Staph in a young person

[Katie0302]

In the duration of a week my boyfriend has been to the ER 3 times with an unknown infection with a fever of 105. Two of the times we were sent home and told to rest and keep up on fluids. The third visit he was finally given a chest XRay which confirmed severe pneumonia. He has been in the ICU for 3 days now and has rapidly deteriorated. The prognosis is lesions/ nodules surrounding the heart that need to be removed which they are unable to do until his pneumonia clears up. There is an apparent Staph infection of one of the nodules inside a ventricle of the heart. He is on a a breathing machine and is headed towards having to be on a respirator. He was a strong and active 26 year old with no known prior medical conditions. It seems very unusual to me that his condition has worsened so quickly. When I visit him, he is confused and agitated. What is the prognosis for this type of condition? At one point he was prescribed Zofran, which from what I gather is usually given to cancer patients, he has been on a vanomycin drip for 3 days but is regressing. I am getting no information from medical staff and I realized his condition is very serious, therefore I'm having a hard time understanding why this happened especially to someone young and normally very resilient to illnesses and why he isn't improving... is it even possible that he going to recover? Is is possibly there is something else going on?

[mkh9]

Well, that is all great news. He is doing very well under the circumstances. He must not have a resistant staph because he wouldn't be on the antibiotic methicilllin. So that is very good news. Also, I wouldn't worry too much about morphine even though he has used drugs. They will taper him off and since it is used for medical reasons I don't think it affect him the same way. It was necessary. The Zofran is for nausea. My brother in law was on it too. I think so far so good. Hang in there.
mkh9

[Katie0302]

Thank you so much for taking the time to answer my questions. He is a recovering IV drug user and we realize this is likely how he got ill, the medical staff knows this as well. I known that it is common for people with this type of condition to either have pre-existing heart conditions, have used IV drugs, or had a recent surgical procedure. He also has had an old infected root canal for a few weeks that he never mentioned until recently which couldn't have helped matters. He was moved out of the ICU yesterday and has made good progress, he is breathing now without assistance. He is still on Vanomycin I believe as well as Methicillin. Also Morphine, Ativan, and/ or Dilaudid for pain or anxiety, which also concerns me since he is an addict. We are considering seeking surgical care elsewhere would we want to search for an infectious diseases or cardiology specialist? Lastly, do you know anything about Zofran or why it may have been prescribed to him? Thank you again for the information.

[mkh9]

Hi and so very sorry this has happened to your boyfriend. We are not doctors on these sites but I can try to explain some things. It is a complicated situation. It is hard to know at this point exactly how all this happened. He could have had a structural problem with his heart such as mitral value prolapse and didn't know it. A lot of people (including young people) can have this. It can cause a lot of problems.

But do you know him well? Did he ever use injectable drugs? Sorry to ask this. It helps in figuring out how well he will do. If not then it is possible when he went to the ER he may have had community acquired Staph aureus. It can be resistant to antibiotics so that is why he is on Vancomycin. Also, any problem such as he could have had this heart valve problem, and that the bacteria either from the skin or even from another area in the body got into his lungs then into the heart. When the heart is not strong to start with to the say the valve not working right the bacteria can get in. This is all theory since I don't know what really went on for sure.

Then, they would have to treat him with antibiotics and clear the bacteria out of the heart area so it can pump right and then when he is clear of it fix the mitral value if that is what he has. He may not have a heart valve problem and it just spread because of the pneumonia.

The problem is that he may have a resistant strain of Staph called MRSA and so it is harder to treat. Also, the bloating is probably because the fluids they give him are hard to get rid of and the kidneys have to work harder.  When the heart is not functioning as well fluid can back up. So the fluid retention isn't the main problem here.

He also may have a heart murmur.

If he didn't do drugs and he did get the Staph in the community then the cure rate is really high.  But he is strong and young. So it is actually very high considering he has it on the heart. He got treated early. So you should talk to his doctors about this.

I really don't know the whole story.  But I can only go by the small amount of information given me. He may not have a heart value problem which would make his cure rate higher. I can only go by possibilities.

I hope this helps.
mkh9

[Katie0302]

Additionally, I noticed today that his belly has become extremely bloated even though he is not able to eat or drink. When I mentioned it to the nurse, she seemed unconcerned and oblivious and simply shrugged it off. What could be the cause of this?