Conversation: The conversation between human and AI assistant.
[|Human|] I am an physician, I have a patient 19 year old female with one and half month history of fever treated elsewhere with various antibiotics like doxy, oflox, rifampicin. Blood counts normal.ESR normal. Brucella is 1:320 two fold rise in 15 days, X ray shows left paracardiac pneumonia. Pt looks toxic. What do you experts feel
[|AI|]  Thanks for your question on Chat Doctor. I can understand your concern. If patient is looking toxic, with left para cardiac haziness and not improving with routine antibiotics, she needs 1.  CT thorax 2. Sputum culture and sensitivity report 3. Bronchoscopy with BAD (bronchoalveolar lavage) analysis. CT scan will diagnose if other abnormality is there or not. Sputum culture will isolate the causative organism and sensitivity report will guide about effective antibiotic treatment. If sputum is not available then patient needs Bronchoscopy and BAD analysis. She may need higher antibiotics and other supportive Chat Doctor.  So consult pulmonologist and discuss all these. Hope I have solved your query. I will be happy to help you further. Wishing good health to your patient. Thanks.