Question: Hi Doctor,
Brief Case History of my father:-
He met with an unfortunate accident 2 months back on 30th of May 2016.His final CT Scan report says
he has infarct in left basal ganglia region.He is in a semi conscious state.His Right part legs and hands don't have much movements.He is on RT feed and now he has started swallowing semi-solid food as well he is taking liquid orally also.
Concerning point is he is having motions 5 times a day.He is having 7 feeds in a day 150 ml each.
What could be the reason and what medicine would you suggest?.

Hi Sir,

Today he had motions after every hour.We sent his blood culture and urine culture in lab.It seems there is some infection.

His current state:-

1.Motion happening very frequently
2.He is not looking weak though.
3.Motions are not loose motions.
4.We are giving antibiotic magnex forte from last two days.

150 ml feed we are giving in each feed which is 7 times a day.

PLease find the reports attached and advise us the medicine required.Is it advisable to give injection meromac 1 gm now?or will it be heavy dose for him?

Thanks Sir,Your reply helped a lot.

Sir,
Based on the prebious history of my father,One more question I want to ask.As my father has UTI.So one of the doctor suggested to place "Male condom catheter".There are no issues with Urine output but the concern is whenever he passes urine,he feels the immense pain that even tears starts coming out while urinating.Is this the normal behavior or some medicine or any ointment can be given to reduce his pain?

Thanks,
XXXX XXXXXXX

Hi Sir,

Your reply really helped us a lot. His UTI is over.Now there is another concern w.r.t my father.He had fever two days back then we have him dolo-650 mg and post that He vomited thrice from last three days and has severe weakness since then.He is even not accepting his full feed even though we are giving him 150 ml feed only.Motion also didn't happen for last two days.It seems there is some acidity kind of problem.He don't feel like having anything much.We are giving him light diet only. What can we give him in diet and what medicine would you suggest? He is very dull now doctor.Kindly suggest us something.

Hello Sir,

Now my father's digestion is proper.He is accepting full feed also.But Sir,he is still having fever like it starts at 100.6 and after giving Dolo-650 mg its getting down to 99.8 ->99->98.9.After every 5 hours same cycle is running.We sent his blood sample for few test like CBC and KFT.Report seems to be normal but not sure why fever is coming again and again.We are waiting for his urine culture report which will come tommorow.Not sure why this fever is coming,what could be the cause?Is this because of the viral fever?or Because of tracheostomy, though Silicon tracheostomy got placed earlier which seems to have 1 year life.We are kind of perplexed.
Kindly guide us.For your reference i am attaching my father's current activity chart and reports.

Report Name:-XXXX XXXXXXX XXXXXXX pdf
Activity chart with temperature cycle:-XXXX XXXXXXX XXXXXXX STATUS

Hello Sir,

Thanks for an instant reply. Just now we measured fever it came out to be 101 and sugar level pp is 223.As you have stated it seems to be urinary/other infection.It would be really helpful for us Sir if you can visit our home once(if at all it is possible) to see our father exact condition. Your guidance till now helped us a lot.If your home visit is not possible,then is it possible that we can come to your clinic/hospital with our father's reports.

Hello Doctor,

We got to know the root cause of my father's recurring fever.It's coming due to tracheostomy,tracheal culture report came positive.Urine and blood culture reports came negative.So what antibiotics would you suggest doctor and also it is advisable to change the tracheostomy tube or shall we remove it?Removing tracheostomy tube right now not seems to be a safer option because he has become fever and dull because of fever and all that's why his activity of taking feeds orally is reduced like anything.
Kindly suggest us medicines required to combat this infection as well as your opinion in change of tracheostomy tube.

Note:-I am attaching tracheal culture reports for your reference