Start exercises. You will gradually achieve normalcy.
If you have any further concerns do write to me. I wish you fast recovery.
Above answer was peer-reviewed by :
Dr. Raju A.T
Thanks mam for ur reply
The pain is not settling of its own.in fact as soon as my lmp is approaching which was last on 10 feb i m feeling more cramps and pain i m attaching my pic again
I have started taking vitamin d supplement,nd was already taking multivitamins and probiotics for a month.
As soon as i stop taking antibiotics my problems resurfaces as i have wrotr earlier
? I feel some weird symptons of numbness i my left hand left nose left ear and left side of brain with thumping sounds eenever i lie or passmotions my heartbeat becomes very fast andvi feel thid is not normal as i have never everfrlt that
Doc please clear my doubt my first usg i XXXXXXX didnt reveal anything but still i was given iv on basis of my ist mri rrport did i really needed that or are theses dide effects of taking them,cant conclude
One thing more mam even if i have to start att please detail me about this treatment its side effects and all minute details
I also read read about abdominal wall scar endometrosis..is there be a possibilty of same.pls guidemam as i m very disturbed with my ill health.despite making my efforts of gud diet and healthy lifestyle things are not just working out and my body is giving me some very bad signals
The pain is not settling of its own.in fact as soon as my lmp is approaching which was last on 10 feb i m feeling more cramps and pain i m attaching my pic again
I have started taking vitamin d supplement,nd was already taking multivitamins and probiotics for a month.
As soon as i stop taking antibiotics my problems resurfaces as i have wrotr earlier
? I feel some weird symptons of numbness i my left hand left nose left ear and left side of brain with thumping sounds eenever i lie or passmotions my heartbeat becomes very fast andvi feel thid is not normal as i have never everfrlt that
Doc please clear my doubt my first usg i XXXXXXX didnt reveal anything but still i was given iv on basis of my ist mri rrport did i really needed that or are theses dide effects of taking them,cant conclude
One thing more mam even if i have to start att please detail me about this treatment its side effects and all minute details
I also read read about abdominal wall scar endometrosis..is there be a possibilty of same.pls guidemam as i m very disturbed with my ill health.despite making my efforts of gud diet and healthy lifestyle things are not just working out and my body is giving me some very bad signals
Brief Answer:
I am still of the opinion that a laparoscopy would be better.
Detailed Answer:
Hi XXXXXXX
Going through all your files I feel the pain is most probably due to adhesions. Probably there is bit of infection which has not cleared completely. Do a blood culture and see, although possibility of finding organisms is more when blood is taken in the presence of fever.
I am not convinced that it is endometriosis. The symptoms of endometriosis start gradually. It would have shown some findings during cesarean, if it was endometriosis. The increased cramps that you notice during mensus could be due to adhesions also.
Though your first ultrasound did not reveal much, you had all the symptoms and signs of infection. You needed to take those antibiotics.
I am still of the opinion that a laparoscopy would be better.
If you start antitubercular treatment you need to take it for six months. In the intensive phase ( first two months) you need to take 4 medicines like Isoniazid with Rifampicin and Pyrazinamide and ethambutol. This is followed by taking two drugs i.e. Isoniazid and Rifampicin for four months in the continuation phase. These drugs sometimes MAY affect liver and kidney function. They can also affect peripheral nerve and optic nerve. Physician /chest physician is the best person with whom you can discuss these.
Keep me updated about your health.
I am still of the opinion that a laparoscopy would be better.
Detailed Answer:
Hi XXXXXXX
Going through all your files I feel the pain is most probably due to adhesions. Probably there is bit of infection which has not cleared completely. Do a blood culture and see, although possibility of finding organisms is more when blood is taken in the presence of fever.
I am not convinced that it is endometriosis. The symptoms of endometriosis start gradually. It would have shown some findings during cesarean, if it was endometriosis. The increased cramps that you notice during mensus could be due to adhesions also.
Though your first ultrasound did not reveal much, you had all the symptoms and signs of infection. You needed to take those antibiotics.
I am still of the opinion that a laparoscopy would be better.
If you start antitubercular treatment you need to take it for six months. In the intensive phase ( first two months) you need to take 4 medicines like Isoniazid with Rifampicin and Pyrazinamide and ethambutol. This is followed by taking two drugs i.e. Isoniazid and Rifampicin for four months in the continuation phase. These drugs sometimes MAY affect liver and kidney function. They can also affect peripheral nerve and optic nerve. Physician /chest physician is the best person with whom you can discuss these.
Keep me updated about your health.
Above answer was peer-reviewed by :
Dr. Raju A.T
Hi mam.
Thanks for the detailed reply.
I consulted a general surgeon and a infectious disease specialist yesterday
In surgeon opinion after seeing my mri nd ultrasound reports and physical examination has prescribed me again some medications.
