I am hoping one of you Infectious disease nurses can answer my questions. About 3 weeks ago my daughter called home and said it looked like she had these big spider bites on her legs and one behind her ear. She said they didn't itch as much as were really painful. This was on a Friday and by Monday she called and said some of them were about the size of a baseball and had broken open with green-thick pus. Told her to go to the doctor as it sounded like staff and she probably needed an antiobiotic. She is very allergic to many antibiotics and in fact had anaphylactic shock from Rocephin and PCN. Many others she gets hives and dependent edema. The doc gave her clindamycin po and said if not better in a couple of days to get back in. Two days later I went with her to the doc and they said she needed to get to the medical center(hospital) for IV antibiotics. They started her on IV vanc and IV clindamycin for 4 days and sent her home on po clindamycin. They were healing up nicely but they forgot to get a culture so do one on the 3rd hospital day. We went for her post-hospital visit and when they called her to go back to the exam room they were in full isolation protocal. They said the cultures came back C-MRSA. She was to continue on the oral clidamycin and see the infectious disease doctor in a week. She saw him and he said the vanc saved her life and to call if she saw they were returning. This doctor is from a large hospital 350 miles away and have a clinic twice a month at our smaller hospital. A couple of days ago she started getting new boils on her left leg. She called the doctor's office and was told to come in. They GP doctor she saw wasn't concerned at all and wanted to give her a script for Bactrim. She is very allergic to it so refused to take the script. He told her this C-MRSA is no big deal and she should quit making such a big deal about it. Today she has developed a couple more boils and is very scared. It seems like one doctor is real concerned and the next doctor not concerned at all. I can't get ahold of the infectious disease doctor and of course now it is a weekend so can't talk to the ID doctor until Monday. Am I wrong to be so concerned over this? Maybe we are over-reacting as one doctor says but I don't know that much about C-MRSA so maybe I am. Do you think she can wait for 3 days to see the ID doc? They aren't baseball size yet but about the size of an egg. Can anyone help me out with this problem and give some advice please?
Sep 29, '06
not to give medical advice , since we're not allowed to here, (but i understand what it's like to face something unknown and turn to colleagues for help too, esp when it's our kids!!)
the doc who saw her in the clinic who was concerned...do you have his card? do you have know his name?
it sounds like she's been treated by whomever is in the office the day she goes. who cared for her in the hosp?
regardless, i would get the name of the doc who originally saw her (who was concerned), call him and see if he's got an answering service. next time you see him, tell him the troubles you've been having with different docs, and the differing opinions. maybe he'll give you a card with his private answering service onit.
since the ID doc doesn't know her and has no history with her, s/he'll prob tell you to go to hospital or call the other doc up.
i know i'm not much help, but i would really try to get a hold of the doc who originally said it was C-MRSA. even though it's w/e, usually they're in a practice you can get a hold of, and if you explain, they may put you through to him.
hope your daughter gets better soon. good luck. how scary!
Sep 29, '06
I'm sorry, but we at allnurses.com cannot possibly advise you on how to manage this with your daughter. If you are concerned, please contact her PCP and/or take her to the ED. Allnurses.com members cannot offer medical advice.
We only wish the best for her.
Sep 29, '06
community-acquired mrsa: current epidemiology and management
since bactrim allergy, can also use ciprofloxacin per above article.
reinforce handwashing with antibacterail liquid soap, paper towel turning off faucets, changing handtowel in bathroom, use isogel...all that good stuff to prevent spread infection.
unless spikes fever, should be able to wait to contact id monday. er if fever over we.
closing thread now.
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