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Old 02-24-2009, 09:41 PM   #1
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Recurring Staph Infection

Hi,

I have been experiencing a recurring staph infection for several years now. My guess (because these infections were not cultured until about a year ago) is that it all began in college with an infection on my right index finger. This (what I believe to be the initial infection) was actually quite bad. It basically ate away all the skin on my right index finger from the fingertip down to the second joint. Since then I have been subject to recurring staph infections about every 4 to 6 months. However, in the last year they have been happening more frequently... about every 2 months, and even more recently almost once a month sometimes.

Initially they were located only on the fingertips but over time have spread to different areas. It seems now to attack my face almost exclusively. It starts out looking like a pimple or a small spider bite and then progresses into (depending on the severity) anywhere from a dime to quarter size wound. I have had it cultured now several times from several different areas of my body. Each time it tests as staph aureus. It is not MRSA because it is vulnerable to several different antibiotics.

Over the years I have been able to treat outbreaks with Augmentin; however, it obviously does not completely erradicate it. The outbreaks are becoming more frequent, it is spreading to new areas and is really beginning to worry me because my doctor seems to have run out of answers.

We have tried Augmentin 500mg - 10 days, Augmentin 875mg - 10 days, Augmentin 875mg with Rifampin (however you spell that) - 15 days, some dermatology antibiotic for 30 days (i forget the name of this one), and now most recently Augmentin 875mg for 45 days. It is now back after my most recent cycle of antibiotics and I do not know what to do now.

We have tested for just about everything imaginable... hiv, aids, herpes, any other std, general blood tests, etc. According to my doctor I am a perfectly healthy individual. But quite obviously, we are missing something.

After some research I brought up the notion that maybe the infection had gotten into my bone and it is spreading that way. He immediately shot that down suggesting that I would be very ill. I also suggested this to a so-called specialist that I went to. She said the same thing. However, this is about the only thing I can think of... we seem to have tested for just about everything else.

I fear that if immediate measures are not taken to address this, I will find myself hospitalized with this infection. Possibly sometime soon with the way it seems to be progressively getting worse (most notably over the last year).

Can anyone provide some sort of insight? Suggestions of doctors I should see (i am in the Denver, Co area)? Suggestions of treatments I might consider or bring up to my doctor? Anything will help as I am becoming extremely concerned with my health.

Also, in case it helps. Each time this infection breaks out, the lymph node in my jawline (right side only) gets swollen and tender. Also, there is still a very small lump remaining on my left elbow (the site of one of my outbreaks)... I have also noticed the formation of similar small lumps around my left temple and right eye and my left armpit.

Sorry for such a long post.

Thanks
Bryan

 
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Old 02-25-2009, 11:28 AM   #2
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Re: Recurring Staph Infection

Cystic nodular acne. I had a staph infection that kept coming back in the form of boils and they realized this is what it was. See a dermatologist.

 
Old 02-25-2009, 03:14 PM   #3
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Re: Recurring Staph Infection

Hi Bryan,

One possibility is that what you have is not infectious at all (despite what the culture says) and that treating it with antibiotics is not the answer. Sometimes breaks in the skin can become colonized with Staph aureus. The thing with that is the bugs live on the surface but are not causing infection.

Another issue is that of MRSA. (Read my sticky on MRSA at the top of this thread). You've been given Augmentin which is amoxicillin/clavulanate. MRSA is a methicillin resistant Staph which is resistant to augmentin. It's possible that the Staph infections you're having are resistant to the effects of augmentin and you'll need something else like Septra (bactrim in the states), to treat it. The other idea is to decolonize yourself. Part of the problem may be that while you are being treated for recurrent staph infections, you're not eliminating the reservoir and these residual staph bugs are coming back to haunt you. There are deolonization protocols involving things like body washes, shampoos, nasal ointments and oral antibiotics (NOT augmentin).

Do you have any other health problems?

 
Old 02-25-2009, 06:17 PM   #4
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Re: Recurring Staph Infection

No other health problems that I know of. I've always been extremely healthy. In fact this is really the only thing, aside from the occasional flu and allergies when I was younger, that I have ever really been to the doctor for. I'm 30 years old and have been to the doctor many more times in the last year because of this than I have in all my life.

One treatment that I went through, which was recommended by an infectious disease specialist, was a combination of Augmentin and Rifampin orally to treat the open wound, as well as an antibiotic cream that I swabbed in my nose 3 times daily, and a soap/shampoo that I used once daily in the shower for 15 days. So, I feel as though I've gone through the decolonization processs once before.

