Culture and sensitivity test of abscess drainage shows E.coli. Is it required to conduct TB test?

Question

Hello doctor,

My samples were taken for culture and sensitivity tests and a TB test during the abscess drainage. However, the TB tests could not be successfully conducted due to certain medical reasons. The culture and sensitivity test showed the presence of E.coli bacteria. I was prescribed antibiotics that are sensitive to E.coli for a duration of five days following the surgery. I was prescribed Amoxicillin with Clavulanic acid, Cefuroxime, Linezolid, and Clarithromycin. Is it necessary to conduct additional tests for TB? Also, will the CT scan be performed with contrast? This concern arises from my previous experience after the last CT scan with contrast, which resulted in high fever, chills, and vomiting. Kindly provide your opinion.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern. Based on the information you provided, It seems that there have been no culture and sensitivity tests conducted on the fluid before administering antibiotics, which may explain why the infection has recurred. Additionally, it is necessary to remove the formed sinus and administer long-term antibiotics. Fortunately, it appears that the infection has not spread to the peritoneum, which could have resulted in various complications. However, since three months have passed since the last CT (computed tomography) scan, I suggest you undergo another CT scan of the abdomen to assess the current status. Two positive aspects are that there seems to be improvement in the condition, and there is no involvement of the peritoneum, suggesting that more intensive therapies could lead to recovery. The next CT scan does not need to involve contrast, but rather a plain, high-resolution, 64-slice (possibly) CT scan of the abdomen and pelvis. I suggest you undergo a chest CT image also to rule out other potential causes as well. Additionally, the drainage fluid after surgery should undergo antibiotic susceptibility tests to determine the most appropriate antibiotics and their combinations for this instance. I suggest you consult a gastrointestinal surgeon for further management. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern. It does not appear to be necessary since E. Coli has already been diagnosed. However, as a precautionary measure, you can undergo the abdominal TB test. Based on the information you provided, you do not exhibit symptoms of TB. Alternatively, you may consider undergoing a blood test called TB Gold (RT PCR). I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Answer 3

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern.I would like to inform you that a chest CT scan is necessary to facilitate the differential diagnosis of noninfective causes and to assess for any potential spread to the pleural or lung areas. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Answer 4

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern. I would like to inform you that drainage is an appropriate approach as long as the perioperative and postoperative antibiotic regimen is evidence-based. This means that the antibiotic therapy should be determined based on antimicrobial susceptibility and resistance testing of the drainage fluid. I suggest you consult a gastrointestinal surgeon to rule out any potential peritoneal spread during and after the surgery. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Answer 5

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern. I suggest you undergo antibiotic culture and sensitivity tests, and receive the perioperative and postoperative antibiotic therapy accordingly. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.