Flucort ointment chymoral forte tds tayo 60k once weekly and tab nurokind and folic acid with one test oc cect abdomen and barium meal through follow
As per infectious disease specialist he suggested for fnac and montoux test to start att or not
Now keeping in view of my health condition and allergic problem is montox test and ce ct safe for me as i m already in healing phase and last year before pregnany i also got cect done..aftr getting that done i had allergy and severe shivering for a day.is it safe in teems of radiation during my healing process
Is ct plain helpful in detection of bowel obstruction or tb..or should i go for 3rd mri
How is fnac done and what are the chances of side effects of this procedure
Can an allergic asthmatic can get mantoux done ,
And what if all these test came negative and still i need to go for empirical att.my gynae said that they follow an empirical att approach to women of i fertility too.is that true mam . I dnt want go fora laproscopy as i m scared ofany further surgeries and their complications post op becaz of these xonsequences
And despitetakingso many medicinesas llist attached ,should i gollow a surgeon prescribed medicine for a week and see if that works,becaz wen i was on zinase d last 15 daysback my track was reduced from 27mm to 14 mm.,had it been tubecular shuld it have been reduced like this
Should i really go for empirical att directlyfor a trial of 2 to 4 weeks..will it be safe for long period of lifetime.in terms of its resitance and reoccurence
I was given amikacin pipzo and orni wen i was admitted .are these also drugs of tb.i read it on net and found them as a second line of treatment.why i was not given ist line
Whose medic8nes should i follow.last dose of cefi xl d is pending
.Pls guide in a detailed manner
Thanks for the detailed reply.
I consulted a general surgeon and a infectious disease specialist yesterday
In surgeon opinion after seeing my mri nd ultrasound reports and physical examination has prescribed me again some medications.
Flucort ointment chymoral forte tds tayo 60k once weekly and tab nurokind and folic acid with one test oc cect abdomen and barium meal through follow
As per infectious disease specialist he suggested for fnac and montoux test to start att or not
Now keeping in view of my health condition and allergic problem is montox test and ce ct safe for me as i m already in healing phase and last year before pregnany i also got cect done..aftr getting that done i had allergy and severe shivering for a day.is it safe in teems of radiation during my healing process
Is ct plain helpful in detection of bowel obstruction or tb..or should i go for 3rd mri
How is fnac done and what are the chances of side effects of this procedure
Can an allergic asthmatic can get mantoux done ,
And what if all these test came negative and still i need to go for empirical att.my gynae said that they follow an empirical att approach to women of i fertility too.is that true mam . I dnt want go fora laproscopy as i m scared ofany further surgeries and their complications post op becaz of these xonsequences
And despitetakingso many medicinesas llist attached ,should i gollow a surgeon prescribed medicine for a week and see if that works,becaz wen i was on zinase d last 15 daysback my track was reduced from 27mm to 14 mm.,had it been tubecular shuld it have been reduced like this
Should i really go for empirical att directlyfor a trial of 2 to 4 weeks..will it be safe for long period of lifetime.in terms of its resitance and reoccurence
I was given amikacin pipzo and orni wen i was admitted .are these also drugs of tb.i read it on net and found them as a second line of treatment.why i was not given ist line
Whose medic8nes should i follow.last dose of cefi xl d is pending
.Pls guide in a detailed manner
Brief Answer:
Follow surgeon's advise. Do FNAC
Detailed Answer:
Hi XXXXXXX
I read your notes and appreciate your concerns. I shall answer them one by one.
1. I feel the symptoms you are going through are due to adhesions and presence of minimal infection.
2. You can have Mantoux test .
3. Usually they give test dose of CT contrast before the procedure. If you are allergic to it then you can have MRI if needed. MRI is better than plain CT. By the way XXXXXXX WHY DID YOU HAVE CT WITH CONTRAST BEFORE PREGNANCY? Do you have h/o chronic pain abdomen ? Do you have any other preexisting problem.
4. FNAC is a very simple procedure. It is done under local anaestesia. It will appear like injection prick.
5. In my opinion that track was post surgery scar tissue. Yes if tuberculosis the track would not have reduced.
6. Take the medications given by surgeon hoping that the pain will resolve with it.
7. Amikacin and Orni are used in other infections too. When they were prescribed to you earlier it was to treat other infections and not tuberculosis.
8. I am of the opinion that if the diagnosis becomes unclear you can try att. It does not have long term adverse effects.
Keep me updated about your health. I wish you fast recovery.
Follow surgeon's advise. Do FNAC
Detailed Answer:
Hi XXXXXXX
I read your notes and appreciate your concerns. I shall answer them one by one.
1. I feel the symptoms you are going through are due to adhesions and presence of minimal infection.
2. You can have Mantoux test .
3. Usually they give test dose of CT contrast before the procedure. If you are allergic to it then you can have MRI if needed. MRI is better than plain CT. By the way XXXXXXX WHY DID YOU HAVE CT WITH CONTRAST BEFORE PREGNANCY? Do you have h/o chronic pain abdomen ? Do you have any other preexisting problem.
4. FNAC is a very simple procedure. It is done under local anaestesia. It will appear like injection prick.
5. In my opinion that track was post surgery scar tissue. Yes if tuberculosis the track would not have reduced.
6. Take the medications given by surgeon hoping that the pain will resolve with it.
7. Amikacin and Orni are used in other infections too. When they were prescribed to you earlier it was to treat other infections and not tuberculosis.
