From Secretion to Solution: The Transformative Role of Pus Culture and Sensitivity in Managing Fistula in Ano: A Case Report
Author : Dr. Prajakta Suresh Vichare and Dr. Jyoti Shinde
Abstract :
Anal fistulas are often difficult to manage due to its chronic nature and resistance to antibiotic therapy. This study highlights the importance of pus culture and sensitivity testing in guiding effective treatment. A 21-year-old male patient presenting with Fistula in Ano since last eight months admitted for treatment in the Institute. He had previously taken treatment from various private hospitals but the symptoms got worsened instead of curing. Initial MRI fistula findings were s/o-, left transphincteric fistula in Ano with local abscess, and he underwent planned surgery as Partial fistulectomy with KS ligation. Despite postoperative antibiotics, the patient developed persistent pus discharge and systemic symptoms. Repeat imaging confirmed a non-healing fistulous tract. Pus culture revealed multidrug-resistant organisms, sensitive only to higher antibiotics. Targeted therapy was initiated based on sensitivity along with Standard Apamarga Ksharsutra ligation, the patient showed significant clinical improvement and the fistula healed completely within a month.
This case demonstrates the limitations of antibiotic regimens in treating complex fistulas, especially when resistant pathogens are involved. Though the MRI fistulogram is the most standard investigation in treating patients, Pus culture and sensitivity test also plays a significant role in treating Fistula, providing clear diagnostic and therapeutic direction. Together, it enables personalized treatment planning, accurate delineation of fistulous tracts, and improved clinical outcomes. The results focus on integration of Pus culture and sensitivity test and Standard Apamarga ksharsutra therapy into routine fistula management to control infection, reduce recurrence and enhance surgical outcome.
In conclusion, culture-guided antibiotic therapy, MRI fistulogram findings and Ksharsutra therapy —plays a vital role in managing fistulas, ensuring timely and effective treatment, and improving overall patient care.
Keywords :
Fistula management, pus culture, antibiotic sensitivity, transphincteric fistula, targeted therapy, multidrug resistance, MRI fistulogram.
