Chronic right hydrocoele case continued

Finally his Urine CS report is attached His S. PSA was 7.5 Please see attached case below I think its part 4 or 5 of the case Patient has been left with mild swelling of right scrotum, but still present He has not undergone PS for microfilarie as he is unwilling to give sample at night, actually a non compliant patient Purnanandam Yedavally sir , Parveen Yograj sir, Jayesh Kalbhande sir, Mrinal Kantil Pal sir Management He is currently on cefuroxime 500mg BD and Hetrazan 100mg TDS Uptil 29.03.2021

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Staphylococcus aureus is unlikely pathogen in urine infection, especially seen in chronically catheteriszed patients Colony count - is 10 raised to 4 which is not significant Therefore choice of antibiotic need not be based on Urine culture Continue same antibiotic as advised before

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I don't recollect the complete details of the case. But I think he had either a large prostate gland or prostatitis - as I concluded- and a hhigher PSA value.In addition to acute funiculitis and epiidymorcitis. Streptococcus is not a urinary pathogen and I strongly feel this is contamination. Suggest repeat c/s of urine. Psa is likely to rise in any acute lower uti .So if the psa is highin the presence of lower uti,it is of prognostic than diagnostic value. Of the psa shows deccilini trend on repeat psa exam, the premise is stregthened. If a peripheral smear at night can't be had make dobeith what you have and continue the current antibiotics.More so since he has responded. The complete resolution of the size of scrotum/testis will normally take till 3weeks after acute symptoms have diminished.So hold your horses.

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Consider netilmycin Piperacilline tazobactum Moxiflox On clinical base.

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Inj amika 500mg iM bds Doxy 100mg As chronic case combined this regime

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Doxycycline will be choice

Thanx dr Mandakini Naikwade
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* LINEZOLID .. * DOXYCYCLINE ..

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Linezolid

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SIR APPLY DASHANGALEPA OVER AFFECTED AREA TWICW DAILY C.P.VATI 1 BID OBSERVE FOR 3 TO 4 MONTHS ELSE SENT FOR SURGERY THX

Doxycycline & Inj Amikacin

General surgeon opinion...

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