8. I am of the opinion that if the diagnosis becomes unclear you can try att. It does not have long term adverse effects.
Keep me updated about your health. I wish you fast recovery.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thanks mam for the detailed reply
1...i had a cect chest done because of my ongoing asthma problem..never had any history of abdomen pain..it all happenend post surgery
2.Mam have u checked the list of medicines attached new file that i uploaded last since i feel i have taken lots of medicines in these three months with different antibiotics on and offwith different docs opinion my concern is now taking again a new set of ,medicines as prescribed by my surgeon will further effect me in a postive way or will it affect my liver and all as i m having pain in my right side below rib for last so many days.
3.
Can i really go for an att ,with all my present complaints ,will it not affect my liver
.i also got a lasik surgery done 4 years back which was followed by a infection of viral keratisis in my one eye,will it be safe now Is empirical att really a routine method as followed by doctors
4
What is the best way to examine stomach PROBLEM MRI OR CT SCAN..WILL CT GIVE A BETTER PICTURE FOR proper EVALUTAION AND DIAGNOSIS or mri will be better to see adhesions and soft tossue infection in my case
5.
isnt there any concrete test to confirm abdominal or skin tb
6..
Can this problem of mine lead to sepsis,i m scared
7.
Can i continue to cuudle my baby even if i m having tb,will it affect his health if he comes in close contact with me
1...i had a cect chest done because of my ongoing asthma problem..never had any history of abdomen pain..it all happenend post surgery
2.Mam have u checked the list of medicines attached new file that i uploaded last since i feel i have taken lots of medicines in these three months with different antibiotics on and offwith different docs opinion my concern is now taking again a new set of ,medicines as prescribed by my surgeon will further effect me in a postive way or will it affect my liver and all as i m having pain in my right side below rib for last so many days.
3.
Can i really go for an att ,with all my present complaints ,will it not affect my liver
.i also got a lasik surgery done 4 years back which was followed by a infection of viral keratisis in my one eye,will it be safe now Is empirical att really a routine method as followed by doctors
4
What is the best way to examine stomach PROBLEM MRI OR CT SCAN..WILL CT GIVE A BETTER PICTURE FOR proper EVALUTAION AND DIAGNOSIS or mri will be better to see adhesions and soft tossue infection in my case
5.
isnt there any concrete test to confirm abdominal or skin tb
6..
Can this problem of mine lead to sepsis,i m scared
7.
Can i continue to cuudle my baby even if i m having tb,will it affect his health if he comes in close contact with me
Brief Answer:
Take treatment prescribed by surgeon
Detailed Answer:
Hi XXXXXXX
1. I was happy to know that the CT you had before was for your chest problem and nothing to do with abdomen.
2. I am of the opinion that you take the tablets prescribed by surgeon expecting it to benefit you.
3. All the tests you have done for tuberculosis so far have been negative. I am of the opinion that it is not tubercosis.
4. CT with contrast is good. But MRI is better than plain CT. Considering your history of allergy, I suggest that you get a MRI done if at all you want to do one.
5. I don’t expect this problem to progress to sepsis
6. Have you started exercises? Take healthy diet. I feel just follow surgeons treatment and see. Start light yoga. It is good for chronic pain.
After that just stop all medications. Take only vitamins and see.
7. You can cuddle your baby while taking treatment for abdominal tuberculosis ( if at all you have it. I feel it is not tuberculosis). I am sure he has been vaccinated.
If you have any further queries, do write to me.
Take treatment prescribed by surgeon
Detailed Answer:
Hi XXXXXXX
1. I was happy to know that the CT you had before was for your chest problem and nothing to do with abdomen.
2. I am of the opinion that you take the tablets prescribed by surgeon expecting it to benefit you.
3. All the tests you have done for tuberculosis so far have been negative. I am of the opinion that it is not tubercosis.
4. CT with contrast is good. But MRI is better than plain CT. Considering your history of allergy, I suggest that you get a MRI done if at all you want to do one.
5. I don’t expect this problem to progress to sepsis
6. Have you started exercises? Take healthy diet. I feel just follow surgeons treatment and see. Start light yoga. It is good for chronic pain.
After that just stop all medications. Take only vitamins and see.
7. You can cuddle your baby while taking treatment for abdominal tuberculosis ( if at all you have it. I feel it is not tuberculosis). I am sure he has been vaccinated.
If you have any further queries, do write to me.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thanks doc,
pls guide me with my tdays reports .elevated crp and abbration in lft and kft..why my crp is elevated in just a span of 1 week despite taking medicines ..it was 4 earlier on 4 mar ..
i gave the blood sample at 12 ..before that i had biscuits at 5 and veg soup at 11..will it affect the blood work.
should i leave the zinase now and switch to chymoral forte given by surgeon ..is it fine after long list of medicines taken so far..does intake of this protein enzymes like zinase causing pain in liver and changed values in lft and kft
mam can u suggest some good tb hospital or tb specialist in XXXXXXX XXXXXXX
pls guide me with my tdays reports .elevated crp and abbration in lft and kft..why my crp is elevated in just a span of 1 week despite taking medicines ..it was 4 earlier on 4 mar ..
i gave the blood sample at 12 ..before that i had biscuits at 5 and veg soup at 11..will it affect the blood work.
should i leave the zinase now and switch to chymoral forte given by surgeon ..is it fine after long list of medicines taken so far..does intake of this protein enzymes like zinase causing pain in liver and changed values in lft and kft
mam can u suggest some good tb hospital or tb specialist in XXXXXXX XXXXXXX
Brief Answer:
CRP is also influenced by too much stress and sedentary life style.
