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Staphylococcus aureus with complications
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Staphylococcus aureus with complications

11178143?1411268986
One month in Kenya in may. Took malarone. Missed some doses. Bitten by plenty of mosquitoes and 1 tsetse fly.
4 dais later i went to 14 Midwest and southern states over the course of 3 weeks and fought off hundreds of ticks,  over 10 were able to attach for various periods of time. 1 for at least 24 hours.
Came home with a rash on right leg that looked like chiggers. Lasted 3 weeks and itched like crazy. (See picture) 2 other rashes on stomach and chest were different, smaller, but still itchy. None looked like EM.
One month later, went to Wyoming. Came back with staph infection on leg after crossing rivers in the backcountry (yeah, my life is pretty badass). ;)
Cultures came back different. One said it was susceptible to all antibiotics, one said resistant only to bactrim. Took keflex for 11 days.
2 days later, staph came back. Manifestation was different this time (dense red petechiae instead of boils).
10 days on bactrim. 6 days after, it came back again as a single weak looking boil.
Augmentin 875 for 10 days.
Fevers had always been Intermittent and in evenings only. Never while on antibiotics. And never over 99.5. However, fever came back after 3 days on augmentin and have continued up to now (though only up to 99 every night so far) 3 days after completion of augmentin.

Lab work includes

High potassium that had come back to normal last we checked.
White blood cell count that peaked at 10
High c-reactive protein
High Sed rate (34)
Positive lyme Elisa 1.33
Negative western blot with one band for each the IgG and the IgM. Band was 41kDa,  a spirochete specific band.

Other symptoms are present but it's difficult to determine which are due to antibiotics. Current symptoms include, neck pain and stiffness, headache, very slight temperature elevation (99.0) every evening.

Abdominal pain was present before antibiotics, but only after ovulation and before menses for about 2 weeks of every month since i got back from Kenya.
7 Comments Post a Comment
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Avatar_n_tn
Yesterday, my right leg (the one with the rash and with the staph infection) began to twitch and there was moderate deep pain (felt like in the bone).  This morning that pain is not there, but there are sharp, intermittent pains in my knee. They are pretty weak right now.

Are there any infectious disease specialists in this forum that might want to take a stab at these ridiculous symptoms?

My doctor is a University Health Services doc that specializes in sports medicine so he is not much help.

Thank you!!
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Avatar_f_tn
Hi, and firstly there are no infectious disease doctors on here. I am a microbiologist and can take a "stab' at it. I may refer you to the Lyme forum also. And, although they don't have doctors on there either they have patients with Lyme. So, yes your rash in the photo looks like chiggers to me too but could be something else (or part of the Staph infection). Maybe some of the Staph infection is probably resistant to some antibiotics and that is why it keeps coming back. You may want to get another culture.

As for the Lyme you need to get treated properly for this. I would see a "Lyme literate doctor" (LLMD). You can find one in your area on www.ILADS.org They can start you on the correct antibiotics and talk to you about the bands but the one at 41kDa is a general band for all spirochetes. Also, you need to get tested for the co-infections that you can get from the tick bites. The LLMD can do this. These would be Ehrlichia, Bartonella and possibly some others.

Have you been tested for Malaria? I know you were on Malarone but I don't know how good that is for Plasmodium falciparum.  Do you have any chills? The low grade fever may be from the Lyme. The sooner you get treated for Lyme the better. It will start causing damage the longer you have it. Bartonella can cause some bad problems as well. You have to take multiple antibiotics for a long period of time for this. I think it is about at least 2 months. It depends on if you caught it early enough. Some may be on them for years. There is also a herbal method called Cowdens. My opinion would  be  to start with the antibiotics and go from there. If it becomes very long term (more than a couple of months then maybe try the Cowdens).  I would see what the LLMD says.

The CRP and sed rate are just showing you have inflammation and are not specific tests. I'm glad you got your potassium down. I do suggest you see a LLMD right away. They know much more about Lyme treatment than your standard MD. Also, they will send your lab work to a specialty lab (IgeneX) that has the ability to get the co-infections done).  You should also have your blood tested for Trypanosomes since you were bitten by a tsetse fly. But you don't have high fevers. Did you have a red sore or chancre where the fly bit you? How many weeks since you were bitten?

Hope I answered most of the initial questions.
mkh9
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Avatar_n_tn
Thank you for you input!  I am a biologist as well and have access to a great microbiologist that studies staph.  What is your focus?  

It's been since May that I was bitten by the tsetse fly so I don't think trypanosomiasis is a concern.  I also agree about going to see an LLMD, but I am concerned about the quack factor with them.  They don't take insurance and they will treat people who test negative for Lyme with Igenex just based on the fact that they don't feel well.  

