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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Does Paracardiac Pneumonia Suggest?

I am an physician, I have a patient 19 year old female with one and half month history of fever treated elsewhere with various antibiotics like doxy, oflox, rifampicin. Blood counts normal.ESR normal. Brucella is 1:320 two fold rise in 15 days, X ray shows left paracardiac pneumonia. Pt looks toxic. What do you experts feel
Tue, 12 Jan 2016
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Pulmonologist,  's  Response
Thanks for your question on Health Care Magic.
I can understand your concern.
If patient is looking toxic, with left paracardiac haziness and not improving with routine antibiotics, she needs
1. CT thorax
2. Sputum culture and sensitivity report
3. Bronchoscopy with BAL (bronchoalveolar lavage) analysis.
CT scan will diagnose if other abnormality is there or not.
Sputum culture wil isolate the causative organism and sensitivity report will guide about effective antibiotic treatment.
If sputum is not available then patient needs Bronchoscopy and BAL analysis.
She may need higher antibiotics and other supportive drugs.
So consult pulmonologist and discuss all these.
Hope I have solved your query. I will be happy to help you further. Wishing good health to your patient. Thanks.
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What Does Paracardiac Pneumonia Suggest?

Thanks for your question on Health Care Magic. I can understand your concern. If patient is looking toxic, with left paracardiac haziness and not improving with routine antibiotics, she needs 1. CT thorax 2. Sputum culture and sensitivity report 3. Bronchoscopy with BAL (bronchoalveolar lavage) analysis. CT scan will diagnose if other abnormality is there or not. Sputum culture wil isolate the causative organism and sensitivity report will guide about effective antibiotic treatment. If sputum is not available then patient needs Bronchoscopy and BAL analysis. She may need higher antibiotics and other supportive drugs. So consult pulmonologist and discuss all these. Hope I have solved your query. I will be happy to help you further. Wishing good health to your patient. Thanks.