Recurring staph

[NeverAgain127]

Hi:

For the past 10 years or so, I would get a pretty nasty staph infection in or on my nose.  Bactroban did nothing,
so I would end up on Bactrim, Cipro, etc.   The round of AB's usually took care of things.

I began to notice that these breakouts happened whenever I got a lot of sun.

These infections happened only 2-3 times a year and I didn't usually worry about it.   My doctor sent me to an ENT, who was pretty useless (she just told me to keep my nares moistured..???)   He actually mentioned that I might want to talk to a plastic surgeon to explore having the part of my nose that "harbored" the staph removed.  

Fast forward to today:   For the past 2 weeks, I've had horrible stuffed up and runny nose due to the incredibly high pollen count where I live.   One day, my left nostril developed a pea-sized red bump just at the opening.  Very painful.  I I ignored it, until the entire side of my face started aching and my glands under my face swelled up.

Last Friday I went to a walk-in clinic.  A very young girl there, (Physician's Assistant) told me it was cellulitis and had the presence of mind to draw blood and run a CBC.   WBC was 5.7, so she told me it wasn't systemic, and prescribed Bactrim 2X/day for 10 days.

Within a few days, the glands went down, but the bump stayed, and still hurt.

TODAY:  I woke up with an ache in my left eye are (same side as the infected nostril.)  My lower eye lid looked a tad swollen.   Within 2 hours, it had turned red.  In another hour it swelled up down to my cheek.  

My doctor is on vacation this week, so I went to a hospital ER, where they saw me right away.   The doctor there looked about 12 years old, but he did do an examine and draw blood.  (CBC and Chemistries, all normal).  He told me that whatever I had was resistant to the Bactrim, and prescribed Clindamycin.

I asked him if this was MRSA.  His answer was "I don't' know and it wouldn't matter anyways."  (Huh?)

Then I asked if it were possible to culture ANY fluid from the affected areas (I didn't care if they aspirated from my face; I'm pretty tough.)   Again, he said "it is impossible to ever do a culture; we are all covered with staph and a zillion other kinds of bacteria.  We wouldn't know which one is causing the infection."  

By this point, I'm getting frustrated with this dude.    My final question to him (before just giving up, and wondering if he REALLY was a doctor) was "Is this dangerous?"   His answer:  "Hey, eating a peanut can be dangerous."

Ok, doc, whatever, I give up.   Got my script for Clindamycin, and left.

So:  my questions:

1. CAN I find out what bacteria this is?
2. Why did this spread from my nose to under my eye, and cheek?  It has never done that before, ever.
3. How can I prevent myself from having these recurring staph infections?  
4. If this is MRSA, can one ever be totally cured from it?

P.S.  He was watching me pack up and leave and his parting words were "You should probably look into alternative healing stuff."

Hmmm..like what?  It's so had to sift through the mountains of info on the 'net, which claims everything from oregano to hydrogen peroxide cures whatever ails you.

Thanks,
NeverAgain

[mkh9]

Did you read the links I sent? Hope that the doctor listens this time.
Take care,
mkh9

[NeverAgain127]

Hi,

I appreciate your replying to me.

I was put on Clindamycin, which is wreaking havoc with my GI tract.  I'm taking a strong pro-biotic along with it to help with the tummy issues...the last thing i need to get is C-diff.

The swelling is completely gone, and I have no fever.  I see my doctor on Monday and i"m going to ask him for a nares swab, although I doubt it will show anything.

My concern is that EVERYTIME  I sit in the sun for more than 10 minutes, I get a staph infection--always in or ON my nose.   I'm 53 and healthy, but someday, if this keeps up, this could potentially kill me (when I'm much older.)

I'll let you know what the doctor says...

