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Dr. Andrew Rynne

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What causes post nasal drip when suffering from enterobacter aerogenes in navel?

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Dr. Shafi Ullah Khan

General & Family Physician

Practicing since :2012

Answered : 3614 Questions

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Posted on Sat, 30 Aug 2014 in Infections
Question: I have had enterobacter aerogenes present in my navel -sinus for at least 6 months. Been treated by a number of anti-biotics. Can not seem to get rid of organism. Can this cause my severe post nasal drip-stream?Been treated for severe post-nasal drip-stream with astepro,dymista,atrovent,singular. Also shot of kenalog 40,QNASAL. nothing has helped my condition. Had allergy tests done-all negative. Have also ruled out acid re-flux causing my condition. Have had upper G-I ,esophagogastroduodenoscopy tests done -showed tiny hiatal hernia. treated with omeprazole-40 mg for 6 weeks and dexilant-60 mg for 3 weeks.No improvement !!
please advise
doctor
Answered by Dr. Shafi Ullah Khan 1 hour later
Brief Answer:
Needs management.

Detailed Answer:
Thank you for asking
I wonder and doubt the quality of medical care. Blind management with barrage of antibiotics like bullets should have been substituted by a simple drug susceptibility test and culture sensitivity to get rid of the organisms. Postnasal dripping with any upper respiratory tract is possible. Blind management is not the solution here. Hiatal hernia if slight may cause the recurrence and consult to a gastroenterologist regarding the pros and cons of its surgical fixation needs to be discussed.
Also anatomical Perspective of respiratory tract like sinus congestion and variabilities like deviated septa etc also needs to be considered here.
No matter how resistant the organism is, there is a way to get rid of it.. Just a competence and caliber is needed which you have been missing last six months.
Nutshell, Get a competent otorhinolaryngologist and and gastroenterologist and let them decide what is best for you.
I hope it helps.take good care of yourself and dont forget to close the discussion please.
May the odds be ever in your favour.
Regards
Khan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shafi Ullah Khan 37 minutes later
I have had C-T scan of sinus. No -structural problems found. Also Immunoglobulins test-all results in standard range.
The very reputable gastroenterologist that I saw ,said he doubted any connection with my slight stomach issues and my severe post nasal drip-stream. I have no sinus congestion, just severe post nasal stream. I have had my sinus scoped many times by many ENT doctors-all say my sinus is clear(even use the word pristine to describe)yet enterobacter aerogenes shows up when my sinus is cultured.
I am presently on my 4th ENT doctor. All pretty much do the same, treat the symptoms not the cause.
Please advise
I have had 4 culture sensitivities test done all come up with the same results. that is the reason I have been prescribed the various antibiotics . that correlate with the culture sensitivities. Infectious DR. ?
doctor
Answered by Dr. Shafi Ullah Khan 1 hour later
Brief Answer:
SOme dot is missing.

Detailed Answer:
Thank you for getting back to me.
I seriously doubt the persistence of an organism after the 6 months of different antibiotics all responsive to the culture. Something is wrong. Transmission source is persistent, management is insufficient, other options we discussed already and also a misdiagnosis but 4 times culture with same result rules that out.
Immune status assessment to rule out any compromise is also advised. As there is no other sane option with sensitive antibiotics no correlated morbidity and healthy immune system to resist the healing. Something is wrong and that something needs a lot of work up to find out. Infectious disease specialist it is.
Please get to them and let them connect the dots. Its beyond the scope of this discussion.
I hope you see it in a right perspective.
Take care
Khan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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