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Suggest Treatment For Severe Cough And Gastric Issues After Angioplasty

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Posted on Mon, 20 Feb 2017
Question: Hi dr
My dad age 65 underwent angioplasty on XXXXXXX 1st
After that he was discharged on 6th XXXXXXX and had symptoms of cough plus with mucus and difficult to hawk out
Gastric complaints plus
Had low sodium on 12th XXXXXXX Bp went down was admitted again and started with broad spectrum antibiotic
Meneperum 1gm tds Iv
T planin od
Levoflox od iv

His sodium was improved giving back 3% and sodium capsule

His tlc was high for which the antibiotics was started and it was fluctuating
From 13-19 -24 -19-13-9 And he was discharged on 20th XXXXXXX
Morning his reports shows sodium 136
Tlc19.6 and it was increased in a gap of2 days
He has fever also
Dr did procalcitonin and it was 0.27 and allowed to get discharged as he said it's better marker for bacterial infectionand it's Normal
While he was in icu he was given 3 days azithromycin also bd .14-16 XXXXXXX
He never had fever during 1-20jan
He had coughon 18th night azithro given again
Cough reduced
19th again cough and fever
Given dolo650 and azith and fever comes down
Dr advised to take voritek 200 mg bd and then od for 7 days

Question why he has fever even though antibiotic is on
Second can voritek and azithromycin be taken together
Current prescription
Cerfux
Precin
Foracort inhaler bd
For respiratory and
Telecast along with cardiac med
Voritek

What is the diagnosis and how long treatment needed
He has cough with slight mucus and mostly dry cough and fever now .fever 101 .4
Chest x ray clear though
Is it atypical pneumonia which was better and reoccurred ??
Is tlc a worrisome ??
doctor
Answered by Dr. Drkaushal85 (15 hours later)
Brief Answer:
High TLC is always worrisome.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.

Answer to your 1st question.

He is having infection for sure because he is having fever an high TLC.

Answer to your 2nd question.

Yes, voriconazole and azithromycin can be used taken together. No worries in it.

Answer to your 3rd question.

Possibility of infection is more and more likely in lungs because he is having coughing. Chest x ray can be normal in atypical infection. In my opinion, CT thorax should be done because CT thorax is excellent tool for lung infection.

Answer to your 4rth question.

Yes, possibility of atypical pneumonia is more. And yes high TLC with fever is always worrisome.

Hope I have solved your query. I will be happy to help you further. Wishing good health to your father. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Drkaushal85

Pulmonologist

Practicing since :2008

Answered : 15006 Questions

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Suggest Treatment For Severe Cough And Gastric Issues After Angioplasty

Brief Answer: High TLC is always worrisome. Detailed Answer: Thanks for your question on Healthcare Magic. I can understand your concern. Answer to your 1st question. He is having infection for sure because he is having fever an high TLC. Answer to your 2nd question. Yes, voriconazole and azithromycin can be used taken together. No worries in it. Answer to your 3rd question. Possibility of infection is more and more likely in lungs because he is having coughing. Chest x ray can be normal in atypical infection. In my opinion, CT thorax should be done because CT thorax is excellent tool for lung infection. Answer to your 4rth question. Yes, possibility of atypical pneumonia is more. And yes high TLC with fever is always worrisome. Hope I have solved your query. I will be happy to help you further. Wishing good health to your father. Thanks.