I haven't been tested for malaria yet, which is absolutely unforgivable.  I had to mention the possibility of Lyme and ask for the test.  This doc is just thinking that we are focused on trying to get rid of a staph infection while I am trying to figure out why I am immune compromised enough to get a staph infection in the first place.  I haven't even had the flu but once in the past 10 years.  I never get sick and my immune system is fantastic.

Thanks again for the info.  I do need to be re-tested for lyme since 41 kDa is often the first band to pop up after infection.  And for co-occurring infections.

Peace to you.
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Avatar_f_tn
My focus was clinical microbiology or I am a licensed and certified clinical microbiologist and worked as such for  a number of years at a county hospital and other hospitals. In the hospital lab you don't focus on just staph. You work on all specimens and bacteria, fungi , parasites etc. But then, I worked for the navy for a while and a research anaerobe lab doing identification and sensitivity testing  on specimens from bite wounds to humans from cat and dogs mostly, and then got into biotech for a while and did some molecular microbiology. But my main interest is clinical. What area of biology are you interested or work on? Anyway, I understand what you are saying regarding the "quack factor."  Although you can get bad doctors in every sector. I would go with IgeneX results only if they come up positive. I know the LLMD's don't take insurance. Probably since you do have the main band for Borrelia that is positive I would hope that an infectious disease doctor would treat you the right way for Lyme. However, I'm not sure if they would treat you as long term as you may need. I have come to have a more open mind about Lyme after having a friend get it. Well, some Staph are more virulent and of course more resistant to antibiotics than others. So it may not all be due to being immuno compromised. But I understand the innate immunity issue  Do keep me posted.
mkh9
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Avatar_n_tn
I am a geneticist. I'm working on my PhD. right now and this illness is really slowing my research (which is a range-wide population genetics study, mostly). I could actually order some primers and PCR my blood to test for lyme, but the results are usually inconclusive with that method.

The infection appears to be coming back in my leg. It's red around the edges of the original wounds and when i stand on it for a couple of minutes, the whole lower leg becomes blotchy red.

New lab work from yesterday shows normal CBS wit WBC of 8.7. ESR is down to 27 from 34 (do you know how long it would usually take for this to come down post-infection?)

Fever came back tonight. Still very minor at 99.1. Headache, Lightheadedness, fatigue, and overall malaise. I'm currently in touch with an infectious disease doctor in the Netherlands and we might Skype at some point this week. Still looking for an appropriate doctor in my area and in my insurance network (impossible!).
Thanks again for your help. What a pain this has been! I am usually the healthiest person around and joking about how everyone should get some of my microbiome injected in their gut.
Are you in the US? My doctor won't use igenex, unfortunately and i can't find an LLMD closer than 2.5 hours from me. I really wish i could just do it myself!
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Avatar_f_tn
Yes I am in the U.S., in California. I worked in a epidemiology lab when I worked for the Navy. I did PCR and DNA sequencing plus micro on samples from recruits in the miltary. One of the studies I worked on was to look at the M Protein gene of Strep group A and which virulent strains there were in different populations across the country. I also did a study on Strep. pneumo and compared serology, PCR, and culture results and the serotypes to various types across the country. Anyway, I'm sorry to hear you are still ill. I think it is important to do the blood test at Igenex. But someone on the lyme site said one of the labs had an equivalent reference lab to them. I would have to ask or you can. Let me know. I know you have to get treated for Lyme soon. That can take you down. The longer you wait the more damage you can do. It hides out in the lymph nodes and then comes out. As for the ESR it varies from person to person. Depends on if you get a flare up and get inflammation. It sounds like if your leg is still getting a rash then it would stand to reason your ESR would still be up.
mkh9
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Avatar_f_tn
I talked to my Lyme friend on here and gave her your symptoms and results and she says you do have Lyme because of the ELISA results and the band. I am not a Lyme expert. I think it would be good if you messaged her. She is really good at answering questions and explaining Lyme and its co-infections. There is a reason why the LLMD's send a person's labs to IgeneX with a negative western blot. That is because their test at the reference lab such as Lab Corp or another one other than IgeneX isn't as sensitive. I forget the reason. You will have to trust me on this. Her nickname is mojogal. I mentioned you to her in case you want to write to her. She has chronic Lyme. The thing that worries me is that if you wait too long to get treatment you may become chronic and it hard to treat. At this stage you should be still curable. I wouldn't wait much longer. Then there are the co-infections to deal with too.
mkh9
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