Question: Hi Doctor,

I would like to:
1) receive second-opinion on the kind of treatments given to me at the moment (what else could be done to expedite the treatments? shall I see Specialist in Infectious Disease?)
2) to know if in amoebic liver abscess, is it possible that the trace of amoeba itself could not be found in both blood and pus culture?
3) to know how soon approximately I can be discharged from the hospital with current condition and what are the typical post-hospitalization care/treatment needed

Condition:
I am undergoing treatments for liver abscess. I suffered the symptoms (fever, shivering, general weakness, flatulence - I then consumed paracetamol) since 24-December 2016 and the liver abscess itself was discovered on 05-January 2017. I was admitted to hospital on 07-January 2017 and went through first procedure to drain the pus on 09-January 2017. I am taking IV now and 2 antibiotics (Flagyle and Ciprobay). I have two globules of pus in liver (10cm diameter and 5cm diameter), the bigger one had been drained out. Tube is set on the second globules and I am still waiting for it to be drained out too. Doctor suspected that this is amoebic liver abscess, however blood and pus culture shows no sign of amoeba nor other bacteria. Gastroscopy and Colonoscopy have been done only to find everything is good. Fever on the first day of admission was 39C, it subsided as soon as the first drainage was done (09-Jan-2017), then it shot up again on 13-Jan-2017 to 39C. Doctor did another procedure to adjust the drain tube to take out more pus on 14-Jan-2017. White blood cells started at 27 on 07-Jan-2017 and at 16 on 14-Jan-2017 (now).

Please share your thoughts. Thank you very much!

Best regards,
XXXX

Thank you very much Doctor!

Endoscopy with tubes throught mouth and anus had been done to me three days ago. doctor pumped in gas to open up my intestines and to observe them better. It makes my stomach feels bloated with gas. It gives me nausea feeling at times and I was given IV, nutrition milk, and soups to eat daily. What would you suggest me to do/eat to push out the gas out of my stomach and intestines faster?

Doctor in charge says this is might be because my intestines move much slower than normal due to infection thats why I can not fart/pass wind out of my stomach. Thanks Doctor!

Hi Doctor,

Thanks for being super helpful! The last Xray shows that my small intestines are not moving. Thus causing the gas to stay there and gives me bloated tummy. They do NG/nasogastric to suck out liquid and gas from my tummy. They hope this can reduce bloated tummy as well as to make my small intestines come back as normal or actively moving. I was told to just wait till small intestine moves on its own. No medication can help. What is your opinion on this?

Next, xray also shows that I have water in one of my lung now (one above the liver). I was told that maybe this is because liver infection. What happens here? Can this water be gone by itself?

Thank you.

Dear Doctor XXXXXXX XXXXXXX

Thank you so much for helping us. May God bless you and family. Would be my last questions below:

1. What might cause the fever?
The second tube attached to liver (to drain pus) was taken out on 18 XXXXXXX 2pm (before this patient has no fever in the last 48 hours, White Blood Cells went down from 16 to 12, almost normal). There was great pain on the hole and painkiller was given to cure the pain after 2 hours. It was suspected that since the tube was in the liver for 3 days, flesh might have grown around it hence when taken out, flesh/tissue was torn and caused the pain.
It still causes a bit of pain till now (20 XXXXXXX 3pm). After tube was taken out, surprisingly patient experienced fever again for three times till now 20 XXXXXXX 3pm. Fever were at 37.8, 37.8, and 38.4 celcius. What might cause this? The scar or the remaining abscess in liver? If it is the latter, does it mean, we need to put tube to drain more pus again?

Note: IV drips have been stopped and patient takes the antibiotics orally. In general, patient feels stronger actually.


2. Shall the patient expect to experience fever during his time out of the hospital?
What are the signs we need to go back to Doctor to check his abscess?
Patient was expected to be discharged in 2-3 days time and need to take antibiotics regularly for the next 6-8 weeks. During this time, shall we expect patient to experience fever? And most importantly, what are the signs that issue has not been resolved and we need to go back to Specialist to check his condition?

Thank you so much Doctor!