Q: My 19 years old brother underwent a heart surgery - Tetralogy of Fallot (ToF) and ventricular septal defect (VSD) 15 days back. Five days after the surgery, he has infliction with TLC - 25/cu.m. Recently, he underwent a blood test, which showed haemoglobin - 11.90 gm/dl, TLC - 22.6 cu.m, ESR - 40 mm and packed cell volume (PCV) - 38.9 %. His differential count (DLC) showed neutrophil - 70 %, lymphocyte - 20 %, monocyte - 04 % and MCH - 31 gm/dl. There is no fever yet. He also has infection. He is taking Piperacillin and Tazobactum injection 4.5 g, and Meropenem injection 500 mg. What precautions should be taken by him?

A:Specific queries of this nature cannot be answered over internet as one needs to have access to direct patient interrogation and examination. I suggest you consult your treating doctor for specific diseases. In generic terms, the clinical picture is taken in its entirety along with investigations before a decision for continuation or discontinuation of antibiotic therapy is taken. If the patient is not getting any fever, he is clinically stable, and then counts may be just observed, especially if there is no obvious focus of infection. Any surgery itself can raise the counts because of the whole body inflammatory reaction that the heart lung machine generates in the body. As far as preventive measures are concerned, I don’t think, there are any specifics that you need to worry about, as you do not have any artificial prosthesis in the body. Still for the first 6-8 weeks after surgery, avoid contact with obviously infected people and avoid going to congested and polluted environment and areas. Also if you visit your doctor for any dental or genito-urinary treatment, do mention to the doctor that you have undergone a Tetralogy surgery.