[mkh9]

Hi, The site has been down a lot today. I understand what you are saying. I do think you probably got it by touching your eye. It can happen. You do sound like you were getting better with the Bactrim since your lymph nodes were going down. That is a really good sign. But then you got the eye infection. Are you on a different antibiotic now or same one? If so I would stay on it until you finish the course they gave you. I would see another doctor about this outside of the ER and not a PA or resident. If it is still puffy and swollen it should be looked at to make sure the eye is okay. They should be able to culture the eye itself. It is hard to lance (cut into) the puffy part  your talking about as it will probably cause scarring. Is this in the soft tissue below the eye?  But they can do it. It may not be necessary if the antibiotic is working. It may cause more harm than good. There are standard treatments for MRSA. But, it doesn't sound like they have figured that out. So has anyone cultured your nose or nares? Do you have a fever? Do you think the eye is getting worse or better? How is your nares and nose area doing? They can easily culture that, Certainly at least inside the nose to see if you are carrying the MRSA. They can culture inside the eye lid with a swab. They can  So, even if your main doctor is out you can see the doctor that is on call or another doctor or an infectious disease doctor.  At least get one that isn't a resident or PA or nurse practitioner. They are good for some things but obviously not this.
mkh9

[NeverAgain127]

Thank you for your reply...I was hoping that you would answer me, as you seem to know a lot.

Yes, I think it was a resident who saw me, and they are so afraid of making the wrong statement or being sued, that they are totally non-commital.

I may have not stated what happened correctly.  It wasn't on my cheek to begin with; it firmly in the outside of my nose, going up into the nares.  I probably touched my nose and then my eye without realizing it.

Here is what I do not understand.

5 days into the Bactrim, my glands went down, almost to normal.    Either the infection was resolving itself, or the Bactrim was working.

Why then, did the infection spread to my eye?

Under my left eye is very baggy and swollen.  If I touch it, it hurts, so I assume there is still infection there.

Since I've been on antibiotics, can the area still be cultured?  There seems to be wildly differing opinions form doctors and PA's about this.  

Thanks again for your help with this,

-NA

[mkh9]

Hi and sorry you have this problem. It sounds like you have had bad luck with the medical staff.

1. You should get your infection cultured. It is ridiculous the way you were treated in the ER. However, I have been treated that way too so I understand. It may have been a resident or nurse practitioner. I think most likely a resident. They don't have much experience with microbiology and complex problems and just give a quick fix to and emergency and get you out. Why do you need it cultured? To determine if it is Staph aureus and if it is MRSA. Of course to make sure it isn't resistant to the antibiotic you are going to take. MRSA can be resistant to Clindamycin and a lot of other drugs.

Of course we have bacteria on our skin. That is not the question. Do you have Staph or MRSA on your skin? It is possible. The problem is when you get it in a cut or in the nose and it goes from being a carrier state to a infection.  So since you have had recurring infections it sounds like you have a persistant infection or you have been reinfecting yourself.

So, first you have to try not to reinfect yourself and if that is the case that is a whole lot better than a persistent infection. You probably had the cheek infection and then you touched the area and touched your eye and it got in that way. You may not even realize you did it. So you will to be very vigilent to wash your hands when you have an infection. Don't touch the wound or infected area and if you do wash your hands and turn off the water with a paper towel or something and throw it away. Then clean the handle with disinfectant. Any clothes, sheets, pillow cases etc. that touch any infected area also have to be washed frequently. Door knobs anything that come in contact with your hands.

2. So we covered this why did it get in your eye probably you touched your check then the eye.

3. We covered part of this by hand washing, not touching the wound. But what if it is a persistent type of bacteria. See the link below. It talks about bacterial persistence. It is hard to get rid of this type. But is sounds like they have certain antibiotics in the article (which are not new) that you can use. I would see an infectious disease doctor about your recurrent infections and perhaps they will deal with it. Maybe you can get a referral to a good doctor.

4.If it is a persistent organism it is hard to cure it. But this article sounds like they have done some good research on these types of strains and used a couple of common antibiotics to get rid of them. Maybe you can print off the article and bring it with you. If you do have MRSA you may want to ask about those antibiotics and the article ( rifampicin or line­zolid) But they do have side effects you may need to look into.

5. Alternative healing. Mostly, they use leaches to treat MRSA in diabetic patients. Are you diabetic? This is not a joke. Also honey is a natural antibiotic. See link below the other link.



http://www.northeastern.edu/news/2013/11/lewis-mrsa/

http://www.medscape.com/viewarticle/563656

mkh9