Detailed Answer:
Hi XXXXXXX
What is the level of CRP now? You did not write it? C reactive protein is a non specific protein secreted by the liver. It is usually raised in the presence of inflammation. It is also influenced by too much stress and sedentary life style.
Biscuits and soup do not influence the reading.
I am not able to see the lft and kft result. Did you upload it? I cannot see it. So I cannot tell whether they are significant.
You can stop Zinase start Chymoral Forte given by surgeons.
Zinase does not cause change in lft and kft.
I am not aware of doctors and hospitals in XXXXXXX
If you have any further queries do write to me.
CRP is also influenced by too much stress and sedentary life style.
Detailed Answer:
Hi XXXXXXX
What is the level of CRP now? You did not write it? C reactive protein is a non specific protein secreted by the liver. It is usually raised in the presence of inflammation. It is also influenced by too much stress and sedentary life style.
Biscuits and soup do not influence the reading.
I am not able to see the lft and kft result. Did you upload it? I cannot see it. So I cannot tell whether they are significant.
You can stop Zinase start Chymoral Forte given by surgeons.
Zinase does not cause change in lft and kft.
I am not aware of doctors and hospitals in XXXXXXX
If you have any further queries do write to me.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
my crp is coming as 7 now from..why is itvelevated dwpite taking zinase is that significant in terms of soft tissue inflammation.
also i have taken zinase d for almost 25 days..so will it be fine now to switch to chykoral forte,.what is the difference between action of zinase and chymoral ..as per my condition which would be beneficial. or should i take both for how long can i take this
is flucort ointment safe to use..isnt that a steorid
is overodose of thses enzymes or probiotics not to be done..i have had darolac for almost one and half month during XXXXXXX and n0w zinase and then chymoral,,will it overdose
can i take tayo 60 k once a week for a month..mine level was 30. with my mulyivitamin of becozym c forte or zevit...which one is gud multivitamin
mam the pain i m feeling in my rib area is that liver pain because of overmedications i m attaching the lft and kft again .please detail the abbraions in both.
also i have xonsulted an ayurvedic surgeon also..can these medicines be taken along with them
if my problem is not of tb ,can it be because of adhesions..are adhesions settle on their own..which is the better way to see the infection of stomach mri or ct.
mam if i feel cramping pain bfore and during my lmp,can i take drotin a or meftal spas or some other medicine
also i have taken zinase d for almost 25 days..so will it be fine now to switch to chykoral forte,.what is the difference between action of zinase and chymoral ..as per my condition which would be beneficial. or should i take both for how long can i take this
is flucort ointment safe to use..isnt that a steorid
is overodose of thses enzymes or probiotics not to be done..i have had darolac for almost one and half month during XXXXXXX and n0w zinase and then chymoral,,will it overdose
can i take tayo 60 k once a week for a month..mine level was 30. with my mulyivitamin of becozym c forte or zevit...which one is gud multivitamin
mam the pain i m feeling in my rib area is that liver pain because of overmedications i m attaching the lft and kft again .please detail the abbraions in both.
also i have xonsulted an ayurvedic surgeon also..can these medicines be taken along with them
if my problem is not of tb ,can it be because of adhesions..are adhesions settle on their own..which is the better way to see the infection of stomach mri or ct.
mam if i feel cramping pain bfore and during my lmp,can i take drotin a or meftal spas or some other medicine
Brief Answer:
I am of the opinion that this pain is due to adhesions.
Detailed Answer:
Hi XXXXXXX
Zinase contains proteolytic enzyme and diclofenac sodium which is a non-steroidal anti-inflammatory drug. Chymoral forte contains proteolytic enzymes. Both help in reducing inflammation, pain and in removing the dead tissue. You have ased Diclofenac sodium for quite some time. I think at this stage it is enough to take chymoral forte. Take it for two weeks and stop it.
When you are taking antibiotics, it can knock down the good bacteria from intestine. So your doctor must have given darolac to put back these good bacteria and restore the health of the intestine.
Both multivitamins have almost the same content. You may take either of them. Don’t worry the vitamins in the capsules are not going to harm you.
Yes. Flucort is a steroid. I did not understand why flucort has been prescribed. Do you have skin wound/inflammation? If you do not have, then you need not use it.
Take tayo 60k once a week for 8 weeks.
I have no knowledge of Ayurveda medications. Yet I feel you should follow one type of treatment only.
I am of the opinion that this pain is due to adhesions. It usually settles down.
For detecting infection in the abdomen both CT and MRI are equally good. Since you are young, for evaluation of this chronic pain I suggest you to have MRI.
