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Suffering From Recurring Boil On The Back Of Head, Arms And Face. Diagnosed With MRSA. Any Treatment?
Question: Over a year ago I developed a boil on the back of my head near an old scar from stitches that I had years before. The boil never healed, at the time I just attributed it to the fact it was on the back of my head. About 6 months later I started to develop more boils under my arms. Then my son got a boil on his face. I took him to the Dr and he was diagnosed with MRSA. After one round of antibiotics his boil went away and he never got another one. Mine kept multiplying so then I went to the Dr. They tested and it was postive for MRSA. They did the test for what antibiotics would work to kill it. I was put on Cipro, then Bactrim, then Tetracycline. The Tetracycline was the only one that did anything. After the first time of being on Tetracycline, it got rid of all the boils except for the back of the head where it all originated. That area then turned into a what I would describe as a hot rash, a very itchy hot rash. 2 weeks after completing the Antibiotics the boils came back again. I felt miserable, lack of energy, and achy. The Dr put me on Tetracycline again and gave me a prescription for special soap (surgical scrub soap). Things got better for a bit. But 2 weeks after being off the anitibiotic everything started again, more boils, feeling crappy. The Dr once again put me on Tetracycline. I tried to tell him that I did not think this was a good idea because I felt by this time the MRSA had most likely become immune to the antibiotics. He said to try it. So I did, things got better while on the antibiotics (the back of the head always stays the same though....itchy hot rash). I have been off the third round of tetracycline for 2 weeks now and sure enough I feel crappy and the boils on the body are coming back. I now take vitamins, garlic pills, make juicing drinks frequently (all this has helped a bit) but nothing so far has made the MRSA go away. I am tired of having this, tired of feeling crappy, just want to get better. What should I do now. I lost my job after a company buy out and do not have insurance. So the money situation is not good.
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Hello and welcome to Healthcare Magic. Thanks for your query.
I understand that you have been going through a difficult time with your chronic and recurrent skin infections. Like you had rightly mentioned, it is possible that the bacteria could have got resistant to the antibiotics you had been on. MRSA is indeed a rapidly mutating bacteria which can quickly develop resistance to several antibiotics (Moreover, Bactrim, Cipro and Tetracycline are all "broad-spectrum" antibiotics and MRSA can easily develop resistance to these antibiotics).
My advise on this issue would be the following:
1) You need to have a pus / swab culture and antibiotic sensitivity testing done again in order to find out which antibiotics the MRSA bacteria is still susceptible to.
2) You may need a higher antibiotic like vancomycin, linezolid, etc. or a combination of antibiotics in order to eradicate this infection completely. Often, in such chronic, resistant cases, an initial course of intravenous antibiotics may be effective in bringing the infection under control, and this can then be followed up with a course of oral antibiotics.
3) You also may need a general medical work-up to check if you have any underlying factors which is compromising your immunity, like diabetes, immunological disorders, etc., thereby leading to non-healing and recurrence of the infection.
Regards,
Dr. Jonas Sundarakumar
I understand that you have been going through a difficult time with your chronic and recurrent skin infections. Like you had rightly mentioned, it is possible that the bacteria could have got resistant to the antibiotics you had been on. MRSA is indeed a rapidly mutating bacteria which can quickly develop resistance to several antibiotics (Moreover, Bactrim, Cipro and Tetracycline are all "broad-spectrum" antibiotics and MRSA can easily develop resistance to these antibiotics).
My advise on this issue would be the following:
1) You need to have a pus / swab culture and antibiotic sensitivity testing done again in order to find out which antibiotics the MRSA bacteria is still susceptible to.
2) You may need a higher antibiotic like vancomycin, linezolid, etc. or a combination of antibiotics in order to eradicate this infection completely. Often, in such chronic, resistant cases, an initial course of intravenous antibiotics may be effective in bringing the infection under control, and this can then be followed up with a course of oral antibiotics.
3) You also may need a general medical work-up to check if you have any underlying factors which is compromising your immunity, like diabetes, immunological disorders, etc., thereby leading to non-healing and recurrence of the infection.
Regards,
Dr. Jonas Sundarakumar
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
As I don't have any insurance and I am quite broke could you narrow down the course of treatment.
For instance another MRSA work up would be another $500. I feel its probably not necessary since after reading articles on MRSA others are suggesting the same antibiotics that you are. So if I were in your office which antibiotic would you start with? And if it is done IV, can that be done in the DR's office? Then what oral antibiotic would you follow that with?
I also read and was told by a nurse that I most likely have some underlying factor that is preventing me from getting well. I have been tested for diabetes, it came back negative. What other tests should I request to find out what is going on. When I changed my diet to include the juicing, more salads, and went on Probiotics I did start to feel better, didn't cure the MRSA but made me feel less sluggish and achy. I am 49 5'6" and weigh 181. The only other thing that I have had bother me is some recurring chest pain. It comes on the left middle side of my chest..feels like someone punched me there. I have had EKG's and stress tests all of which have come back normal.
