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salncrackers 05-04-2009 11:50 AM

Do I have MRSA?
I went to the doctor (a free health clinic by the way because I don't have health insurance, even though I'm a full-time teacher - can you tell I'm sour?) on Wednesday night (April 29th), and she (the nurse practitioner) told me that I had a real severe skin infection in my left nostril, which has spread and lead to a dangerous sinus infection (though you'd never know because I'm not snotty, just mucusy). She gave me a prescription for bactrim. I'm to take two double strength pills two times a day, and I have been doing so since Wednesday. I'm going back this Wednesday to make sure that I'm on the right meds. I'm just feeling like maybe I should've been given a culture or some sort of nasal ointment. I don't know. Does this sound familiar to anyone?

P.S. I'm already aware of the side effects of bactrim. The only issues I'm having are mucus (I think) in my stool and severe nausea (I threw up this morning).:dizzy:

harka 05-04-2009 02:41 PM

Re: Do I have MRSA?
Hey there salncrackers,

There's the american health care system for ya eh? I feel bad that not everyone is covered. There are lots of holes in the Canadian system, that's for sure, but at least everyone is covered. Hopefully that changes for you guys under the Obama administration.

Anyway, so yeah, nasal infections are often secondary to Staphylococcus aureus which is either methicillin sensitive (MSSA) or resistant (MRSA). If you have a second, read the "sticky" at the top of this area of the board where i wrote a little blurb on MRSA.

Are there any visible boils on/in your nose? Why did you go to the doctor/NP in the first place? Do you have a fever? Have you had problems with boils before? Are you having nasal discharge? Blood? Pus? Do you have a headache? Any change in your vision or seeing double?

I don't understand how the NP diagnosed a "sinus infection" by just examining you. If you truly had a Staphylococcal sinus infection, you would be much sicker and not posting here :) That said, you probably DO have a nasal cellulitis, and one of the treatments for this is Septra (Bactrim in the States). There is enough MRSA in the States that for soft tissue infections, it's good to simply treat them all as MRSA. In Canada, we still have a lot of MSSA, so you can start treatment with a semi-synthetic penicillin or 1st generation cephalosporin.

If you get repeated nasal infections or skin boils, or this doesn't totally get better:
#1. You should be seen by the doctor not the NP
#2. A swab should definitely be taken.

Depending on the patient's preferences, we usually would suggest decolonization (i.e. chlorhexidine baths, oral anbiotics and nasal ointment) if the person is having repeated MRSA/MSSA infections. After the first infection, most people wouldn't do anything because it often goes away on its own.

If you develop a worsening fever, red eyes and/or double vision, go to the ER immediately. Those are symptoms of a severe sinus infection. Otherwise, I'm not sure why you were given that diagnosis.

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