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DrRussMD
DrRussMD, Board Certified MD
Category: Medical
Satisfied Customers: 64363
Experience:  Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
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Close friend abroad- wants to know if can avoid surgery

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For a close friend abroad- wants to know if can avoid surgery and take antibiotic injections instead and what type? or any another treaments you can recommend? thank you.
- a chronic discharging sinus at the left anterior lateral chest wall which has caused localized rib osteomyelitis as well as spread into the inner thoracic space but confined. No focal liver parenchymal masses detected and important to exclude diabetes mellitus.
Lab test indicate profuse growth of Staphylococus aureus- (Anaerobic).
- At the left anterior lateral chest wall a sinus cavity, with irregular tracks is demonstrated.
- This has caused infective inflammatory process at the subcutaneous layer as well as involving the pectoralis major muscle at this site.
- There is also irregular expansion of the 7tl'anterior rib at this site which shows evidence of cortical breakdown.
- There are lymph nodes within the diaphragmatic fat adjacent to the lesion.
- Further anterior lateral within the inner thoracic space and abutting the left lobe of liver a well circumscribed soft tissue mass approximately 4 x 3cm in size is demonstrated.
The mass has a density averaging 18 Hounsfield units and means rich proteinaceous fluid.
- A chronic abscess cavity at this therefore suspected.
- This would then indicate evidence of spread of the infective inflammatory process into the inner thoracic space.
- No mediastinal lyrnphadenopathy or vascular masses detected.
- The thoracic aorta has normal integrity,.
- Lung fields are clear and demonstrate no parenchymal nodularity, no lung masses or septal thickening.
- No pleural effusions or calcifications are detected.
- The thoracic vertebral bodies as well as the sternum are normal.
Submitted: 1 year ago.
Category: Medical
Customer: replied 1 year ago.
For a close friend abroad- wants to know if can avoid surgery and take antibiotic injections instead and what type? or any another treaments you can recommend? thank you.
- a chronic discharging sinus at the left anterior lateral chest wall which has caused localized rib osteomyelitis as well as spread into the inner thoracic space but confined. No focal liver parenchymal masses detected and important to exclude diabetes mellitus.
Lab test indicate profuse growth of Staphylococus aureus- (Anaerobic).
- At the left anterior lateral chest wall a sinus cavity, with irregular tracks is demonstrated.
- This has caused infective inflammatory process at the subcutaneous layer as well as involving the pectoralis major muscle at this site.
- There is also irregular expansion of the 7tl'anterior rib at this site which shows evidence of cortical breakdown.
- There are lymph nodes within the diaphragmatic fat adjacent to the lesion.
- Further anterior lateral within the inner thoracic space and abutting the left lobe of liver a well circumscribed soft tissue mass approximately 4 x 3cm in size is demonstrated.
The mass has a density averaging 18 Hounsfield units and means rich proteinaceous fluid.
- A chronic abscess cavity at this therefore suspected.
- This would then indicate evidence of spread of the infective inflammatory process into the inner thoracic space.
- No mediastinal lyrnphadenopathy or vascular masses detected.
- The thoracic aorta has normal integrity,.
- Lung fields are clear and demonstrate no parenchymal nodularity, no lung masses or septal thickening.
- No pleural effusions or calcifications are detected.
- The thoracic vertebral bodies as well as the sternum are normal.
Expert:  Dr. David replied 1 year ago.
This is Dr. Davidyour friends abscess sounds quite serious.how old is your friend?does your friend have HIV or diabetes or use drugs. these can decrease his immune system and cause these abscess infections.most people don't get abscesses of the chest wall like this.MRSA methacillin resistant staph aureus infection also has to be ruled out.has his doctors recommended surgery for him. if they have recommended surgery, that might be the best option for him or her at htis point.
Expert:  DrRussMD replied 1 year ago.
HelloI would like to give you a definite answer to your question.Drainage of the abscess is a minimum, required surgical intervention.This along with the correct antibiotics, systemically, can avoid the need for more advanced surgery.There is no might or maybe here, a combination of antibiotics and surgery are needed; both are required.I am a double board certified US clinical doctor.Besides internal medicine, I am also board certified in integrative medicine.Please click a positive here.If you would like to discuss alternative therapies, let me know, or find me by request in medical.There are alternative medical approaches, but they are very tricky, and must be handled by the correct individual. OK, so that is an initial answer….Please use reply to expert if you have further questions. When you are ready, please click a positive rating [hopefully excellent]. If you forgot something, come back. I am here daily.
Customer: replied 1 year ago.
