Question

mircobiology :)

Roberta is a 46-year-old real estate agent who recently underwent a cholecystectomy (surgery to remove painful gallstones). The surgery was performed laparoscopically with the aid of a duodenoscope, a specialized endoscope that allows surgeons to see inside the body with the aid of a tiny camera. On returning home from the hospital, Roberta developed abdominal pain and a high fever. She also experienced a burning sensation during urination and noticed blood in her urine. She notified her surgeon of these symptoms, per her postoperative instructions.

• What are some possible causes of Roberta’s symptoms?

Part 2

Roberta’s physician suspected that a bacterial infection was responsible for her sudden-onset high fever, abdominal pain, and bloody urine. Based on these symptoms, the physician diagnosed a urinary tract infection (UTI). A wide variety of bacteria may cause UTIs, which typically occur when bacteria from the lower gastrointestinal tract are introduced to the urinary tract. However, Roberta’s recent gallstone surgery caused the physician to suspect that she had contracted a nosocomial (hospital-acquired) infection during her surgery. The physician took a urine sample and ordered a urine culture to check for the presence of white blood cells, red blood cells, and bacteria. The results of this test would help determine the cause of the infection. The physician also prescribed a course of the antibiotic ciprofloxacin, confident that it would clear Roberta’s infection.

• What are some possible ways that bacteria could have been introduced to Roberta’s urinary tract during her surgery?

Answer 1

Cholecystectomy​​​​​​

​​​​It is the surgery to remove gallbladder.

There a two methods of surgery :

- Open method and laparoscopic method.

Even though the gall bladder surgery is comparatively safe, there are certain side effects and complications such as ;

*Reaction to anesthesia

*Bleeding

*Infection

*Damage to the bile duct.etc

possible causes of Roberta's symptoms after surgery :-

​​​​​​There is a chance of developing post cholecystectomy syndrome . It occurs when any gall stones remain in the bile duct or if bile leaks in to stomach. Abdominal pain is one of its symptoms.

Urinary tract Infection and infection at incision site can cause fever after surgey.

Urination problems are also seen after surgery due to anesthesia and urinary catheterisation or the combination of two.

PART 2

possible ways that bacteria have been introduced to Roberta's urinary tract during her surgery:-

​​​​​​Urinary tract infection is the infection of the bladder or kidneys.

In the case of laparoscopic surgery it has 0.5%.

- Urinary catheterisation is done using Foley's catheter to drain the urine during surgery.The presence of a catheter increases the possibility of causing UTI. It is called catheter associated UTI.

Urinary retention is common after anesthesia,it can also develop UTI. Because,the bladder won't empty completely during voiding. It will result in the presence of urine in bladder longer than normal condition. So it will causes urinary problems.

Additional possibilities of developing UTI after surgery are ;

Age of patient (Older patients are at high risk)

Gender ( women are at high risk)​

​​​​​​​​​​​​Convey your feedback to improve my answers.

Have a nice day.