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Case
Создана
Harold Gomez
⟶ Обновлено 4 фев 2018 ⟶
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События
Onset of abdominal pain
Presentation to OSH Admission for PNA ceftriaxone, metronidazole, and azithromycin
Febrile, paracentesis: peritonitis Pseudomonas Cefepime and metronidazole
Repeat paracentesis Secondary peritonitis US: loculated ascites CT A/P: no abscess Vancomycin
Transfer to HFH IR guided paracentesis with drain ACS consult
ACS evaluation: SBP, poor surgical candidate, Drain removed
Laparoscopy converted to laparotomy Abscess drainage and appendectomy Perforated appendix and complex abscess
CT A/P Fluid cultures from 01/22 positive for Enterococcus, citrobacter freundii and Lactobacillus
ACS: diagnostic laparoscopy, possible exploratory laparotomy
Daptomycin and meropenem
Surgical pathology: no appendix identified
Cultures from 01/25: Candida dubliniensis Eraxis
Discharged to SAR on IV antibiotics