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Suggest Treatment For Recurrent Staphylococcal Infections
Question: My 19 y.o. daughter has had 3 staph infections in the last 6 months involving her L thigh. This has been associated with a fast h.r. 120-160 bpm. The initial infection 'cleared up' in August. She was admitted for a recurrence in October. Microbiology was done from a cut biopsy of a boil on her thigh which identified S.Aureus that I believe wasn't MRSA. After 3 days in hospital she was discharged with a prescription of apo-amoxy w clavulonic acid. Along with one week off from school the infection 'cleared up'. Now she has a boil and swelling on the same leg. Over the past year she has lost 10 or more pounds (now 110 and 5' 8")The current antibiotics she is on are septra 800/160 mg 2/day x 14 days, topical mupirocin , and keflex (not yet started) to be taken 4/day x 10 days .
She is a 2nd year nursing student and in her clinical she has probably been exposed to antibiotic resistant pathogens. I am concerned she may have an underlying weak immune system and shouldn't be in this setting. She has never had this type of infection prior though was ill for much of her early childhood. My questions are:
What work-up is involved in determining if ones immune system is weak ? If it is shown that one has or as a matter of the past hx one could deduce this then are there activities or work that should be avoided? Having a less demanding career choice?
I am concerned about her taking a combination of antibiotics where the rationale to take two kinds doesn't appear to be evidence-based. Any thoughts ?
We aren't relying just on antibiotics . Although not prescribed we are also giving our daughter vitamin C 4000 mg/day or more , cod liver oil and mesosilver. And she will be trying to see a local infection disease specialist .
Thank you for looking at this.
She is a 2nd year nursing student and in her clinical she has probably been exposed to antibiotic resistant pathogens. I am concerned she may have an underlying weak immune system and shouldn't be in this setting. She has never had this type of infection prior though was ill for much of her early childhood. My questions are:
What work-up is involved in determining if ones immune system is weak ? If it is shown that one has or as a matter of the past hx one could deduce this then are there activities or work that should be avoided? Having a less demanding career choice?
I am concerned about her taking a combination of antibiotics where the rationale to take two kinds doesn't appear to be evidence-based. Any thoughts ?
We aren't relying just on antibiotics . Although not prescribed we are also giving our daughter vitamin C 4000 mg/day or more , cod liver oil and mesosilver. And she will be trying to see a local infection disease specialist .
Thank you for looking at this.
Brief Answer:
Recurrent staphylococcal infections may happen in healthy individuals
Detailed Answer:
Hello,
if she had a weak immune system then she'd probably have many more problems with her health than the staphylococcal infections alone. A normal complete blood count, blood film, HIV and hepatitis status, serum protein electrophoresis and serum immunoglobulin levels is a basic check-up that will exclude most cases. More specific tests might be needed like neutrophil function tests etc. I have not considered conditions like diabetes mellitus because it would have been diagnosed during her hospital stay.
Please note that most recurrent skin infections are not related to immunodeficiency!
I don't believe she should change her career. She'd better try to be more careful when coming into contact with patients and potentially contaminated surfaces.
If the antiobiotic regimen is guided by culture results, it has to be right! I don't quite understand your notion about evidence-based treatments. Culture results guide treatment choices. Would you like to ask about a specific antibiotic combination?
Visiting an infectious diseases specialist is a good idea. Till then give priority to following medical advice regarding treatment regimens and to hygiene (washing hands, avoiding sharing items like towels, clothes etc, keeping her place clean - using bleach may help - perhaps using mupirocin cream - I know you mentioned that but it is ambiguous whether it helps or not in the long run).
I hope I've helped!
If you'd like me to clarify anything, please let me know.
Kind Regards!
Recurrent staphylococcal infections may happen in healthy individuals
Detailed Answer:
Hello,
if she had a weak immune system then she'd probably have many more problems with her health than the staphylococcal infections alone. A normal complete blood count, blood film, HIV and hepatitis status, serum protein electrophoresis and serum immunoglobulin levels is a basic check-up that will exclude most cases. More specific tests might be needed like neutrophil function tests etc. I have not considered conditions like diabetes mellitus because it would have been diagnosed during her hospital stay.
Please note that most recurrent skin infections are not related to immunodeficiency!
I don't believe she should change her career. She'd better try to be more careful when coming into contact with patients and potentially contaminated surfaces.
If the antiobiotic regimen is guided by culture results, it has to be right! I don't quite understand your notion about evidence-based treatments. Culture results guide treatment choices. Would you like to ask about a specific antibiotic combination?
Visiting an infectious diseases specialist is a good idea. Till then give priority to following medical advice regarding treatment regimens and to hygiene (washing hands, avoiding sharing items like towels, clothes etc, keeping her place clean - using bleach may help - perhaps using mupirocin cream - I know you mentioned that but it is ambiguous whether it helps or not in the long run).
I hope I've helped!
If you'd like me to clarify anything, please let me know.
Kind Regards!
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Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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