It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Infectious Diseases Message Board
Post New Thread   Closed Thread
LinkBack Thread Tools
Old 11-11-2008, 10:17 PM   #1
Junior Member
(male)
 
Join Date: Apr 2005
Posts: 36
MysteryWhiteBoy HB User
Unhappy possible MRSA...help please!!!

seems i'm popping in here every so often with a new set of problems...go figure this one really has me in an emotional twist, though i'm sure i'm being a bit premature with my concerns.

about two weeks ago i noticed an outbreak on my inner thighs of what i thought was eczema. it's something i've dealt with in the past. but with this episode something wasn't quite the same. instead of the 'blotchy' patches i would get, this was more area specific (i.e., smaller 'lesions' if you will). they itched like eczema, but haven't responded to my usual treatment of lidex. one of the side effects of taking lidex is folliculitis, which is what i thought i had. today, after about a week of no results from lidex and seeing a few smallish pus-filled spots flare up, i saw a doctor. he immediately ruled out eczema and said my sores or boils resembled an MRSA infection. of course, my mind went blank from the shock of hearing this and i failed to ask some critical questions. to make an already long story short, he has me on Bactrim for 14 days (2x/day) while i wait (5-7 days!!!) for results (he took a culture of the pus in the largest of the sores. isn't there a blood test that gets results in hours instead of days?!?). i'm a nervous wreck right now and can't believe this is happening.

i guess i'm just venting my fears more than anything. this really has me concerned. i read cgranulomatis's informative post about the differences between MRSA and MSSA (thank you for that). i feel like a freak right now who can't touch anything, is worried about getting my family infected, etc.

i see that it's best to get at least three rounds of different types of tests to rule out MRSA. if my culture comes back negative, what should i do next? is another round of a different antibiotic needed after i'm done with the Bactrim? should i start to see signs of improvement within a few days or does it typically take longer?

thanks for indulging me...it's very helpful to hear from you.

 
Sponsors Lightbulb
   
Old 11-12-2008, 07:27 AM   #2
Senior Veteran
(male)
 
Join Date: Jul 2008
Location: Canada
Posts: 999
harka HB Userharka HB Userharka HB Userharka HB Userharka HB Userharka HB Userharka HB Userharka HB User
Re: possible MRSA...help please!!!

Hi there! First of all don't worry. There are plenty of worse things this could be. MRSA has everyone in a tiff because of the bad press it gets in the news. I'm glad you read my article, and I wanted to bring up a couple of things.

First off, MRSA if you have it is a bug that lives on your skin. You can wash your bedsheets, you can wash your house you can do whatever you like, but IF someone is going to get colonized with it who is a close contact in your household, they will already be colonized. Being colonized means that the bacteria live on you, but they don't cause disease. Not everyone who comes in contact with MRSA even gets COLONIZED with it let alone get an infection! So unless you put yourself in a bubble and don't touch anything ever again, your family has been exposed to it. And you know what? That's not really a big deal. Staphyloccocus aureus is a normal bug that lives on the skin.

As for the testing and treatment: the only difference with treating MRSA is that we have to use antibiotics. It sounds like they're using Bactrim on you, and that's a great choice. The main issue with the boils is that they need to be drained. I'm not sure which testing they're doing, but there is no magic to testing MRSA. They first do a culture and see the Staphylococcus aureus and then do antibiotic susceptibility screening. If the screen is positive, they'll do a confirmatory visual test (called a Denka) to see if it's MRSA or not. The whole process takes about 2 or 3 days--not weeks.

Now, the whole thing about three negative swabs--that's a different issue. That's what you look at when you are decolonizing someone. After your acute MRSA infection is treated, they will try to put you through a week of treatment to see if they can eradicate the bacteria from the surface of your skin. This involves:

1. One week of daily chlorhexidine washes.
2. One week of thrice daily application of mupirocin ointment to the nostrils to kill the intranasal colonizers.
3. On day 4, a triclosan shampoo.
4. One week of two antibiotics (usually doxycycline/rifampin) to eradicate gastrointestinal carriage of MRSA.