There is no risk of allergy and radiation with MRI.
For the cramping pain before and during period, take Meftal spas 1 tablet three times daily after food. If the pain is severe, you can take two tablets three times daily.
I am sorry I am unable to see your liver and kidney function test results to comment on it.
If you have any further concerns do contact me through Healthcare Magic.
I am of the opinion that this pain is due to adhesions.
Detailed Answer:
Hi XXXXXXX
Zinase contains proteolytic enzyme and diclofenac sodium which is a non-steroidal anti-inflammatory drug. Chymoral forte contains proteolytic enzymes. Both help in reducing inflammation, pain and in removing the dead tissue. You have ased Diclofenac sodium for quite some time. I think at this stage it is enough to take chymoral forte. Take it for two weeks and stop it.
When you are taking antibiotics, it can knock down the good bacteria from intestine. So your doctor must have given darolac to put back these good bacteria and restore the health of the intestine.
Both multivitamins have almost the same content. You may take either of them. Don’t worry the vitamins in the capsules are not going to harm you.
Yes. Flucort is a steroid. I did not understand why flucort has been prescribed. Do you have skin wound/inflammation? If you do not have, then you need not use it.
Take tayo 60k once a week for 8 weeks.
I have no knowledge of Ayurveda medications. Yet I feel you should follow one type of treatment only.
I am of the opinion that this pain is due to adhesions. It usually settles down.
For detecting infection in the abdomen both CT and MRI are equally good. Since you are young, for evaluation of this chronic pain I suggest you to have MRI.
There is no risk of allergy and radiation with MRI.
For the cramping pain before and during period, take Meftal spas 1 tablet three times daily after food. If the pain is severe, you can take two tablets three times daily.
I am sorry I am unable to see your liver and kidney function test results to comment on it.
If you have any further concerns do contact me through Healthcare Magic.
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Hi mam,
Thanks for the reply,
1
Mam i have got an ultrasound and mri with contrast done as per the requirement of my gynae,attaching the reports.based on these reports she has now given me a course of antibiotic in the name of nor metrogyl(norfloxain 400+metrogyl 400) bd forvthree days and candid cl pessaries for 3days with meganeuron od plus..keeping in view of history of my attached list of medicines previously taken feom nov till now is it safe again to go for these antibiotics
2
Pls guide me with the interpretation of usg and mri latest reports.whyis there a contracdiction in every report
3
Also attaching the latest blood work pls detail the abbration of lft and kft
4..as per mri it is suggestive of pid..what is that and what are the diagnostic tests for confirmation of pelvic inflammatoy disease
5
In the mean time i have been asked for a tb pcr on day 1 of menstrual blood test and a mantoux test..is it fine to conduct them while i m on above antibiotics..will it affect the actual the results of both tb pcr and mantoux test.is is safe to go for mantoux while having this candid cl and norm,etrogyl.
6.i m not having any urinary trouble although but yes motions are becoming a problem,again need to exert a lot of pressure for that
7
Also my lower abdomen is getting swelled day by day,with a same localised pain on right side and some feeling of heaviness and some momentin left side just below the navel button and abovebs car line.that portion sometimes palpitate and fwels if something is moving there.also for last 10.15 days im fwelingkind of heaviness on my scar(this is the first time i m feeling thos)because of abdominal swelling.my last lmp was 10th feb
7 for last 20days i m having feverish fewling again but no temperature on recording..taken vitamin d 60k twice till now
8 mam is this the high time to start att as nobody is giving a proper diagnosis or are my symptoms is of pelvic inflammatory disease or tuberculosis
9 after taking these antibiotics i feel a kind of itching for some time in my body..is it fine
Pls guide me in point wise detailed manner mam..i will be greatful..what sho6ld be now my future course of action.pls reply asap
Thanks for the reply,
1
Mam i have got an ultrasound and mri with contrast done as per the requirement of my gynae,attaching the reports.based on these reports she has now given me a course of antibiotic in the name of nor metrogyl(norfloxain 400+metrogyl 400) bd forvthree days and candid cl pessaries for 3days with meganeuron od plus..keeping in view of history of my attached list of medicines previously taken feom nov till now is it safe again to go for these antibiotics
2
Pls guide me with the interpretation of usg and mri latest reports.whyis there a contracdiction in every report
3
Also attaching the latest blood work pls detail the abbration of lft and kft
4..as per mri it is suggestive of pid..what is that and what are the diagnostic tests for confirmation of pelvic inflammatoy disease
5
In the mean time i have been asked for a tb pcr on day 1 of menstrual blood test and a mantoux test..is it fine to conduct them while i m on above antibiotics..will it affect the actual the results of both tb pcr and mantoux test.is is safe to go for mantoux while having this candid cl and norm,etrogyl.
