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Dr. Garvin Nsubuga recently posted a video in which he explained bacterial infections and how they should be diagnosed and treated.
In the video, he said:
If you go to a clinic or a hospital and they tell you that the diagnosis they're treating is a bacterial infection, then just know those people either don't know what they're doing or they're just trying to make money.
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When bacteria attack your body, usually, it will start by infecting a particular body part, what we call the focus of the infection. Usually, different bacteria will be found in different infections. For example, the bacteria that affect your lungs to cause what we call pneumonia will be different from the bacteria that we find in your stomach, where we cause an infection called gastritis.
This means that the seriousness of the illness and the treatment we are supposed to give it are usually different. This means that it's the duty of your clinician or doctor to try and discover the exact focus of this infection through asking you questions and doing blood tests so that you can make an accurate diagnosis and treat you appropriately.
Therefore, instead of saying bacterial infection, if you're having an infection of the lungs, that would be pneumonia. An infection in the stomach would be gastritis. An infection in the intestines is a gastritis. An infection involving your bladder is cystitis, while an infection involving your uterus is endometritis.
Each of these infections has its own recommended treatment, despite all of them being bacterial infections. If your doctor fails to make this distinction, he won't give you the optimum care or treatment.
Dr. Innocent Immaculate Acan also weighed in via X.
I love it when the “bacterial infection as a diagnosis” conversation comes up every year or so because it allows me to do something I love — teach. A thread.
So, is the good doctor right or wrong? It’s not black and white. First, we must understand some key definitions. What is: A bacterial infection A focus of infection A bacterial infection is essentially a localized battle between your body and invading bacteria.
These germs have entered a specific part of your body and are multiplying, causing a reaction from your immune system. It can be a skin wound, the urinary tract, or even your lungs. So, the symptoms you’ll see are usually specific to the site of infection. E.g., a skin infection could cause redness, swelling, warmth, and pus; a UTI could cause pain during urination and increased frequency. General symptoms like fever and fatigue can also occur.
A focus of infection is where an infection starts and from where it may spread to other areas. Think of it as the initial battleground where the germ first establishes itself and begins to multiply. So, it could be your skin, lungs, brain, stomach, heart, teeth — anywhere.
So, when you go to the doctor with a tummy ache, vomiting, and a fever, and he runs one test and tells you that you have a bacterial infection, is he wrong? Not necessarily. It’s very likely that you do have a bacterial infection. But how can the doctor know this?
An accurate diagnosis is based on: A good clinical history A physical examination Tests Using some or all of these, a good doctor can make a diagnosis that goes beyond just bacterial infection. In this example, the likely focus of infection is your stomach, based on your history, which would be a “gastritis” (as mentioned by the OP).
Bacteria in different locations of the body respond to different antibiotics differently, so it’s important to know the focus of infection. While it’s ideal to do adequate (often expensive) lab tests to be extremely sure of your diagnosis (e.g., bacterial culture and sensitivity), a good doctor also takes into consideration their patient’s pocket.
If it’s possible to make an adequate diagnosis without spending a lot — through a comprehensive history, examination, and simple tests, then they’ll probably do that. Empirical treatment is the backbone of healthcare in resource-limited settings. However, if you can afford to do additional tests, feel free to discuss this with your doctor.
TL;DR: “Bacterial infection” is not so much a “wrong” diagnosis as it is an incomplete one. The next time a doctor tells you that you have a bacterial infection, ask them, “Where?” A good doctor will be happy to explain and give you the right treatment.