At that point they'll do three sets of swabs (each a week apart) to see if the bug has been eradicated from your system.

Just because you got MRSA boils, doesn't mean that it necessarily has to happen again. The best thing you can do for yourself is relax and take a deep breath. I'm not saying MRSA is fun, but it's not like you have tuberculosis or HIV--things that would make ANYONE hyperventilate!

 
Old 11-13-2008, 07:37 PM   #3
Junior Member
(male)
 
Join Date: Apr 2005
Posts: 36
MysteryWhiteBoy HB User
Re: possible MRSA...help please!!!

thank you so much for your reply...i truly appreciate your insight.

it's not easy, but i'm doing my best not to be too worried...i read such mixed things about MRSA and the degree of severity it presents (as you mentioned, it tends to get blown out of proportion sometimes). i've learned from past experience not to spend too much time researching on the internet, lest i find myself in uber freakout mode. but i need to inform myself and not take one doctor's assessment as the gospel.

since i was thrown this curveball this past tuesday...and because i probably won't hear test results until monday or tuesday of next week (hopefully!), i looked into what other tests might be available to get quicker results. apparently the FDA recently approved a blood test to detect MRSA called the BD GeneOhm StaphSR assay. it gives results in hours, not days. read more here:

[url]http://www.*****.com/news/20080102/fda-oks-1st-quick-mrsa-blood-test[/url]

[url]http://www.bd.com/geneohm/english/products/idi_staphsr.asp[/url]

unfortunately, my doctor (or rather, his nurse) had no idea what i was talking about when i asked about this test on wednesday. what's most disconcerting is the rather lackadaisical attitude my doc has about all of this. when i ask if i should be doing anything different in my day to day activities to avoid possibly spreading it more to myself and other in my household, he said, "no, you don't to do anything different." nothing about washing my hands more often, not sharing towels, etc. granted, i don't know yet if i'm dealing with MRSA, but the fact my doc seemed pretty convinced it was a possibility and prescribed Bactrim in the interim, wouldn't it make sense to at the very least give some fundamental information just in case? once again, i'm venting...sorry.

i'm trying to relax and "go about my life normally." but, in truth, i'd rather play it safe and be overly cautious within reason, and be one step ahead of the game if i am dealing with MRSA. it's just difficult to find a sense of normalcy with this looming over my head...the waiting is very difficult.

i do have a question:

-if the test result comes back negative (they took a sample of the pus from one of my sores), are there additional tests i should ask for to make sure it's not a false negative?

thanks again for answering my questions and taking the time to listen...it means a lot.

 
Old 11-14-2008, 10:24 AM   #4
Senior Veteran
(male)
 
Join Date: Jul 2008
Location: Canada
Posts: 999
harka HB Userharka HB Userharka HB Userharka HB Userharka HB Userharka HB Userharka HB Userharka HB User
Re: possible MRSA...help please!!!

it's not easy, but i'm doing my best not to be too worried...i read such mixed things about MRSA and the degree of severity it presents (as you mentioned, it tends to get blown out of proportion sometimes). i've learned from past experience not to spend too much time researching on the internet, lest i find myself in uber freakout mode. but i need to inform myself and not take one doctor's assessment as the gospel.
******I think what you need to do is take a step back and ask yourself what you are so afraid of. On one hand you are saying you know that it's nothing to be freaked out about, but then on the other you are..well...freaking out. As you know, Staphyloccocus lives on your skin, and more than 80% of the population at one time has some form of Staphylococcus aureus on the skin. Now, go down to the states where up to 80% of the Staph aureus is MRSA (as opposed to MSSA) you'd realize that there are TONS of people who have it on their skin and it's no problem.