6.i m not having any urinary trouble although but yes motions are becoming a problem,again need to exert a lot of pressure for that
7
Also my lower abdomen is getting swelled day by day,with a same localised pain on right side and some feeling of heaviness and some momentin left side just below the navel button and abovebs car line.that portion sometimes palpitate and fwels if something is moving there.also for last 10.15 days im fwelingkind of heaviness on my scar(this is the first time i m feeling thos)because of abdominal swelling.my last lmp was 10th feb
7 for last 20days i m having feverish fewling again but no temperature on recording..taken vitamin d 60k twice till now
8 mam is this the high time to start att as nobody is giving a proper diagnosis or are my symptoms is of pelvic inflammatory disease or tuberculosis
9 after taking these antibiotics i feel a kind of itching for some time in my body..is it fine
Pls guide me in point wise detailed manner mam..i will be greatful..what sho6ld be now my future course of action.pls reply asap
Brief Answer:
I would advise clindamycin for 2 weeks.
Detailed Answer:
Hi XXXXXXX
Welcome to Healthcare Magic.
Just yesterday I was thinking about you. I was just curious to know how you are feeling now and look today I am hearing from you. Though I saw your question in the afternoon could not answer it as I was busy with emergency on call.
I shall answer your queries one by one. I am not answering in the chronological order. Just check with the numbering.
7. You said the swelling of lower abdomen is increasing day by day. This is your perception. What does the surgeon or Gynecologist say about it? You know XXXXXXX all of us put on some bulge on the abdomen after delivery. Is it that in your case? As regards feeling of heaviness in the scar area, don’t worry about it. If it is severe just take Ibuprofen. That should be enough.
Did you take Vitamin D for 8 weeks? If not, please take it. That is the correct course.
1,2&3. I cannot see any of the new uploads of investigations. I could see the MRI report which you sent to my email. You may send all the reports to my email or please upload it again on Healthcare Magic website with a new name to the file.
4. Yes, MRI report is suggestive of pelvic inflammatory disease. I was happy to see this report. There is nothing serious ( like abscess etc) reported. Are you having vaginal discharge? What does the ultrasound report say?
The diagnosis of pelvic inflammatory disease is by laparoscopic findings and swab test. But often pelvic inflammatory disease is diagnosed by clinical symptoms of lower abdominal pain along with cervical motion tenderness/uterine tenderness/adnexal (site of ovary) tenderness.
In my clinic, for a lady with similar complaints like you I would advise clindamycin for 2 weeks.I know you have taken several antibiotics. But since you are still symptomatic I would prescribe it.
5. Go ahead with TB PCR test and Mantoux test. Those medications will not interfere with the test results.
6. Were your motions regular before cesarean section? Are you taking enough fiber in your diet? Please take plenty of salads, fruits and drink at least two liters of water daily.
8. Let us wait for PCR and Mantoux test results. I advised Mantoux test to you in my first reply to you on 2nd March. I don’t understand why are you so scared to get it done.
9. Since you feel that itching for a brief period, I don’t think you should worry.
Have you started yoga/mild exercises/meditation? If you don’t like any of these go for a walk with your husband / mother/sister daily.
Wishing you fast return to normalcy,
Dr Rama
I would advise clindamycin for 2 weeks.
Detailed Answer:
Hi XXXXXXX
Welcome to Healthcare Magic.
Just yesterday I was thinking about you. I was just curious to know how you are feeling now and look today I am hearing from you. Though I saw your question in the afternoon could not answer it as I was busy with emergency on call.
I shall answer your queries one by one. I am not answering in the chronological order. Just check with the numbering.
7. You said the swelling of lower abdomen is increasing day by day. This is your perception. What does the surgeon or Gynecologist say about it? You know XXXXXXX all of us put on some bulge on the abdomen after delivery. Is it that in your case? As regards feeling of heaviness in the scar area, don’t worry about it. If it is severe just take Ibuprofen. That should be enough.
Did you take Vitamin D for 8 weeks? If not, please take it. That is the correct course.
1,2&3. I cannot see any of the new uploads of investigations. I could see the MRI report which you sent to my email. You may send all the reports to my email or please upload it again on Healthcare Magic website with a new name to the file.
4. Yes, MRI report is suggestive of pelvic inflammatory disease. I was happy to see this report. There is nothing serious ( like abscess etc) reported. Are you having vaginal discharge? What does the ultrasound report say?
The diagnosis of pelvic inflammatory disease is by laparoscopic findings and swab test. But often pelvic inflammatory disease is diagnosed by clinical symptoms of lower abdominal pain along with cervical motion tenderness/uterine tenderness/adnexal (site of ovary) tenderness.
In my clinic, for a lady with similar complaints like you I would advise clindamycin for 2 weeks.I know you have taken several antibiotics. But since you are still symptomatic I would prescribe it.
5. Go ahead with TB PCR test and Mantoux test. Those medications will not interfere with the test results.
6. Were your motions regular before cesarean section? Are you taking enough fiber in your diet? Please take plenty of salads, fruits and drink at least two liters of water daily.
8. Let us wait for PCR and Mantoux test results. I advised Mantoux test to you in my first reply to you on 2nd March. I don’t understand why are you so scared to get it done.
9. Since you feel that itching for a brief period, I don’t think you should worry.
Have you started yoga/mild exercises/meditation? If you don’t like any of these go for a walk with your husband / mother/sister daily.
