help with a saph infection

[kevieb]

Hi all--this is the first time I've been on this forum, but I need some advice with a staph infection I've had for 3 weeks.   I woke up with what looked like an ingrown hjair with a whitehead under my arm 4 saturdays ago--by evening my armpit was swollen.  The next day i new I had a problem, I was guessing MRSA, which I had 3 years ago because of how quickly it got so swollen.  I went to an afterhours clinic on sunday and the nursepracticioner lanced it, but got nothing  out, packed it, and sent me home with no antibiotics and told me  to see my family doc after Memorial day on tuesday.  within a few hours I was feeling really sick and running a fever.    we called our orthopedic surgeon--he seems to be the most reliable doctor we have.  He sent me to the ER and said he would tell them I was coming, that I needed IV antibiotics.      ER doc said it looked like the nurse practitioner had just cut into my lymph node, and he didn't want to dig around it anymore. My arm was getting red--it had gone to celluitis.  they could not get a culture, but gave me IV levaquin and sent me home with the IV part that goes into your arm flushed and wrapped--I woke up a pretty bad rash during the night, and when I returned the cellutlitis had moved 2 more inces down my arm. I was given vancomycin through the IV and sent home.  returned next day and was given vancomycin again--but halfway through i started itching and breaking out in hives--they gave me benadryl and finished the treatment.  I was finally able to start getting it to drain that night and the next morning. I had been started on septra and they were able to get a culture and drain quite a bit out of the original site.  they removed the IV , packed the wound and sent me home. the next day the culture came back regular staph--not MRSA, but ER doc though cellulitis looked worse and called surgeon in to take a look.  he poked around, said it was fine--and they had me start goping to wound care the next day.  the cellulitis moved another inch down my arm after the surgeon poked around.  I have been going to wound care for 2 1/2 weeks.  I ran out of septra, but was still running a fever and still draining pus.  orthoped put me back on septra and added clyndamicin,  surgeon told me not to take any more antibiotics???  I finished both meds last monday, but have continued to drain pus.  Saturday, I was running a fever again---nurse thought I should call doc.  orthoped put me back on septra and clyndamicin for another 10 days.  there are 3 channels inside the wound and it continues to drain pus.   A friend told me today that her husband, who is a doctor, told her that with a staph abcess the standard of care is to NOT keep giving antibiotics???    He says the body walls it off and the antibiotics can't get to it.  They are not draining and repacking it every day any more--they are letting it go a few days between packing changes.  i sometimes have to change the dressing at home because it gets too gross.  what should I be doing here?  The infection has never completely cleared up to a clear drainage, there is always some pus and finally blood----and when I was off antibiotics for only 4 days, I started running a fever again--and felt sick after the nurse stirred things around.  I felt fine before I went in.  My whole arm and shoulder seem to be slightly tender--but the cellulitis is gone.

I could really use some advice on this one.

[kevieb]

If it is finally draining, it may start to heal up without a problem. Your doctor should be able to get a culture of it now if you want to be sure of whether or not it is a staph infection.  You don't need stitches----if it is staph, that hole needs to be able to drain and heal from the inside out.  

If it doesn't get better, getting a culture will tell you whether or not it is regular staph or if it is MRSA.  MRSA reaquires different antibiotics.

Keep it covered so you don't spread the infection.  I try and change the towels in our bathroom almost every day---especially if I've touched them---even if it's just after I've washed my hands.

You're not weird for being tempted to pick at it-----probably most people want to pick at something that looks like it needs to drain.

When i was in the ER getting my IV antibiotics, they told me they had one nurse that just loved to get the pus out of infections!!  I thought it was pretty funny because I am a picker and drive my kids nuts.

I figured I had better not pick on any of my kids faces while I had this staph infection because I didn't want to give it to them---but one of the nurses said that I actually could have gotten my staph infection from picking on one of my kids----I seem to be somewhat susceptible to staph.

[mkh9]

Sounds like the pus is starting to come out. But if you pick a staph infection it isn't like a pimple it will spread the infection. Try not to touch it. Wash you hands often and use clean towels. You may want to go back to the doctor since you opened it up. If it isn't getting better they may need to change the antibiotic.
mkh9

[alexneedshelp]

I am 16 years old and with what my doctor and I think is a staph infection, although my doctor never said anything about what it was. He gave me cephalexin 500mg for an antibiotic and I have been using it for about 4 days now. I am quite weird and was always tempted to pick at it like a pimple, or to "drain" as you say. So on this day, Monday, I was trying to drain all of it and it popped, disgusting it was and some blood. Now there's just a hole that keeps leaking either pus or bodily fluids, I don't know which. There is still VERY little redness around hole and wherever is was spread to. Do I need stitches, or is that little redness going to be needed to drain as well?

[kevieb]

I'm working with a doctor to balance my endocrine system.  He believes that if your endocrine system is imbalanced, than your immune system will be compromised.

I don't remember getting sick alot as a teenager, I always thought one of my sister's was the one who seemed to get everything that was going around.  She has been really healthy as an adult---and then several months ago was diagnosed with lung cancer.