Your problem is that you're clearly an intelligent person, and you have some medical knowledge BUT IT'S NOT IN CONTEXT!!! Intelligent people are always trying to problem solve an analyze, but by not having a basis from which to compare, all you do is freak yourself out. Internet reading, you're right, is not helping. Secondly, you're right that you shouldn't take the doctor's word as gospel--it's important to read, but that is for the average person. People with your profile (again, intelligent, analytical) tend to be unable to take a doctor's word because "you want to read it for yourself". The problem is, you forget the doctor is not only your source for the medical info, but also the translator of its significance. Aeronautical Engineers may be of the smartest people in the world, but even they don't necessarily have medical knowledge in context, and though difficult, have to take a step back and allow the doctor to interpret things for them.


since i was thrown this curveball this past tuesday...and because i probably won't hear test results until monday or tuesday of next week (hopefully!), i looked into what other tests might be available to get quicker results. apparently the FDA recently approved a blood test to detect MRSA called the BD GeneOhm StaphSR assay. it gives results in hours, not days. read more here:
******Whether or not it gives you the result, it doesn't matter. If you have a soft tissue infection, you treat empirically with antibiotics. The cultures only help to identify a bug so you can tailor your antibiotics later. Plus, your skin swab may grow MRSA, but that doesn't even necessarily mean that the rash on your legs is an infection.


unfortunately, my doctor (or rather, his nurse) had no idea what i was talking about when i asked about this test on wednesday.
********They don't have an idea because they're not microbiologists or infectious diseases specialists. Doctors don't know everything in every area of medicine. Every doctor is familiar with the basics of microbiologic cultures, but 95% of them don't know the exact mechanics of how things work in the lab. Why? Because it's not clinically relevant most of the time. The fact that your doctor and your nurse didn't know about specific MRSA testing is not surprising (or alarming) in the least. You have likely read about a test which is either experimental, not widely available or for research purposes only. Getting an early diagnosis of MRSA isn't that relevant if you are going to treat empirically with antibiotics.

what's most disconcerting is the rather lackadaisical attitude my doc has about all of this.
******It's not lackadaisical--it's just relatively calm compared to your overreaction. MRSA is not a big deal--you say you know that, but then that is not what you are demonstrating. The majority of skin & soft tissue infections in the US are from MRSA, and just like most MSSA soft tissue infections are not a big deal--either are most MRSA soft tissue infections.


when i ask if i should be doing anything different in my day to day activities to avoid possibly spreading it more to myself and other in my household, he said, "no, you don't to do anything different." nothing about washing my hands more often, not sharing towels, etc.
*************Yeah, why would you do that? If 80% of the isolates of Staph aureus are MRSA, how would washing your hands more or sharing towels more do anything?! If you have MSSA or MRSA on your skin, there is almost NOTHING you can do to NOT pass it on to your close contacts--in fact, you may have gotten it from one of them. Staph aureus is EVERYWHERE, and all you're going to do by freaking out is become obsessive-compulsive about cleaning, and unless you flame-torch your entire house, you'll never get rid of it. Decolonization of all the people in your household may work if you are all getting recurrent boils, but otherwise is not helpful.


granted, i don't know yet if i'm dealing with MRSA, but the fact my doc seemed pretty convinced it was a possibility and prescribed Bactrim in the interim, wouldn't it make sense to at the very least give some fundamental information just in case? once again, i'm venting...sorry.
***********You're right about this. Maybe he should have given you some information about exactly the risks involved with MRSA, but would that have really been helpful for you? You already don't totally trust his opinion, and no matter WHAT he said to you, you would be freaked out about it. I mean, it's okay to be freaked out initially, but I'm giving you rational information here, and your internet reading and doctor mistrust is kinda perpetuating your anxiety. I am really not trying to offend you, but sometimes actually calling someone out on his fear helps the person recognize that there's not all that much to be nervous about.

i'm trying to relax and "go about my life normally." but, in truth, i'd rather play it safe and be overly cautious within reason, and be one step ahead of the game if i am dealing with MRSA. it's just difficult to find a sense of normalcy with this looming over my head...the waiting is very difficult.
************So let's say it's MRSA, how does that change things for you? A second question: let's say it turned out to be Group A Streptococcus (the etiologic agent of necrotizing fasciitis) or MSSA, would that make you nervous?

i do have a question:

-if the test result comes back negative (they took a sample of the pus from one of my sores), are there additional tests i should ask for to make sure it's not a false negative?
**********You've been doing reading haven't you? No, the current standard of diagnosis for MRSA goes through two stages--an actual disc diffusion test to screen for resistance to a semi-synthetic penicillin then a confirmatory test looking for MRSA's mutated penicillin binding protein via a latex agglutination assay. This is a very sensitive test, and its negativity can be taken as confirmatory.

thanks again for answering my questions and taking the time to listen...it means a lot.
******I'm always glad to listen. Please take a second and actually listen to what I'm trying to tell you as well. The way you're going, you're just going to continue to spiral down in to anxiety. Take a step back, try to identify exactly what's bugging you, and you'll realize it's not all that much to be afraid of!