Wishing you fast return to normalcy,
Dr Rama
Above answer was peer-reviewed by :
Dr. Raju A.T
thanks mam
i have tenderness and painnin that track area as well as too much discomfort and heaviness on a particilar point radiated at left side also
i have got amontoux tesr done yesterday..with tb pcr scheduled for tommorow as i got my periods today..can that be done on day 2,though my gynae asked it for day 1
mam what does that pelvic inflammatory diaesae reveal with fluid collection in that area
of pouch of XXXXXXX what are all the relevant test for diagnosisng that..
the doctors here are in the opinion that this soft tissue track is probably tubercular..and considering my symptomps i feel i should go for empirocal att as they are now leaving me with an option of doagnostic lap,which i dont want to go for
can i start empirical att and see if it benefits me ,...is it Safe for me keeping in view the list of medicon3s i have taken so far in last four months.
right now three days of norfloxacin and metrogyl each 400 has been given.what sre thy used for
does mri with contrast reveals if the track has been tubecular or not
if i take a trial of 15 days to see the difference in my pain... will thesedrugs reallybecome totally ineffective if needed in future..
mam can i take liv 52 syrup additionally if taking att,since i want to counter its side effects
with multivotamins and probiotocs too
also if i m allergic and have asthma too, can att be taken
mam pls guide in detail..sending u my current pic..the striae marks on left are now giving me touching pain now for last two days
what does my mri report means because they have not mentio ed it as scar tissue,but some triangular intensity..is it common post cesarean dwlivery..does that happen to everyone
i have tenderness and painnin that track area as well as too much discomfort and heaviness on a particilar point radiated at left side also
i have got amontoux tesr done yesterday..with tb pcr scheduled for tommorow as i got my periods today..can that be done on day 2,though my gynae asked it for day 1
mam what does that pelvic inflammatory diaesae reveal with fluid collection in that area
of pouch of XXXXXXX what are all the relevant test for diagnosisng that..
the doctors here are in the opinion that this soft tissue track is probably tubercular..and considering my symptomps i feel i should go for empirocal att as they are now leaving me with an option of doagnostic lap,which i dont want to go for
can i start empirical att and see if it benefits me ,...is it Safe for me keeping in view the list of medicon3s i have taken so far in last four months.
right now three days of norfloxacin and metrogyl each 400 has been given.what sre thy used for
does mri with contrast reveals if the track has been tubecular or not
if i take a trial of 15 days to see the difference in my pain... will thesedrugs reallybecome totally ineffective if needed in future..
mam can i take liv 52 syrup additionally if taking att,since i want to counter its side effects
with multivotamins and probiotocs too
also if i m allergic and have asthma too, can att be taken
mam pls guide in detail..sending u my current pic..the striae marks on left are now giving me touching pain now for last two days
what does my mri report means because they have not mentio ed it as scar tissue,but some triangular intensity..is it common post cesarean dwlivery..does that happen to everyone
Brief Answer:
Biopsy of the track for histopathology would give you a definitive answer.
Detailed Answer:
Hi XXXXXXX
Welcome back.
As I already wrote to you in my email, as regards that track in skin, I am not convinced about the diagnosis of tuberculosis. It should have been seen in MRI too.
Menstrual blood for PCR test should be collected on the day you have heavy bleeding. You should know that even this is not confirmatory test.
Biopsy of the track for histopathology would have given you a definitive answer.
Don’t worry about the small amount of fluid in pouch of XXXXXXX It is seen with ovulation, inflammation etc. I have already written to you in my previous XXXXXXX about how pelvic inflammatory disease is diagnosed. In my clinic I would have prescribed clindamycin for 14 days.
Your MRI says, “There are postop changes in the subcutaneous fat of anterior abdominal wall without any discrete collection”. Probably this is seen as track in ultrasound.
If your doctors who examined you feel the track could be due to tuberculosis then you may take the trial ATT. There is a small possibility that those drugs may become ineffective if required in future. This does not mean that they definitely become ineffective. Discuss with your physician about which drugs are best suited for you.
You may take Liv 52 along with these medications.
If you have any further queries do contact me through Healthcare magic.
Biopsy of the track for histopathology would give you a definitive answer.
Detailed Answer:
Hi XXXXXXX
Welcome back.
As I already wrote to you in my email, as regards that track in skin, I am not convinced about the diagnosis of tuberculosis. It should have been seen in MRI too.
Menstrual blood for PCR test should be collected on the day you have heavy bleeding. You should know that even this is not confirmatory test.
Biopsy of the track for histopathology would have given you a definitive answer.
Don’t worry about the small amount of fluid in pouch of XXXXXXX It is seen with ovulation, inflammation etc. I have already written to you in my previous XXXXXXX about how pelvic inflammatory disease is diagnosed. In my clinic I would have prescribed clindamycin for 14 days.
Your MRI says, “There are postop changes in the subcutaneous fat of anterior abdominal wall without any discrete collection”. Probably this is seen as track in ultrasound.
If your doctors who examined you feel the track could be due to tuberculosis then you may take the trial ATT. There is a small possibility that those drugs may become ineffective if required in future. This does not mean that they definitely become ineffective. Discuss with your physician about which drugs are best suited for you.