When these things break out, sometimes its a bad outbreak and sometimes not so bad. What causes it to be bad at times and not so bad at others really confuses me. However, when home remedies are not working, it seems to get worse and worse until I am put on Augmentin. Its an almost an immediate effect once i start the antibiotics... it instantly starts getting better. So for that reason, I feel like whatever it is certainly is susceptible to that type of antibiotic. Not to mention the cultures that show it is susceptible to that antibiotic. However, I do see what you are saying, that maybe when taking the culture I am picking up the normal staph that lives on the skin. Some of the cultures that I have taken, I could certainly see that being the case, but sometimes (and this is really gross) there is so much secretion that you don't even have to touch the skin at all with the swab in order to take a significant amount of testable substance.

I should also note that recently, none of these outbreaks forms from a cut on the skin. It either comes in the form of a pimple or large, under-the-skin lump that eventually has to be drained.

I will read your post on MRSA to see if there are any additional treatments or considerations to explore.

As for the comment on cystic nodular acne, I will have to look into that. I'm not sure it would explain the large marble sized (and extremely painful) lumps that I experience on my arm just below my bicep. However, it also could be the case that the spot on my arm and the stuff on my face are not related.

Thanks for the replies. If there is anything else that you think of please let me know.

 
Old 02-25-2009, 07:20 PM   #5
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Re: Recurring Staph Infection

If you are being seen by an ID specialist then I'm sure the treatment you've been given is absolutely correct. The fact you're on Augmentin/Rifampin is highly suggestive that you do NOT have MRSA.

One other thing: in terms of the decolonization protocol you were given, it sounds like the one I was talking about; however, it probably won't work if you use it WHILE you have any boils present. You should wait until after all boils are cleared and THEN do the decolonization procedure.

Last edited by harka; 02-25-2009 at 07:20 PM.

 
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Old 02-27-2009, 05:23 PM   #6
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Re: Recurring Staph Infection

Yeah i'm also pretty sure its not MRSA. Is there any way that the bacteria has colonized internally rather than externally on the skin? Everywhere I go, I keep getting the same basic diagnosis... it cultures as MSSA, I'm given Augmentin, and am instructed to go through the decolonization process. Yet it continues to come back. I have been tested for just about everything imaginable with a few exceptions. One of the very few things that has not been explored is the fact that the infection is colonized in the bone. From the responses I have gotten, if this were the case I would be extremely ill. However, some reading I have done suggests that if it were colonized in a smaller bone (such as the fingertip which is were I suspect this all started), I may not necessarily feel horribly ill. Is this a possibility? If so, what kind of doctor should I see? Thanks for your help!

 
Old 02-27-2009, 06:28 PM   #7
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Re: Recurring Staph Infection

Quote:
Originally Posted by esorb11 View Post
Yeah i'm also pretty sure its not MRSA. Is there any way that the bacteria has colonized internally rather than externally on the skin? Everywhere I go, I keep getting the same basic diagnosis... it cultures as MSSA, I'm given Augmentin, and am instructed to go through the decolonization process. Yet it continues to come back. I have been tested for just about everything imaginable with a few exceptions. One of the very few things that has not been explored is the fact that the infection is colonized in the bone. From the responses I have gotten, if this were the case I would be extremely ill. However, some reading I have done suggests that if it were colonized in a smaller bone (such as the fingertip which is were I suspect this all started), I may not necessarily feel horribly ill. Is this a possibility? If so, what kind of doctor should I see? Thanks for your help!
Yes. That is true--bacteria don't "colonize" bone. If there is bacteria in the bone it is an infection called osteomyelitis and it is very symptomatic including bone pain redness and fevers.

Have you been tested for an immunodeficiency? Also have you washed all the surfaces in your house? Are any of your roommates colonized with Staph?

 
Old 03-24-2009, 08:25 PM   #8
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Re: Recurring Staph Infection

I've had recurring staph for a couple of years now. I've gone to several doctors including an infectious Disease Dr. and it's always the same...just prescribe some antibiotics, use bactroban up the nose for 10 days, and hope it doesn't come back...but they always do, beginning as an innocuous little dot that itches and grows into a nasty, extremely painful boil. They also leave a scar after they're gone.
I hope there's some relief at some point in the future.

Last edited by Cane Man; 03-25-2009 at 02:49 PM. Reason: grammar

 
Old 03-31-2009, 08:48 AM   #9
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Re: Recurring Staph Infection

Did you use the nasal bactroban or was it just the regular ointment (miopricin 2%) ? The reason I ask is because my daughter was diagnosed with mrsa & we were given bactroban for use in our nostrils for the whole family to kill whoever is the carrier of the staph. I've read that there is a bactroban nasal & the information leaflet with the tube of bactroban says not for use in mucosal surfaces. I am just curious if we should be putting this (non-nasal) bactroban in our noses??!?