For a close friend abroad- wants to know if can avoid surgery and take antibiotic injections instead and what type? or any another treaments you can recommend? thank you. - a chronic discharging sinus at the left anterior lateral chest wall which has caused localized rib osteomyelitis as well as view full spread into the inner thoracic space but confined. No focal liver parenchymal masses detected and important to exclude diabetes mellitus. Lab test indicate profuse growth of Staphylococus aureus- (Anaerobic). - At the left anterior lateral chest wall a sinus cavity, with irregular tracks is demonstrated. - This has caused infective inflammatory process at the subcutaneous layer as well as involving the pectoralis major muscle at this site. - There is also irregular expansion of the 7tl'anterior rib at this site which shows evidence of cortical breakdown. - There are lymph nodes within the diaphragmatic fat adjacent to the lesion. - Further anterior lateral within the inner thoracic space and abutting the left lobe of liver a well circumscribed soft tissue mass approximately 4 x 3cm in size is demonstrated. The mass has a density averaging 18 Hounsfield units and means rich proteinaceous fluid. - A chronic abscess cavity at this therefore suspected. - This would then indicate evidence of spread of the infective inflammatory process into the inner thoracic space. - No mediastinal lyrnphadenopathy or vascular masses detected. - The thoracic aorta has normal integrity,. - Lung fields are clear and demonstrate no parenchymal nodularity, no lung masses or septal thickening. - No pleural effusions or calcifications are detected. - The thoracic vertebral bodies as well as the sternum are normal.
Expert:  DrRussMD replied 1 year ago.
HelloI don't think you saw by answer.This is a surgical case.Period.At minimum the abscess must be drained and antibiotics must be started.I printed this extensively above.Please review that answer from Dr. Thomas. OK, so that is an initial answer….Please use reply to expert if you have further questions. When you are ready, please click a positive rating [hopefully excellent]. If you forgot something, come back. I am here daily.
Customer: replied 1 year ago.
Thank you for both your replys. He is 63 yrs old. He has no diabetes or HIV.
He has had plenty of lab tests and CT scans ongoing- and had operations before 2yrs back and has done abcess drainage before but it keeps on re occuring with no success. As there has been no progress after operations, he looking for an alternative method as they didnt work previously.
He had been injected many weeks with "gentimicin- with no effect.
His doctor has currently prescribed the tablets named Ciprofloxacin as an antibiotic. But it has not killed the bacteria- Staphylococus aureus- (Anaerobic)- gram negative bacteria and has spread but confined. He is in alot of pain.
1- Please can you assist him with Antibiotic names that work for him - injection or tablet form.
2- Can you help with the advice of "ALL alternative medical approaches " as options as you mentioned. thank you.
He is interested in this approach more than surgery as it didnt work before.
3- If he takes surgery - what would be the process you recommend so he can compare it to the advice his doctor.
He appreciates your help. Thank you and i await to hear from back you.
Expert:  DrRussMD replied 1 year ago.
If drainage has not worked, he needs an open surgical procedure to clear it up.He should find the best surgeon he can. OK, so that is an initial answer….Please use reply to expert if you have further questions. When you are ready, please click a positive rating [hopefully excellent]. If you forgot something, come back. I am here daily.
Customer: replied 1 year ago.
- Thank you for helping - i no now there is no option but surgery, - What would be the right surgical procedure for him?
- Another doctor sugested being injected him with the drug Amakacin - could that clear it up. Would that ever work?
Thank you for all your help , you are helping him decide the right choice. Ure a star!
Expert:  DrRussMD replied 1 year ago.
The procedures is called debridement.No amakacin is simply another antibiotic.The problem is the complicated abscess. Please don't forget a positive rating.We are only paid per rating, for bonuses, etc.I am here daily in medical.You can find me by request anytime.dt
Customer: replied 1 year ago.
After surgery will he able to walk etc.... What state will he be in. How long will he take to recovery. Is there a chance it could reoccur again?thank you!
10/10/2015 04:37
- Thank you for helping - i no now there is no option but surgery, - What would be the right surgical procedure for him?
- Another doctor sugested being injected him with the drug Amakacin - could that clear it up. Would that ever work?
Thank you for all your help , you are helping him decide the right choice. Ure a star!
Expert:  DrRussMD replied 1 year ago.
Yes.6 weeks to main recovery.surgical debridement.Amakacin is just another antibiotic.The problem is a comlicated abscess. The procedures is called debridement.No amakacin is simply another antibiotic.The problem is the complicated abscess. Please don't forget a positive rating.We are only paid per rating, for bonuses, etc.I am here daily in medical.You can find me by request anytime.dt
Customer: replied 1 year ago.
After debridement. surgery will he able to walk etc.... What state will he be in. How long will he take to recovery. Is there a chance it could reoccur again? Ure a star!!! i will leave you excellent feed back after. thank you Dr : )
Expert:  DrRussMD replied 1 year ago.
As I saidYes he will6 weeks to main recovery.Out of the hospital in a day or two.It would not be likely to recur.
Customer: replied 1 year ago.
Thank you : ), Thank you : ), Thank you : ), Thank you : ), Thank you : ), Thank you : ), Thank you : ), Thank you : ), Thank you : ), Thank you : ), Thank you : ), Thank you : ), Thank you : ), Thank you : )...
Expert:  DrRussMD replied 1 year ago.
You are welcome....please click a positive rating.....
DrRussMD, Board Certified MD
Category: Medical
Satisfied Customers: 64363
Experience: Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
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