You may take Liv 52 along with these medications.
If you have any further queries do contact me through Healthcare magic.
Above answer was peer-reviewed by :
Dr. Raju A.T
hi mam
i have got tb pcr done that is negative and mantoux that is positive..my health is gettibg deteroiated day by day.
for last three days i m having vomitings and weakness ..
what should i do the abdominal swelling is increasing ..my surgeon is now alsonin a opinion of starting empirical att.
i personally feel the problem is now increasing upto intestines level as i have diacomfort in both areas
i have got tb pcr done that is negative and mantoux that is positive..my health is gettibg deteroiated day by day.
for last three days i m having vomitings and weakness ..
what should i do the abdominal swelling is increasing ..my surgeon is now alsonin a opinion of starting empirical att.
i personally feel the problem is now increasing upto intestines level as i have diacomfort in both areas
Brief Answer:
Start ATT as per your doctors opinion.
Detailed Answer:
Hi XXXXXXX
Since you are not willing for diagnostic laparoscopy and biopsy, start ATT as per your doctors opinion.
Good luck and best wishes.
Start ATT as per your doctors opinion.
Detailed Answer:
Hi XXXXXXX
Since you are not willing for diagnostic laparoscopy and biopsy, start ATT as per your doctors opinion.
Good luck and best wishes.
Above answer was peer-reviewed by :
Dr. Shanthi.E
hi mam
thanks for the reply.
mam is it possible to see the tubercular track during cesarean delivery at the timw wen i was being operated for the baby
is there somwthing called rc 26 used at the time of operation.,and why is foreceps used during delivery.sorry to askbthis but this is something very important info for my diagnosis
mam is that possible that if i havenot taken att mybproblem is converting into fibrosis of stomach and intestine..how long does it take to become complicated..do fibrosis come into mri...which was done last week..i have still not started att but somewhere i feel this is turning into something bigger...can that track drastically become problematic overnightnor in a few days..pls guide
thanks for the reply.
mam is it possible to see the tubercular track during cesarean delivery at the timw wen i was being operated for the baby
is there somwthing called rc 26 used at the time of operation.,and why is foreceps used during delivery.sorry to askbthis but this is something very important info for my diagnosis
mam is that possible that if i havenot taken att mybproblem is converting into fibrosis of stomach and intestine..how long does it take to become complicated..do fibrosis come into mri...which was done last week..i have still not started att but somewhere i feel this is turning into something bigger...can that track drastically become problematic overnightnor in a few days..pls guide
Brief Answer:
Either have at least fine needle biopsy of the track or start ATT.
Detailed Answer:
HI XXXXXXX
Welcome back.
What about your vomiting, pain abdomen and other symptoms?
During cesarean section if the baby’s head is floating in the uterus, doctor’s need to use one blade of foreceps as lever to get the baby out. If the track was communicating with abdomen, then it would have been easily seen during cesarean. It is difficult to appreciate so called blind abdominal track of 2 cm, especially if the abdominal wall is thick.
I am not aware of what is this rc 26 used during cesarean section. May be you have got it wrong.
I know only of rc 26 pill used in Alzheimer’s disease.
Were there adhesions in the abdomen during cesarean section? That is one of the findings suggestive of abdominal tuberculosis. In tuberculosis abdomen in addition to adhesions usually there are enlarged lymph nodes. Thickening of ileocaecal valve, omental thickening, hypoechoiec lesions in liver, speen etc. Your MRI does not say any of these.
The track is not going to be problematic overnight or in few days’ time. XXXXXXX I feel if your symptoms are worsening it is not good to delay. Now that you have the knowledge, you have to decide for yourself. Either have at least fine needle biopsy of the track or start ATT.
If you have any further queries, do write to me. I will be happy to answer. I want you to get back to normalcy at the earliest.
Either have at least fine needle biopsy of the track or start ATT.
Detailed Answer:
HI XXXXXXX
Welcome back.
What about your vomiting, pain abdomen and other symptoms?
During cesarean section if the baby’s head is floating in the uterus, doctor’s need to use one blade of foreceps as lever to get the baby out. If the track was communicating with abdomen, then it would have been easily seen during cesarean. It is difficult to appreciate so called blind abdominal track of 2 cm, especially if the abdominal wall is thick.
I am not aware of what is this rc 26 used during cesarean section. May be you have got it wrong.
I know only of rc 26 pill used in Alzheimer’s disease.
Were there adhesions in the abdomen during cesarean section? That is one of the findings suggestive of abdominal tuberculosis. In tuberculosis abdomen in addition to adhesions usually there are enlarged lymph nodes. Thickening of ileocaecal valve, omental thickening, hypoechoiec lesions in liver, speen etc. Your MRI does not say any of these.
The track is not going to be problematic overnight or in few days’ time. XXXXXXX I feel if your symptoms are worsening it is not good to delay. Now that you have the knowledge, you have to decide for yourself. Either have at least fine needle biopsy of the track or start ATT.
If you have any further queries, do write to me. I will be happy to answer. I want you to get back to normalcy at the earliest.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Raju A.T
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