Another thing I've experienced! Really.
Working in outpatient setting, I got a pretty bad blister on my hand. Since I had not yet figured that all my itching was due to latex sensitivity, I frequently ended up with little areas of non-intact skin - not major, just cracks and stuff.
The blister looked ugly and I went to my doctor. There was a little elevation in WBC, Believe it or not, this led the doctor to worry about endocarditis (a possiblity that had occurred to me) and despite lack of murmur,we both felt deserved hospital work up, IV antibiotics until proven otherwise (well, she didn't quite know I had agreed with her decision, I told her I'd go).
So, in I go, blood work. echo, IV something or other. Echo negative, not really febrile, finger getting worse. So, my doctor wants a culture. But, she wants a surgeon. Because this is on my hand (the amazing expanding blister) general surgeons refused, took another night to get a hand surgeon. Who, by the way, did the same thing I could have done, stuck a pin (sterile needle) in my blister, and got some pus. He said, "I'm sure this won't show anything." Overall behavior, what's behind this big deal. Which, I'm beginning to think myself, starting to call this the ten thousand dollar blister. I got a little concerned when I spiked a fever (about 103) after he stuck the needle in my finger. I thought might be related, others did not, just a fever.
Shortly after, I'm seen by ID guy. I'm feeling fine except for the finger, the fever's gone, I want to go home. Then I discover:
So, now it's serious again. Started IV Vanco, couple of doses in hospital, then sent home with home health for two week course or something.
I'm feeling fine, no more fevers, the job, of course, needs to know exactly when I'll be back. I know I'm fine for work (ID stuff later), but my Vanco is timed during work hours and the IV in my arm might get in my way.
I looked at my culture report, also thought, "Isn't this really just a local infection now?" At follow up, I pointed out to ID guy - thank god, one who actully listened to patients. I basically said, look, this seems local to me and it says MRSA is sensitive to Bactroban. Can't I just do wound care with Bactroban, I know how to do that. I can take Cipro to be safe.
He said, well bactroban works, if its local it will. Cipro - it says it's sensitive on report, but MRSA is resistant after a day or two.
I said let's pretend it's local then. If it isn't, I promise, I'll come right back.
He said, OK, but might as well take the Cipro.
So, IV pulled, back to work the next day, used bactroban, took the cipro, all got better.
In terms of ID: My setting was outpatient, health dept. So, MRSA is in the community. The director of the county dept (MD, MPH)saw no problem with me working in community setting given all the above.
So my, pRobably greater than $10K finger amazing expanding blister was a local MRSA infection, transmitted in a non-hospital setting to a susceptible host (non-intact skin). There were no full blown systemic symptoms until the C&S - sent it right into my bloodstream but I think my body reacted pretty quickly with fever. Though fever gone by the time I took Vanco, probably couple of days did help.
I suppose its possible that I got the MRSA in the hospital but until treated with Vanco, then Bactroban, blister kept growing.
TALES FROM THE HEALTCARE SYSTEM