 
Old 04-01-2009, 10:32 AM   #10
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Re: Recurring Staph Infection

Cane,

Sounds like you have had very similar experiences to mine. Each time I go I am prescribed essentially the same thing, and every time it helps, but only temporarily - the boils, wounds, whatever you call them, always come back. Mine is definitely not MRSA so i don't understand why it cannot be eliminated. I am always told to clean my house (laundry, disinfect basically the entire house, etc.)... i can't tell you how many times I've gone through this process. Hell I've even moved a couple time during this ordeal. From my experience, doctors seem to have a pretty simple playbook when it comes to staph, and the doctors I have seen have no real interest in trying to figure anything out beyond that. It is extremely frustrating. Its also getting pretty stressful and scary because my condition seems to be progressively getting worse. I feel like I'm going to have to end up in a hospital bed before anyone takes this seriously. Even then I have my doubts as to whether or not it would be addressed properly.

As for the nasal-specific ointment... not real sure. When prescribed that medication, I was unaware that there were different version for different areas of the body. Sorry I couldn't be of any help.

 
Old 04-01-2009, 02:45 PM   #11
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Re: Recurring Staph Infection

Quote:
Originally Posted by esorb11 View Post
Cane,

Sounds like you have had very similar experiences to mine. Each time I go I am prescribed essentially the same thing, and every time it helps, but only temporarily - the boils, wounds, whatever you call them, always come back. Mine is definitely not MRSA so i don't understand why it cannot be eliminated. I am always told to clean my house (laundry, disinfect basically the entire house, etc.)... i can't tell you how many times I've gone through this process. Hell I've even moved a couple time during this ordeal. From my experience, doctors seem to have a pretty simple playbook when it comes to staph, and the doctors I have seen have no real interest in trying to figure anything out beyond that. It is extremely frustrating. Its also getting pretty stressful and scary because my condition seems to be progressively getting worse. I feel like I'm going to have to end up in a hospital bed before anyone takes this seriously. Even then I have my doubts as to whether or not it would be addressed properly.

As for the nasal-specific ointment... not real sure. When prescribed that medication, I was unaware that there were different version for different areas of the body. Sorry I couldn't be of any help.
Don't be so quick to blame your doctors for "going by a playbook". Infectious disease doctors have a lot of training to get where they are, and given the nature of their practice, are doctors who are LEAST likely to do things by reflex and actually THINK about each situation on a case by case basis. Staphylococcal infections like the one you have are VERY difficult to eradicate. The reason the doctors seem to give the "same treatment" is because there is not much else we can do about the bug because it lives on the surface of your skin.

In terms of decolonization protocols you've gotten, I take it you've had something like this? --

7 days of TWO oral antibiotics
7 days of chlorhexidine body washes
1 to 2 days of a triclosan shampoo
7 days of a nasal ointment (mupirocin) three times daily.

Does that sound about right?

If you have had a decolonization protocol, were you prescribed the protocol when you had active boils on the skin? Which oral antibiotics were you given?

Last edited by harka; 04-01-2009 at 02:48 PM.

 
Old 04-03-2009, 07:25 PM   #12
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Re: Recurring Staph Infection

Very good post. I haven't done the protocol you outlined, but just bits and pieces of it. I've never done more then one oral antibiotic at any one time and have done the ointment up the nose, but never the body washes and/or triclosan shampoo. I'll have to explore that further. This might be a 'who's buried in Grant's Tomb' question, but if the MSSA or MRSA colonizes up the nose, could they not take some kind of sample culture from your nose and confirm that it is in fact there?

Thanks!

 
Old 04-05-2009, 10:07 PM   #13
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Re: Recurring Staph Infection

Hey Cane man,

Yes you can do a swab of the nose to see if there is Staph aureus there, and that is in fact what the doctors to do make sure the Staph has been eradicated once the decolonization protocol is complete.

For the decolonization protocol to work, one can't have any active lesions or boils on the body. If you are getting recurrent Staph infections, it's one place where there is possible benefit from this decolonization protocol.

 
Old 04-06-2009, 11:03 AM   #14
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Question Re: Recurring Staph Infection

I have been having a slew of problems dealing with Staph aureus. To make a very long story short, my doctor tells me that I have a strain of staph older than ten years. For the past three months, I have been on several antibiotics and I have followed the strict regimen of decolonization to fight it.
Chlorhexidine body washes
triclosan shampoo
nasal ointment (mupirocin) three times daily

I also add 1cup of bleach to my bath water.
I also do a Nasal rinse that includes hot water, salt, baking soda and Neosporin. I combine these ingredients by shaking them until the Neosporin dissolves. Then I inhale the mixture into each nostril. Itís a very strange feeling =0
I floss and brush with baking soda each morning and night. I rinse with hydrogen peroxide.
I wash and then clean each wound with hydrogen peroxide. Wait for that to dry, and then apply Neosporin to each wound with separate q-tips. Lastly, I cover each with a circular band aide prior going to sleep.

