Lee was a 62 year old patient suffering from congestive heart failure. He had be

Question

Lee was a 62 year old patient suffering from congestive heart failure. He had been a type I diabetic since age 18 and his blood sugar levels were not well controlled. The ravages of this disease coupled with Lee's two pack/day cigarette habit had led to a massive coronary at 40. Lucky to have survived, Lee now took his physician's advice seriously. He stopped smoking and finally monitored his blood sugar levels, diet, and insulin, as directed Unfortunately, the damage was already done. Over the years, Lee continued to suffer from numerous smaller heart attacks. He was in and out of the coronary care unit of his local hospital several times a year. On one such occasion, as he was recovering from angioplasty, Lee alerted his nurse to the tender, warm, reddened area around his IV. She noted the inflammation but told Lee she thought it was due to irritation from the securing adhesive She promised to inform the cardiologist when he arrived Dr. Scott examined Lee five hours later. His temperature was 101.4 (38.6 ) and the inflammation at the lV site was now significant. Dr. Scott ordered the IV removed and a new line started. Additionally, he issued orders for two sets of blood cultures and a hematology panel. Although Lee had already received pre- and post-operative antibiotics, Dr. Scott initiated empiric therapy with Cefazolin and Amikacin. The hematology results were complete two hours later Lee's white blood cell (WBC) count was 16, 000 cell/microliter. Because of the potential for diabetic complications, Lee knew that he would stay in the hospital for 48 hours following his angioplasty. However, he was disappointed to discover that the results from the microbiology laboratory arrived the next morning and would prolong his stay. Both sets of Lee's blood cultures demonstrated bacterial growth during the night. Samples from the cultures were immediately plated so organism identification and sensitivity could be determined as soon as possible. Direct examination of the specimens consistently revealed numerous Gram-negative coccobacilli By late afternoon, the microbiology laboratory reported Lee was infected with sensitive to aminoglycosides and Aztreonam. Lee's antibiotic therapy was adjusted accordingly. Although glad to know what the problem was and that it could be cured cter baumannii which was

Explanation / Answer

1. An angioplasty patient would need an antibiotic therapy before/after the procedure even if they were not demonstrating any signs of infection because angioplasty patients are more prone to develop infection of the heart valves or the inner lining; known as endocarditis. This may occur in response to surgical procedures which may cause the contamination of blood by bacteria or fungi. People having heart conditions need to take antibiotic therapy so as to prevent this beacuse endocarditis in case of angioplasty patients are likely to get even more dangerous and if not treated properly can even lead to heart failure.

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