Thank you for your reply, you are the first DR that seems to know what you are doing. No other Dr has mentioned IV antibiotics or trying to find the underlying cause. There are 5 people in my household and other than my younger son getting a quick case of it no one else has gotten this. I believe this supports the thinking that there is indeed an underlying cause.
I appreciate your help and I am trying to find the best course of action, figure out how to pay for it and then find a Dr who is willing to listen to me and help treat me so I can finally be rid of this!
For instance another MRSA work up would be another $500. I feel its probably not necessary since after reading articles on MRSA others are suggesting the same antibiotics that you are. So if I were in your office which antibiotic would you start with? And if it is done IV, can that be done in the DR's office? Then what oral antibiotic would you follow that with?
I also read and was told by a nurse that I most likely have some underlying factor that is preventing me from getting well. I have been tested for diabetes, it came back negative. What other tests should I request to find out what is going on. When I changed my diet to include the juicing, more salads, and went on Probiotics I did start to feel better, didn't cure the MRSA but made me feel less sluggish and achy. I am 49 5'6" and weigh 181. The only other thing that I have had bother me is some recurring chest pain. It comes on the left middle side of my chest..feels like someone punched me there. I have had EKG's and stress tests all of which have come back normal.
Thank you for your reply, you are the first DR that seems to know what you are doing. No other Dr has mentioned IV antibiotics or trying to find the underlying cause. There are 5 people in my household and other than my younger son getting a quick case of it no one else has gotten this. I believe this supports the thinking that there is indeed an underlying cause.
I appreciate your help and I am trying to find the best course of action, figure out how to pay for it and then find a Dr who is willing to listen to me and help treat me so I can finally be rid of this!
Hello again,
Since, finance is a constraint, my course of action would be to start IV antibiotics right away and follow it up with a powerful oral antibiotic. Since, you have already tried 3 to 4 courses of broad-spectrum antibiotics, it wouldn't be a good decision to still keep 'trying' other similar classes of antibiotics and 'hope' one of it clicks.
In my clinical experience with MRSA, I have always found it more effective (and actually even cost-effective) to go full-fledged and start off with a powerful antibiotic initially itself, rather than trying things in a graded or step-wise manner. This is because, the MRSA strains nowadays are getting increasingly resistant to even several second-line oral antibiotics. Secondly, the cost of one course of a targetted, powerful antibiotic will be ultimately work out less than having a trial-and-error basis of several courses of different broad-spectrum antibiotics (and of course, not to forget the prolongation of the suffering to the patient).
So, I would recommend that iv vancomycin would be an effective choice - which has to be taken as an iv infusion, with a twice-daily dosing schedule, for a period of 7 days, and can be taken on an out patient basis also. After this, it can then be converted to oral vancomycin which has to be taken for another7 to 10 days. It would be a good idea to additionally take a pro-biotic (like lactobacillus supplement) while taking the iv antibiotic course, in order to prevent antibiotic-induced stomach upsets or diarrhoea.
Regarding the work-up for underlying causes, this would include a CBC (complete blood count), PBS (peripheral blood smear), ESR (erythrocyte sedimentation rate), absolute lymphocyte count, immunoglobulin levels (IgM, IgA, IgG), complement levels (C3, C4), plus liver function and renal function tests. A chest x-ray is also advisable, especially since you complain of recurrent chest pain (and your cardiac work-up has come out negative).
Wish you all the best.
- Dr. Jonas Sundarakumar
Since, finance is a constraint, my course of action would be to start IV antibiotics right away and follow it up with a powerful oral antibiotic. Since, you have already tried 3 to 4 courses of broad-spectrum antibiotics, it wouldn't be a good decision to still keep 'trying' other similar classes of antibiotics and 'hope' one of it clicks.
In my clinical experience with MRSA, I have always found it more effective (and actually even cost-effective) to go full-fledged and start off with a powerful antibiotic initially itself, rather than trying things in a graded or step-wise manner. This is because, the MRSA strains nowadays are getting increasingly resistant to even several second-line oral antibiotics. Secondly, the cost of one course of a targetted, powerful antibiotic will be ultimately work out less than having a trial-and-error basis of several courses of different broad-spectrum antibiotics (and of course, not to forget the prolongation of the suffering to the patient).
So, I would recommend that iv vancomycin would be an effective choice - which has to be taken as an iv infusion, with a twice-daily dosing schedule, for a period of 7 days, and can be taken on an out patient basis also. After this, it can then be converted to oral vancomycin which has to be taken for another7 to 10 days. It would be a good idea to additionally take a pro-biotic (like lactobacillus supplement) while taking the iv antibiotic course, in order to prevent antibiotic-induced stomach upsets or diarrhoea.
Regarding the work-up for underlying causes, this would include a CBC (complete blood count), PBS (peripheral blood smear), ESR (erythrocyte sedimentation rate), absolute lymphocyte count, immunoglobulin levels (IgM, IgA, IgG), complement levels (C3, C4), plus liver function and renal function tests. A chest x-ray is also advisable, especially since you complain of recurrent chest pain (and your cardiac work-up has come out negative).
Wish you all the best.
- Dr. Jonas Sundarakumar
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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