 
Old 11-23-2008, 11:07 AM   #5
Newbie
(female)
 
Join Date: Nov 2008
Location: enterprise al
Posts: 9
gsac114 HB User
Re: possible MRSA...help please!!!

Quote:
Originally Posted by cgranulomatis View Post
it's not easy, but i'm doing my best not to be too worried...i read such mixed things about MRSA and the degree of severity it presents (as you mentioned, it tends to get blown out of proportion sometimes). i've learned from past experience not to spend too much time researching on the internet, lest i find myself in uber freakout mode. but i need to inform myself and not take one doctor's assessment as the gospel.
******I think what you need to do is take a step back and ask yourself what you are so afraid of. On one hand you are saying you know that it's nothing to be freaked out about, but then on the other you are..well...freaking out. As you know, Staphyloccocus lives on your skin, and more than 80% of the population at one time has some form of Staphylococcus aureus on the skin. Now, go down to the states where up to 80% of the Staph aureus is MRSA (as opposed to MSSA) you'd realize that there are TONS of people who have it on their skin and it's no problem.

Your problem is that you're clearly an intelligent person, and you have some medical knowledge BUT IT'S NOT IN CONTEXT!!! Intelligent people are always trying to problem solve an analyze, but by not having a basis from which to compare, all you do is freak yourself out. Internet reading, you're right, is not helping. Secondly, you're right that you shouldn't take the doctor's word as gospel--it's important to read, but that is for the average person. People with your profile (again, intelligent, analytical) tend to be unable to take a doctor's word because "you want to read it for yourself". The problem is, you forget the doctor is not only your source for the medical info, but also the translator of its significance. Aeronautical Engineers may be of the smartest people in the world, but even they don't necessarily have medical knowledge in context, and though difficult, have to take a step back and allow the doctor to interpret things for them.


since i was thrown this curveball this past tuesday...and because i probably won't hear test results until monday or tuesday of next week (hopefully!), i looked into what other tests might be available to get quicker results. apparently the FDA recently approved a blood test to detect MRSA called the BD GeneOhm StaphSR assay. it gives results in hours, not days. read more here:
******Whether or not it gives you the result, it doesn't matter. If you have a soft tissue infection, you treat empirically with antibiotics. The cultures only help to identify a bug so you can tailor your antibiotics later. Plus, your skin swab may grow MRSA, but that doesn't even necessarily mean that the rash on your legs is an infection.


unfortunately, my doctor (or rather, his nurse) had no idea what i was talking about when i asked about this test on wednesday.
********They don't have an idea because they're not microbiologists or infectious diseases specialists. Doctors don't know everything in every area of medicine. Every doctor is familiar with the basics of microbiologic cultures, but 95% of them don't know the exact mechanics of how things work in the lab. Why? Because it's not clinically relevant most of the time. The fact that your doctor and your nurse didn't know about specific MRSA testing is not surprising (or alarming) in the least. You have likely read about a test which is either experimental, not widely available or for research purposes only. Getting an early diagnosis of MRSA isn't that relevant if you are going to treat empirically with antibiotics.

what's most disconcerting is the rather lackadaisical attitude my doc has about all of this.
******It's not lackadaisical--it's just relatively calm compared to your overreaction. MRSA is not a big deal--you say you know that, but then that is not what you are demonstrating. The majority of skin & soft tissue infections in the US are from MRSA, and just like most MSSA soft tissue infections are not a big deal--either are most MRSA soft tissue infections.