Needless to say, none of this has worked. The wounds are on my face and they are just getting more painful and larger. I have never had a history of acne before these wounds. People tend to look at me and assume that I am not a clean person and it is the exact opposite. I am extremely worried because it is rapidly getting worse. I do not know what to suggest to my doctor and I am tired of having to see him every week. There must be an antibiotic that is more affective than what I have been taking. I found out the hard way that I am allergic to sulfa. I am on Azithromycin 250mg right now and it has been useless. I have had an extensive history of ear nose and throat problems since I was a young child. Mainly ear infections and strep. I also have hypothyroidism, which is currently at a stable level. I am otherwise very healthy and active.

Any advice is welcome. I meet with my doctor again today and I would like to be able to suggest a different antibiotic.

 
Old 04-10-2009, 04:49 PM   #15
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Re: Recurring Staph Infection

My husband and I have been MRSA free for a little over a year now, and I just thought I'd share what seems to have helped us.

First, a little background...my husband works on a military base and 4 or 5 of his co-workers came down with spider bites within a couple months of each other. He's a mechanic, so no one thought anything of it because they have to reach up into vehicles that haven't ran for a bit. In June of 2006, my husband came home with a spider bite himself. He went to the doctor's, who told him it looked like a staph infection, took a culture and told him he had nothing to worry about. She gave him some cream, and that was that. I have to be honest, we had no clue what a staph infection was, and we didn't take necessary precautions to stop it from spreading. It wasn't long, and I started getting them too. The culture came back and verifyed that it was a "staph infection". No mention of MRSA or anything.

Time goes by and we suffer with them continuously, in the worst of locations. I usually had no less than 2 or 3 at a given time. We found out in November of 2007, that I was going to need abdominal surgery, and I started doing research online about boils and staph infections. That's when I found out about MRSA. We went to another doctor, who confirmed that we did have it (on the skin, not in our nose), and prescribed us Bactrim and Bacroban nose cream (just incase). The boils went away for a short time and then came back.

After trying several other antibiotics that only gave temporary relief, and having to prospone my surgery several times, I decided to take matters into my own hands in March of 2008. The following is what my husband and I both did over a two week time frame. I know it is tedious and a bit costly, but it's worked.

We both requested another bout of antibiotics (Bactrim and rifampin).

We started taking probiotics, vitamin c, drinking aloe vera juice, and an ounce of Noni/Mangosteen/Goji/Acai juice (all of which, we got from our local health food store).

We showered daily, using a routine of washing with Hibiclens soap for two days and Betadine on the third. We also stopped using hand soap, and starting using liquid soap (germs live on the bars). Razors were changed after each use. When we got out of the shower, we sprayed ourselves with a spray-bottle mixture of colliodal silver (antibacterial) and drinking water. Every four days, we would wipe Germ-X over our whole body.

We washed our clothes daily, including anything that was only on our bodies for a minute, in borox soap and whatever laundry detergent we used. We also went out and bought all new white bath towells, wash clothes and bed sheets, which were washed/bleached daily.

Every three days, I went through the house and wiped everything we touched (sink/shower handles, toilet, door knobs, light switches, fridge/stove/cabinet handles, counter tops, tables, remote controls, cell phones, everything!) with Clorox antibacterial wipes. I also sprayed the couches and carpets with Lysol Aerosol disinfectant spray.

We also gave our house cats a bath in Betidine, incase they were carriers. Not to mention that we washed our hands CONSTANTLY, especially after touching any body part.

I ended up having surgery in June 2008, where I was cut from my ribcage, down. Since my surgeon knew I was a MRSA patient, we took extra precautions after the surgery, and I was treated with Vancomycin, just incase I hadn't gotten rid of it. But I'm glad to say that I made it through with absolutely no complications, and I haven't seen a boil in this house since. I don't know if it was just one thing, or a mixture of several little things.

Now mind you, I work at an elementary school where boils are making their rounds. And my husband and I still take precautions when dealing with the public. We wash our hands often and especially after town outtings, and we always have Germ X with us. If we have to use a public bathroom, we wipe the seat down with the Germ X. Other than that, we don't use any kind of antibacterial soap at all. It's better to let our bodies natural "good" germs protect against the "bad" germs.

And I have to admit, I always have the fear that another boil is on the horizon. So as soon as any kind of bump shows up (ingrown hair, pimple, etc.), I soak a cotton ball in Germ X and apply it to the bump for a few minutes. Then I apply a roll on "Dial" deoderant that I get from a 99cent store. It has an ingredient in it that seems to stop the bump in it's tracks.

I hope that this can help someone else out there, who is suffering from these Horrible, painful things!

Last edited by nobodytotalkto; 04-21-2009 at 02:15 PM.

 
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