question-icon

What does my TLC result report indicate?

default
Posted on Sat, 4 Feb 2017
Question: hi my dad is 65 had angioplasty right coronary artery XXXXXXX 1st
tlc reports 24000 increased from 12000 in last 6 days and from 17000 to 24000 last night
had low sodium 117 and pottasium 2.5, stupour and weakness noticed
he is on antibiotics in iv tanzact and now menopina 500 mg
usg normal x ray normal gastric c/o +,
had enema last evening after admitting him
, bp was low and so he was admitted
what treatment to be given

urine shows pus cells 0.1 hpf
culture reports pending
k/c/o prostate grade 2
doctor
Answered by Dr. Sagar Makode (49 minutes later)
Brief Answer:
Needs broad spectrum antibiotics, potassium and sodium correction.

Detailed Answer:
Hello,
First thing in his, infection, source of which is probably Urinary tract infection. Pus cell report you mentioned is probably wrong, you have mentioned 0.1, it must be more. Culture is already sent , we need to collect it urgently so as to guide the antibiotics to be chosen. We also need to get ultrasound of kidneys and prostate in order rule out their infection.
Next thing is which antibiotics to be given, I whatever he is receiving is fine, but better option would be a combination of tazact and gentamicin if kidney function is normal. Antibiotics will be guided by culture and by the response of the patient like if tlc is increasing inspite of 48 hrs of antibiotics then we need to change it.
Next thing is his low sodium which is a probable cause for his stupor, we need to correct it with 3% NaCl or oral Salt which your doctor must be doing. Also the cause for it, probably diuretics should be modified. His potassium is also low which is dangerous which needs to be corrected promptly with intravenous potassium and oral potassium syrup.
You also mentioned his bp is low so all his bp medicine should be stopped and he ll bp increasing medicine called as ionotropes, if bp is low and urine quantity is decreasing. Antiplatelets must be continued otherwise may lead to stent blockage.
So in nutshell infection is the culprit here, which can treated with antibiotics and other supportive care.
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
default
Follow up: Dr. Sagar Makode (1 hour later)
Dear Dr
Thanks for the prompt reply
Bp is normal, probably all are guessing as urine infection, broad spectrum antibiotic is on meronem 500 iv tds
levoflox 100 iv od
injection tazact 4.5 gm given on 12/1 and 12/1 at 6 am and 2 pm
ecosprin 75 mg od
clopitab 75mg od
atorva 25 mg od
eptus 25 mg od
inj pantop 10 mg bd
cap. gonatine od
salt capsule 2 tds
syp potklor 2tsf tds
powder peg move bd
nebulization with levolin tds
silofast d8 for prostate
targocid 400 mg od now

urine culture and blood culture is under process , it takes 48-72 hrs

tlc 24000
dlc
neutrohil 89
lymphocyte 6
eosinophil 0
monocyte 5
basophil 0

serum urea 123mg/dl
serum creatinie 1.07mg/dl
serum magnesium 3.06

what should be expect with this treatment line. and how soon we can expect changes
doctor
Answered by Dr. Sagar Makode (9 minutes later)
Brief Answer:
Treatment is okay and we can expect the recovery

Detailed Answer:
Treatment is fine, they are covering from all the angles. Normal bp is good sign, I think he will respond within 48 hrs and recover completely in a week if no resistant organism is grown on culture. All the best.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Sagar Makode

Cardiologist

Practicing since :2013

Answered : 1823 Questions

premium_optimized

The User accepted the expert's answer

Share on
What does my TLC result report indicate?

Brief Answer: Needs broad spectrum antibiotics, potassium and sodium correction. Detailed Answer: Hello, First thing in his, infection, source of which is probably Urinary tract infection. Pus cell report you mentioned is probably wrong, you have mentioned 0.1, it must be more. Culture is already sent , we need to collect it urgently so as to guide the antibiotics to be chosen. We also need to get ultrasound of kidneys and prostate in order rule out their infection. Next thing is which antibiotics to be given, I whatever he is receiving is fine, but better option would be a combination of tazact and gentamicin if kidney function is normal. Antibiotics will be guided by culture and by the response of the patient like if tlc is increasing inspite of 48 hrs of antibiotics then we need to change it. Next thing is his low sodium which is a probable cause for his stupor, we need to correct it with 3% NaCl or oral Salt which your doctor must be doing. Also the cause for it, probably diuretics should be modified. His potassium is also low which is dangerous which needs to be corrected promptly with intravenous potassium and oral potassium syrup. You also mentioned his bp is low so all his bp medicine should be stopped and he ll bp increasing medicine called as ionotropes, if bp is low and urine quantity is decreasing. Antiplatelets must be continued otherwise may lead to stent blockage. So in nutshell infection is the culprit here, which can treated with antibiotics and other supportive care.