Conversation: The conversation between human and AI assistant.
[|Human|] 2 weeks ago , i had abdo pain, fever for 3 days. went to doctor, prescribed cipro 500mg bd for presumed uti. 3 days later admitted to hospital , abdo pain, fever , rigors. crp 350, ct ,ultrasound of abdo, mrcp outruled gall stones, obstruction etc. pylonephritis (urologist felt secondary , not cause of infection). continued cipro , iv gentamycin x 3 days. blood , urine cultures etc all negative. yesterday crp 24 but lfts raised significantly, microbiologist said to have cipro x 7 more days. discharged home yesterday, now temp 37.9, abdo pain back , some back pain. pain across centre of abdomen. any thoughts welcome.
[|AI|]  HI. Gone through the history. 2 Weeks : fever and pain in ABD- Cipro- admission-pain, fever, RIGORS, CRP - investigations- Genoa- CRP reduced- LFT elevated-pain- back pain- center of ABD... I would advise such a patient... Repeat ultrasonography for pancreas, hepato-billiary. Tidal for typhoid, slide and antibody test of malaria.  Add Metronidazole 400 mg thrice daily-immediate clinical response suggestive of an added amoebic hepatitis and will give complete response within 5 to 8 days. Blood culture may help.  I would change to another / add another antibiotic. And adjust according to reports.