I've lost one sister to metastatic breast cancer, and another sister has 4 autoimmune diseases----one of which will eventually kill her liver, but she is not sick enough yet to be on a transplant list.

My brother is diabetic, and I have 3 children with celiac diease----a doctor once told my sister that we have bad genes!!

[mkh9]

Wow, you really are susceptible to Staph and maybe other bacterial and/or viral infections. Sorry you have been through all this. The only way I know to boost your immunity are lots of fruits and veggies especially berries. In severe cases they can give you a shot of immunoglobulin for example if you get exposed to someone with hepatitis. I had impetigo once as a teenager and strep throat (various kinds) about 3 times. Lots of bugs out there.
stay healthy!
mkh9

[kevieb]

we don't have a local infectious disease doctor---but if I ever get another staph infection---I should probably see one.    i spent a week in the hospital when I was 3 with osteomyelitis---and I know that is staph--and not exactly the most common thing.  I got bi-lateral shingles when I was 4---my family doc now tried to tell me you can't get them on both sides---it's rare, but it happens.

I also remember having a boil in grade school---i know that is usually staph---then MRSA 3 years ago---and now this.   i think my immune system is a bit compromised, plus, I have atopic dermatits---so I almost always have an open sore somewhere on my skin---easy places for nasty critters to get in---caught the herpes virus from my daughter's cold sores that way----only I don't get cold sores----but It has only broken out twice in 18 years---and that was in the first two months.  Can't complain about that one, too much.

[mkh9]

You are welcome. Let me know if you have any other questions. I am glad you are doing better. It sounds like the doctor has things under control.
mkh9

[kevieb]

Thanks so much for the reply.  As far as I know, the culture just showed staph.  I am familiar with c-diff---I was tested for it when I had MRSA and ended up with the runs pretty bad--but I didn't have it.    

I get oral and esophageal thrush when I am on the strong antibiotics for a long time---so I was given a course of diflucan to take while I was traveling.

The doc checked my wound on tuesday and decided that the wound care packing was just irritating it, and told me not to go anymore, stay on the antibiotics, gave me a supply of large bands, and told me he wanted to see me on monday.  I asked for something for the thrush that I knew would  be coming---he gave me swish and swallow nystatin--it helped the last time.

I have a friend who told me to get pro-biotics as soon as I told her I had to go back on antibiotics.  I actually think I may still have some.

My arm and shoulder are hurting less, there is a hole in my armpit that drains a little, but not alot---but sometimes you can hear the air kind of popping in and out of the tracks that are still in there.

I feel better about being on the antibiotics because the cellulitis got pretty bad and it seemed like they were having a hard time getting it under control before it finally abcessed enough to drain----even after that, the ER doc thought they might have to open it surgically.

I'll never go back to that after hours clinic--there used to be a nurse practitioner there that i trusted more than my family doctor---but she retired.

I'm changing the towels in our bathroom often.   I'm just hoping everything closes up soon and I don't get a fever back when I go off antibiotics.

Thanks for the reassurance that what is being done seems appropriate.

[mkh9]

Hi, also did you say they did a culture on the area and did it ever turn up negative or grow anything else besides Staph? Cellulitis is usually caused by Staph or strep and sometimes other bacteria. Staph can produce nodules. Maybe this is what your friends doctor meant. When you have pus (an abcess) you definetly need to be on antibiotics. But if the pus is gone then you are getting better. Cellulitis doesn't aways have pus but usually is treated with antibiotics. Since it was not MRSA it sounds like the right antibiotics were given to you (clindamycin). It takes months for this to go away sometimes. Be sure to keep the towels, and wash rags , any clothes that come in contact with it very clean so as to not reinfect yourself. It you get a fever again and/or pus I would revisit the doctor. Also, they gave you vancomycin to start with because they didn't know at first whether it was MRSA and so it works on both. Then when they found it wasn't MRSA they swicthed to a less toxic and more appropriate antibiotic. This is standard care.
hope you get better soon.
MKh9

[mkh9]

First, it sounds like malpractise with the nursepractitioner. That being said,  I think you know you had an allergy to the antibiotics. Glad that it wasn't MRSA. But still cellulitis takes a while to treat. I haven't heard or read that Staph walls itself off, not like TB can. But, they form carbuncles and pus pockets, furuncles, so in that way they can sort of form a pocket to evade the antibiotics and immune system.  It sounds like it needs to be drained. But, it does should like you are clearing up the infection since  the cellulitis is gone. Do you have an infectious disease doctor in your area? The doctor probably was concerned that you might get another infection called Clostridium difficile, which has a toxin and can come out and give you bad diarrhea and then other problems. So, he took you off the drug. But, Instead I would suggest also that you take probiotics for  a few months. They have the pills at various places like Costco or some pharmacies and probably GNC or vitamin stores. These probiotics should be at 10 billion active cultures or CFU. They compete with C.difficile and doesn't affect the effacy of the antibiotics. You need to take them for a while after the infection clears up. I don't know why doctors don't talk about them. My doctors nurse told me to take them. Clindamycin is notorius for these kinds of secondary infections. But do try to see the infectious disease doctor as a second opinion. Although, this doctor did seem to get a grip on the infection.