Fluid collection concerning infection

[drl143]

How can a doctor be sure a patient does not have an infection when a MRI report states that there is rim enhancing fluid collection anterior to the L5/S1 disc space concerning for infection?


This discussion is related to chronic bad infection post spinal surgery.

[DrKalraMD]

Hi, doctor’s rely on clinical presentation rather than reports which can be at times misleading and in contrast to clinical presentations but reports have lot of importance if they co related well with clinical picture.

Please have faith in your doctor, collection of fluid does not always mean infection. Please write down full report.

[singh_ab]

Please Help -
I developed an Inflamation (inflammation) on the right side of neck right after playing cricket . Initially i thought it was a msucle pull and would go away on its own but it did not . I consulted an ENT surgeon to get it checked and he suggested that i get a Sonograpgy done . The report of the Sonography is -

Technique - Ultrasonography of the neck was done using a high frequency Linear Transducer .

Observation -
There is a collection seen in the right side of the neck .
This lies deep to the Sternocliedomastoid Muscle .
This collection Measures 3.5 x 2.3 x 3.5 Cm
It is thick walled and Show Multiple Internal Echoes.
The right IJV is Mildly Compressed in the region of this collection .
The right Carotid Vessels are Normal
The Thyroid Gland Shows Normal Appearances .
Several Lymph nodes are seen in the right side of the neck . These are subcentimeter in Diameter .

Impression :
Collection in the right side of neck deep to the sternocliedomastoid muscle . Differential Diagnostic Possibilities would Include -
1.) Resolving Hematoma.
2.) Abscess
Advice - Aspiration and Further Management .

After the Sonography Results i was given medication which included

1. Augmentin 625 MG (2 Times a Day )
2. Enzoflam (2 times a Day )
3. chymoral Forte (3 Times a day )
4. Roles D (Once a day )

I continued with these medicines for about one and a half week and after that the swelling started subsiding . All of a sudden due to physical activity (dancing ) it increased again and now the doctor says that i should get aspiration done .

My questions -
1. Is an ENT the right doctor to goto or should i goto a general surgeon or some other specialist ?
2. How serious is it and what are the possibilities ?
3. what could have caused it ? is it strenous physical activity (all of a sudden ) or is it a dormant infection which became visible right after the muscle pull ?
4. Medically how should i proceed . Should i get the aspiration done or there are other tests that i should focus on ?
5. Am i doing the right thing by avoiding aspiration ?
6. Are my lymph nodes normal or is it an Infection of the Lymph Nodes ?

Would really appreciate if someone could  help me with this as this is killing me .

Abhishek
singh_ab***@****

[DrKalraMD]

Hi, since it is recurrence of fluid collection, aspiration of fluid is must followed by acid fast staining, gram staining and culture sensitivity of fluid to find out the organism responsible, it is important to rule out tuberculosis or tubercular abscess.

Please consult surgeon or physician for further management.