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Dr. Andrew Rynne

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Exp 50 years

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Taking Doripenam, Linozilid and Hetrazan for rising TLC count and painful scrotal swelling

Hi,

My father aged 57, Diabetic and having gouty arthritis was admitted in hospital with chills and Fever around 102 F. His TLC count was 22000 at that time.He was given Doripenam for 8-9 days.There was also Prostate enlargement, PSA-9.1, burning urination and pain while urinating. All the symptoms subsided after day 4. Dynapress was also started.First day Urine culture report was missing and after 2nd sample was taken on third day, it came sterile. He was discharged from hospital with Farobact 200 and Dynapress added.After 4th day, Farobact was discontinued.Fever recurred a couple of times and we found E.coli in the urine culture report after 15 days.Farobact was started again and the report came as sterile.One day the fever went to 104, Nucoxia, Paracetamol was given and it was controlled.After a week, there was abdominal pain and bitter vomiting and he was again admitted and Imipenam Cilastin was given till the report came Staph Positive and resistant to all antibiotics except Linozolid. TLC reached 40000. Linozolid started and TLC came to 17000.Hetrazan was also being given as there was painful scrotal swelling doubting Filariasis. Doctor also started giving Ertapenam.There is no fever from Day 1.BP was on lower side initially which is now stable.The problem is fluctuating TLC.It has became 12000 but again it is around 16.8.
Wed, 4 Dec 2013
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General & Family Physician 's  Response
Hello,
It is better to go for Differential count rather than Total Lymphocyte count.
Because white cells count (TLC) compraise of following cell counts i.e neutrophils (increase is called as neutrophilia), lymphocytes (Increase is called as lymphocytosis), monocytes (Increase is called as monocytosis), eosinophils (Increase is called as eosinophilia) or basophils (Increase is called as basophilia). This can be judged by a differential leukocyte count.
In addition to Infection, White cells may be increased in cancers (leukemia), Allergy.
It also better to go for peripheral smear report.
It will additionally yield the information about the size and shape of white blood cells in blood,
If all these are normal, then Bone marrow biopsy may be necessary to yield the diagnosis.

Hope this helps.
Please write back for further queries.
Wishing you good health.
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