Reference no: EM133475675

Problem

A 75-year-old man is admitted to the hospital with a 2-week history of progressive malaise, fever, diarrhoea, and pain in the left lower quadrant of his abdomen. It is ultimately determined that he has diverticulitis (infection and inflammation of multiple, small, pathologic outpouchings or diverticuli of the descending colon). The infection has spread beyond the bounds of the colon, and he has a large, pericolic abscess. He is treated with surgical resection of the inflamed segment of the colon, and drainage of the abscess. The surgery was followed by the administration of a long course of antibiotics, including aminoglycoside gentamicin. In the course of this treatment, the patient can barely walk, his gait is wide-based and extremely unsteady, and he becomes nearly deaf. Sometimes he can hear but is not able to understand the origin of the sound or what it means. A year after the treatment, the patient's balance is recovered, but his hearing is the same as during the course of treatment. He also complains on persistent abdominal pain and chronic constipation.

Dysfunction of which structures of the nervous system are involved in this patient's symptoms he developed after surgery?

Using your knowledge and recent (within the last 20 years) research publications, explain pathophysiological mechanisms and neurological pathways involved in the clinical presentation of all of the patient's post-surgery symptoms.