Suggest Treatment For Recurrent Bacterial Infection And Fever

Posted on Thu, 10 Sep 2015

Question: Sir,
My Father's name is XXXX. He is has heart right bundle branch block for nearabout 10 years and asthma for 20 years. He is taking Calaptin 40 thrice, Cloptab75, Atorvastatin Caat 40 and seroflo 250 inhaler and asthalin sos.
Recently about 2 mnth ago he suffered accident and got trochanteric fracture near right femur. He undergone Femur fixation by zimmer company plate . He has no complan about infection from that part.
About 4 days ago my father is suffering from throat infection with dry cough not of much important.. Doctor consulted and given Augmentin Duo 625 twice for 6days and Levokast for 6 days. But suddenly at prvious night my father got fever about 102 deg. and also at morning 100 deg. Again doctor called for safety. Blood test done and Found Total Count increased 13400 (normal 6000-10000)
Platelet count slightly decreased 1,40,000( normal 1,50,000-4,50,000).. Neutrophil 75% (40-80), lymphocytes 21% (20-40), monocytes 1% (2-10%), Eosinophils 3% and Basophils 0%. ESR 20 in 1st hour(men <20). C-reactive protein 6.4 mg/L (normal less than 6). Malaria and dengue test found negative.
Doctor again prescribed LIZOFORCE-600 TABLET( linezolid) for bactereial infection and said that the fever is due to infection at operation sight. Is that really due to operative infection or due to cold infection and what 2 do? please suggest me.

Answered by Dr. Tushar Kanti Biswas (1 hour later)

Brief Answer:
Bacterial infection in an elderly

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.

Fever with leucocytosis (total WBC count 13,400/c mm) with predominant neutrophils( 75 %) goes in favor of bacterial infection. Dose the neutrophils showed any toxic granules on peripheral smear report?

Throat infection (causing dry cough) itself may be the source of infection.Upper respiratory infection is mostly viral but often gets complicated by secondary bacterial infection.

Is there any pain at right hip joint or close to the site of operation?
If painful , x-ray right hip joint would be advised to rule out any bone infection causing fever and leucocytosis.

Both Augmentin (amoxicillin and clavulanate potassium)and Lizoforce ( Linezolid) are potent antibiotics against a host of bacterias.

Regards

Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Tushar Kanti Biswas (2 hours later)

Yes he is sensing pain after walk. Just 2 mnth has gone. x-ray report 20 days ago shows 67% cure and no infection. He sometimes fill pain after too much exercise. But that according to Orthopaedic surgeon will remain. Butv 3 days ago my father suffered havoc pain.
99.2 deg temp now maintaning continuously.
What 2 do

Answered by Dr. Tushar Kanti Biswas (1 hour later)

Brief Answer:
Fever with leucocytosis in an elderly-and fracture femur neck rt (optd.)

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.

Your father needs to continue the antibiotics as prescribed and repeat complete blood count after 3 days of treatment to see if WBC count is coming down or not.Subjectively his fever spikes have reduced (99.2 degree F). Your father has also bronchial asthma and hence lower respiratory tract infection is not unlikely. If WBC count increases and pain right hip escalates, MRI hip joint will be needed as plain x-ray won't pick-up clearly soft tissue infection.

Regards

Dr. T.K. Biswas M.D. XXXXXXX

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj