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Next Diagnosis Please ...

May 21, 2009 - 8 comments
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diagnosis

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Pain

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Infection

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Weight

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help

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food journal

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Nocardia

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MRSA



OK .. so I was "supposed" to have MRSA and taking Clindamycin for the past 2+ weeks and that, along with the I&D procedures (Incision & Drainage) to the abscesses, should be done, better, over, and well.

Of the 4 areas, the middle one is healed, the bottom one is draining a little and has a knot forming underneath it, the top one is draining a lot and has a large knot forming underneath and around it and the one on my hip fills and then about every 3 days it drains.  Sorry .. there is no prettier way to describe it.  

Since I was supposed to be better .. I kept telling myself and willing myself to BE BETTER!  Mind over matter .. isn't that what they say?  Anyway, tonight I got a call from the nicest doctor I saw at the ER.  He was the one who opened the top and bottom ones and aspirated the one on my hip and said .. "This is infection; I'm sending it for culture."  Well, he did and when the preliminary report came back he ordered a longer incubation period.  And .. voila .. we now have a formal diagnosis of what we are dealing with .. it is "Nocardia".  

Now I hadn't heard of it and it appears they are reading up on it as well.  He answered my questions and offered to print off medical literature for me as well.  He feels this may have been present since my initial surgery over a year ago .. which happens to totally Agree with My complaints all along.  It is a bacteria that requires a 3-6 month course of antibiotics -- Bactrim.  (After my research .. it appears 6 months minimum to a year - another question for the doctor.)  The fact that the abscesses appear to be forming again is not surprising as he explained they would continue to do so until I am treated with the correct antibiotic.  

The Bactrim will be started tomorrow and we will keep an eye on the 3 areas I described as they may indeed have to be I&D'd again.  The antibiotic will help clear the bacteria but the only way to heal an abscess that has formed is to lance it and open it.  Well, at least it explains why I still don't feel well .. and it is not in my head .. and it is not because I haven't followed protocol.  

One lesson to be learned is persistence .. we each know our bodies best and know when things are not right.  We just have to cross the hurdle to get others to understand and believe we know what we are talking about.  

I have a HUGE THANK YOU to this kind and caring doctor who treated me patiently and explained the procedures, answered my questions, did his homework, went the extra step and talked to me twice tonight since I didn't quite have all my thoughts organized when I first heard this news.  

This information has been conveyed to Mikki (my daughter) so she can inform Kalista's doctors.  It poses the same risks to immunocompromised patients so Kalista's health comes first and it may be some time before I can see them ... a small price to pay for her to be in remission and as healthy as she can be fighting the leukemia.

Taking a pain pill and heading off to bed .. planning to post tomorrow and/or the next day and get us all rolling on this weight loss thing.  So very anxious to join you all again!

And .. SOME BIG NEWSSSSSS ... MedHelp will be rolling out a new Food Tracker very very soon!!!!  Am SOOOOO EXCITEDDDDDD .. so we ALL need to GET ON BOARD in the next few weeks and work together!!!!  Share more details soon!

Love and HUGGGSSSS .. Ranae

PS - Here's some additional information on Nocardia .. so those interested in "what" it is don't have to go look it up.

INFORMATION ON NOCARDIA - The various species of Nocardia are pathogenic bacteria with low virulence; therefore clinically significant disease most frequently occurs as an opportunistic infection in those with a weak immune system, such as small children, the elderly, and the immunocompromised.

Nocardia may also cause a variety of cutaneous infections such as actinomycetoma (especially Nocardia brasiliensis), lymphocutaneous disease, cellulitis and subcutaneous abscesses.

Antibiotic therapy with a sulfonamide, most commonly trimethoprim-sulfamethoxazole, is the treatment of choice.

Antibiotic therapy is continued for six months (in immunocompetent people) to a year (in immunosuppression), and may need to be continued indefinitely.[2] Proper wound care is also critical.



Comments
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579258 tn?1250649343
by Ranaesheart, May 21, 2009
Oh .. and I am not immunocompromised.  It is suspected from surgery and contained in my skin and should clear with a 6 month course of antibiotics.  Did I mention how much I hate taking pills???  But I WILL TAKE THEM AS SCHEDULED!  Good thing I didn't get rid of that weekly pill case .. lol   Got to find something to laugh about .. don't you think???  

428506 tn?1296557399
by wonko, May 22, 2009
Wow, your attitude is a great example of how persistence is key in these situation!

I hear you on the pills, I need to use one of those cases with an AM and PM section, or else I forget.  

So, if you had this since the surgery like they say, then does that explain how you got it?  Is it usually transmitted DURING surgery, or is there any clue how you were exposed?


168348 tn?1379357075
by ChitChatNine, May 22, 2009
And, Ranae, I'm wondering if the steroid injection weakened the area to make that area immunocompromised and the bacteria took off like wildfire ???

I am so glad you have your bacteria bcz it's like treating a urinary tract infection wit the wrong med as you wait for the cultures to come back .. it'll act as a band aid but not a cure!

WELCOME BACK RANAE ..............you should start to feel better soon and that other doc in the ER still needs his wrist slapped.

C~

483733 tn?1326798446
by TrudieC, May 22, 2009
Unbelievable!  So happy they now have it right and hope it isn't too long before you can see your Kalista.  Yes, those of us in tune with our bodies just know when something isn't right and it is heaven when a doctor gives us the respect we deserve.  

Much love, Trudie

649848 tn?1534633700
by Barb135, May 22, 2009
Wow, that's just incredible...... As if MRSA wasn't bad enough, now they throw in something else......  But I'm glad they now know what it is and can get you started on the right meds.  

I totally agree with what you say about persistence and standing up for yourself.  I have (and still am) going through the same thing with my thyroid issues.  AND I, also have to use a weekly "pill organizer" in order to make sure I get all my meds.  BUT, in addition to THAT - I also have three alarms set on my cell phone to REMIND me when it's TIME to take them because I get busy at work and don't keep up with the time - when one of my alarms goes off, I know it's time to take SOMETHING - just have to figure out WHAT....  lol

I'm excited about the news that MH is coming out with a food tracker..  I started one on another website, but it takes too much time to have so many sites to go to, keeping up with passwords, things to do, etc....  

Get well soon............ still praying for you and Kalista...  

657315 tn?1319491387
by twehner5, May 22, 2009
I already wrote in your other journal what *I* thought MRSA stood for (LOL), wanna know what *I* think Nocardia is???  NAH!!!  I didn't think you did!  I don't blame you.

I'm just so glad SOMEONE cultured this stuff and got to the bottom of it.  Now that you're on the right meds, let's make sure you're on for the right amount of time and YAY!  We'll get Ranae healthy again.  What a crazy, scary, unheard-of experience.

Now that you are relieved to have gotten what truly seems to be THE ANSWER, I hope you will still report the inappropriate  behavior by the doctor that one visit.  

I will continue to pray for you.  Don't push yourself too fast too soon.

Avatar universal
by VaBreeze, May 22, 2009
I'm so sorry to hear that you are having to go through this painful illness.  I can relate as I had problems with breast abscesses, having them drained, lanced and the works.  It ended with having surgery to remove the surrounding tissue, in order to prevent them from reoccuring.  I've only had one since then and just pray I never go through that again.  

I'm so happy that you found out what is causing them and it can be treated.  That's great news.  I had been to an infectious disease specialist, but they never found out what was causing mine.  I pray that you get this resolved in the next few months and never have another one.  

Be safe and take special care of yourself.  Feel better soon.

Avatar universal
by rashminm, Jun 07, 2016
Sir
Earlier i had written to you abt my 6 yr old son who had an abscess on his right forearm between the elbow and wrist in middle which was 13mmx7mm . After 4 weeks , one day it suddenly started leaking i mean the pus from the abscess and we got it drained and cleaned . He was given 4 more days of antibiotics on the day of drainage , moxclav and fusidin cream to apply in the area for 10 days and to keep the area clean. The place of the abscess is flat now and little redness around the whole from where it was drained . When i asked my child he said it is not paining . Now we have stopped the ointment and just washing it with water soap to clean. Originally the abscess was 13mmx7mm as i told you and now when we touch the area of the wound thick skin is feeled of smaller size but shape is rectangle type as the original abcess. I searched online for it and was confused to see about induration and antibioma but how do we know what it is . The doctor who drained it is in a different city and it is not possible to visit him again but when contacted through phone he said that it is skin induration which will take 4 weeks to go . It is already 12 days since the drainage but hardness is still there though we do not know if it has regressed in size but when touched we can feel the hard skin as a rectangle piece below the skin. Someone said the skin induration will go in 4 weeks and someone who said it is antibioma it will take 6-8 weeks for the hardening to go off completely and no treatment is required. Will the hardness below the skin where the abscess was drained go off completely on its own?

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