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Fatigue and AnemiaFatigue and Anemia
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Aug 29, 2004

Hello Doctor,

I am asking you this question because I feel the most comfortable with your persona and the other person in charge, only responds once every month or so. Probably is on vacation. l

I don't want to wait that long.

I hope you can give me at least some very professional advice on how to proceed because I am getting very desperate. I am suffering for 4 month already from MRSA (diagnosed in Switzerland) infection. Originally it all started started with a pimple which I scratched - here at home in NY City.

It turned into a huge abscess on my butt -- had it drained here in the NY City Hospital and it was treated after drainage with one antibiotic which was given to me in the hospital. (forgot that name (no growth of culture was found)

lEverything went fine -- No new abscess. Then I traveled to Europe 10 days later for vacation. I went to a resort in Switzerland to a well known thermal baths with family. ( 2 HR in water) and solarium. (nobody told me not to bath - actually thought it will be good to heal) Next day I got 5 new abscess all over but mostly on butt. Then I traveled to Holland. There I had to see a doctor since it did not get better. He told me it's a clear staph infection and gave me erythroc for 10 days. At that point I never even heard of MRSA

At first it got better but after 3 days - much worse than ever before. I treated myself with hiobiscrup Iodine and antibiotic creams, plenty of band aids etc - showered 3 times plus changed underwear 2 times daily. A ll very stressful while living in hotels and friends houses.

When I traveled back to Switzerland 12 days later I had to go to the emergency room in Zurich - There I was diagnosed ( 4 days after given the antibiotic "augumentin") and after surgery on my hand for an abcess on my hand) with MRSA . They all missed that fact in the lab report except one smart doc saw it in the lab result while checking online. Next day after the diagnosis I came back to NY City and called my regular HIV doc and told her everything.

She told me to come to her office. In the meantime the abscess got much smaller and all seemed getting better. I also told her I had this persistent cough. She was not worried and told me that my lungs sounded clear. Now she is on vacation and I got another 2 new abcesse on my butt.

Yesterday I went to walk in clinic in the Village in Manhattan and the doc there gave me bactrim , nasal and regular skin bactroban cream. He said this will work. I am very worried now. My cough is still here (persistent itch in the throat) I am wondering if I am being treated the right way or just being a trial and error subject. I really don't know anymore where to turn.

It seems every doc including mine just prescribes me some other antibiotic -- the last one not even cared to look at my resistance lab test list which I showed him. ( which I got in Zurich) Yesterday I received bactrim and nasal as well as skin cream bactroban. am poz since 19999 but never was detectable. 850 t4. Any advice? thanks a million for taking my question. Please email in private if you dont want to post the question. NYJ

Response from Dr. Frascino

Hello NYJ,

MRSA (methicillin resistant staphylococcus aureus) can be a very serous infection. The preferred regimen for significant MRSA infections is vancomycin intravenously, sometimes with the addition of gentamicin (intravenously) or rifampin (orally). TMP/SMX (Bactrim) can be effective in some cases. (You would need to check the sensitivity report.)

I would suggest you re-contact your HIV specialist. If she is not back from vacation and/or doesn't have another HIV specialist covering her practice, I would suggest you seek the attention of an infectious diseases specialist. There is no doubt your condition has been inadequately treated in the past. Particularly in light of your HIV-positive status, you should make sure your current treatment is the best and most effective option for you.

Good luck. Continue to demand that your problem be appropriately and quickly evaluated and effectively treated.

Good luck. By the way, you've been poz since 19999??? (OK, I guess it's back to the future with you.)

Dr. Bob

The New High Cost of New-Fill

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