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Old 10-24-2005, 06:59 PM   #6
FearlessYeti
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Join Date: Oct 2005
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Re: Persistent maxillary sinusitis and bronchitis for 38 days despite Levaquin&Augmenti

Titchou, are you able to take tetracyclines or cephalosporins? You might ask your doctor about ketolides if you haven't already tried that as well (there may only be one available thus far, though).

Sneezydiva, ready for the trippy part? I've had allergy skin and serum testing multiple times and I'm hardly allergic to anything, and what I am allergic to is mild and non-seasonal. LOL. So ***? They assumed I'd have allergies off the charts and shots would fix everything, and instead they find out I'm hardly allergic at all? They were pretty perplexed, as was I.

I really, really, really want my ACE levels looked at. Clearly something autoimmune is going on if a sinus infection renders me unable to walk, y'know? lol That or something neurological, which would be scary. One disturbing thing is that my Mom has morphological and symptomatic signs of cardiac and pulmonary sarcoidosis, though the pulmonary component might be CF - they aren't sure yet. Given my symptoms though, it's worth noting.

The disturbing thing is that they now know you can have just one of the gene copies needed to have diseases such as CF, and not have the disease but still be symptomatic due to the presence of the gene. Not cool. That means lots of people could be walking around with intrinsically sub-clinical things that would almost certainly not get diagnosed or treated (if they even could be treated). Medical science doesn't like to acknowledge that people can sort of "almost" have this or that, rather than it being cut and dried. As in all things, they're being forced to accept now that clinical disease exists at many points within a spectrum, and can exist in grey areas that are very elusive or amorphous in nature.

I'm glad you found relief from your surgery. The mysterious thing in my case (and yet another reason we suspect something immunological) is that my ostia are wide open, I have no polyps, and there's no structural narrowing or obstruction of any kind. Like the rest of my respiratory tract in fact, everything's larger and wider than it should be, which is equally mystifying.

I would certainly LOVE some prednisone. I've begged my doctor for it throughout the year. It does indeed help me clear up rapidly - sometimes overnight! That's another odd feature of my "condition" whatever it's etiology is - I become ill over an extremely rapid 24 to 48 hour period (completely asymptomatic to full blown symptoms), and then when it goes away, I'm just as sick as ever the night before, but wake up feeling perfectly fine. It trips me out.

The problem with my primary care doctor is twofold. On the one hand, she believes I have chronic sinusitis. Technically speaking, I do. However, it's far more likely that that's a complication of an underlying inflammatory disorder of some kind, rather than the result of the more traditional causes such as nasal polyps. Failing to accept that possibility, she refuses to prescribe prednisone because it would suppress my immune system, and make my body less capable of fighting off the infection (an infection which, in fact, wouldn't exist if not for whatever my immune system is doing to impair my immunity so drastically in the first place! lol). The second problem is that she's on maternity leave right now, and the covering physician believes what I believe, but concludes from this that I shouldn't be on antibiotics. There needs to be a happy medium here lol. Know what I mean?

Anyway, my hopes rest with immunology on Nov. 9th. My goal is to convince them to give me prednisone, a different antibiotic, and to do some more serious blood labs than I've had thus far (especially ACE). I'd also really like them to plead the case for a sinus biopsy to ENT, who don't want to do that. If I have something like Wagener’s, they're very likely going to need a biopsy to diagnose it.
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Old 10-24-2005, 07:32 PM   #7
Titchou
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Re: Persistent maxillary sinusitis and bronchitis for 38 days despite Levaquin&Augmenti

No, can't do tetracycline (it won;t stay down so no point in taking it!) and I'm not sure about the other....my doctor has a comprehensive list of things we've tried and what happened...some just made me feel crappy...which is OK but hives, vomiting, blisters and anaphalaxis I just won't abide....anyway, I rarely get anything baterial so we'll just keep hoping that stays the case. That sinus infection was the first one in about 10 years so....I had taken the Z pak for an seriously infected toenail ( on the same toe I had had joint surgery only 3 weeks before) about 2 years before with no problem. But that's how these antibiotic allergies do me...one time it's fine and then the next something goes haywire. I was very sickly with throat and respiratory issues as a child (my mother refused to have my tonsils removed so I suffered until age 25 when I had them out on my own) and I think all those years of antibiotics screwed with my immune system...which already had allergy issues too.

Bottom line, good luck to you and keep us posted....
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Old 10-24-2005, 08:45 PM   #8
FearlessYeti
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Re: Persistent maxillary sinusitis and bronchitis for 38 days despite Levaquin&Augmen

Titchou:
I'm really sorry to hear you have such a broad range of antibiotic sensitivities. Here's a list of Cehalosporins so you can determine whether you've had them. They include:
Cefaclor (Ceclor; Raniclor)
Cefadroxil (Duricef)
Cefamandole (Mandol)
Cefazolin (Ancef)
Cefdinir (Omnicef)
Cefditoren (Spectracef)
Cefepime (Maxipime)
Cefixime (Suprax)
Cefmetazole (Zefazone)
Cefonicid (Monocid)
Cefoperazone (Cefobid)
Cefotaxime (Claforan)
Cefotetan (Cefotan)
Cefoxitin (Mefoxin)
Cefpodoxime Proxetil (Vantin)
Cefprozil (Cefzil)
Ceftazidime (Fortaz)
Ceftibuten (Cedax)
Ceftizoxime (Cefizox)
Ceftriaxone (Rocephin)
Cefuroxime and Cefuroxime axetil (Ceftin; Zinacef)
Cephalexin (Keflex; Pan|xne Disperdose)
Cephalothin (Keflin; Seffin)
Cephapirin (Cefadyl)
Cephradine (Velosef)
Loracarbef (Lorabid)

The only ketolide that I'm aware of is called Telithromycin (Ketek, which I believe someone mentioned on this board recently). It's not a macrolide, but is structurally related to them, so there is the possibility of a similar allergic reaction to it as you'd have to macrolides.

The only other types of antibiotic you haven't already used that's FDA approved for the treatment of sinusitis are Lyncomycins (also structurally related to macrolides), only one of which is really safe (Clindamycin). However, there are some other antibiotics with unlabled but nonetheless well documented and clinically successful efficacy against the common bacterial causes of sinusitis.

Last edited by FearlessYeti; 10-24-2005 at 08:51 PM.
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Old 10-24-2005, 09:17 PM   #9
Titchou
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Re: Persistent maxillary sinusitis and bronchitis for 38 days despite Levaquin&Augmenti

WOW, Fearless! You've really done your homework! I vaguely recall Keflex...does that give you a metallic taste for the duration of the use? If so, that's the one...nasty...gained weight trying to eat something to kill the taste! Anyway, I'll be sure to keep this list handy. Hopefully, I won't get another sinus infection. I've had my deviated septum repaired and my sinuses reamed out so everything usually drains pretty well. And I irrigate a lot...Thanks so much!
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Old 10-24-2005, 10:58 PM   #10
FearlessYeti
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Re: Persistent maxillary sinusitis and bronchitis for 38 days despite Levaquin&Augmenti

Note that not all of those I listed are approved for the treatment of sinusitis, but some are - I listed them all just in case you had them for some other infection.

Many antibiotics can leave a metallic taste, but did you have any other negative reaction to Keflex? If not, hopefully cephalosporins will be a viable alternative for you. They're the most common replacements for people allergic to the commonly prescribed URI antibiotics.

No problem. ^_^ I'm glad your surgery fixed you up.
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