when i ask if i should be doing anything different in my day to day activities to avoid possibly spreading it more to myself and other in my household, he said, "no, you don't to do anything different." nothing about washing my hands more often, not sharing towels, etc.
*************Yeah, why would you do that? If 80% of the isolates of Staph aureus are MRSA, how would washing your hands more or sharing towels more do anything?! If you have MSSA or MRSA on your skin, there is almost NOTHING you can do to NOT pass it on to your close contacts--in fact, you may have gotten it from one of them. Staph aureus is EVERYWHERE, and all you're going to do by freaking out is become obsessive-compulsive about cleaning, and unless you flame-torch your entire house, you'll never get rid of it. Decolonization of all the people in your household may work if you are all getting recurrent boils, but otherwise is not helpful.


granted, i don't know yet if i'm dealing with MRSA, but the fact my doc seemed pretty convinced it was a possibility and prescribed Bactrim in the interim, wouldn't it make sense to at the very least give some fundamental information just in case? once again, i'm venting...sorry.
***********You're right about this. Maybe he should have given you some information about exactly the risks involved with MRSA, but would that have really been helpful for you? You already don't totally trust his opinion, and no matter WHAT he said to you, you would be freaked out about it. I mean, it's okay to be freaked out initially, but I'm giving you rational information here, and your internet reading and doctor mistrust is kinda perpetuating your anxiety. I am really not trying to offend you, but sometimes actually calling someone out on his fear helps the person recognize that there's not all that much to be nervous about.

i'm trying to relax and "go about my life normally." but, in truth, i'd rather play it safe and be overly cautious within reason, and be one step ahead of the game if i am dealing with MRSA. it's just difficult to find a sense of normalcy with this looming over my head...the waiting is very difficult.
************So let's say it's MRSA, how does that change things for you? A second question: let's say it turned out to be Group A Streptococcus (the etiologic agent of necrotizing fasciitis) or MSSA, would that make you nervous?

i do have a question:

-if the test result comes back negative (they took a sample of the pus from one of my sores), are there additional tests i should ask for to make sure it's not a false negative?
**********You've been doing reading haven't you? No, the current standard of diagnosis for MRSA goes through two stages--an actual disc diffusion test to screen for resistance to a semi-synthetic penicillin then a confirmatory test looking for MRSA's mutated penicillin binding protein via a latex agglutination assay. This is a very sensitive test, and its negativity can be taken as confirmatory.

thanks again for answering my questions and taking the time to listen...it means a lot.
******I'm always glad to listen. Please take a second and actually listen to what I'm trying to tell you as well. The way you're going, you're just going to continue to spiral down in to anxiety. Take a step back, try to identify exactly what's bugging you, and you'll realize it's not all that much to be afraid of!
HI I AM NEW ONE THE MESSAGE BOARD SO HOW ARE YOU DOING NOW? BECAUSE I HAVE BEEN DEALING WITH THIS SINCE 2004, BUT DID NOT NO IT WASN'T CURABLE SO NOW I AM VERY WORRIED BECAUSE I HAVE IT ON MY LEG. AND IT STARTED TO DRAIN AGAIN SO THEY TOOK ANOTHER COULTURE TO SEE IF IT THE SAME INFECTION I HAVE A 50/50 CHANCE OF LOOSING MY WHOLE LEG DUE TO A HIP SURGERY THAT HAD TO BE DONE TWICE AND THEY BROKE THE FEMUR . SO MURSA GREW UNDER THE PLAT AND SCREW. SO LAST MAY I WAS BACK ENFOURTH WITH IV. AND NOW IT STATED AGAIN . I SHOULD FIND OUT IF THE COULTURE COMES BACK TUES.

 
Old 11-23-2008, 11:12 AM   #6
Newbie
(female)
 
Join Date: Nov 2008
Location: enterprise al
Posts: 9
gsac114 HB User
Re: possible MRSA...help please!!!

Need Help On Talking To Someone Who Is Going Threw This To Please Help

 
Closed Thread




Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off




Sign Up Today!

Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

I want my free account

All times are GMT -7. The time now is 10:16 AM.



Site owned and operated by HealthBoards.comô
Terms of Use © 1998-2014 HealthBoards.comô All rights reserved.
Do not copy or redistribute in any form!