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Doctor insights on: Mrsa Secrets Revealed

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My grand mom urine report has 4-5 pus cells, 1-2 epithelial cells, ....Is any treatment required ?Her age is 70

My grand mom urine report has 4-5 pus cells, 1-2 epithelial cells, ....Is any treatment required ?Her age is 70

If she has: No symptoms then this result is nothing to worry about provided that was the only abnormality identified. If she has any urinary tract symptoms it could be consistent with an early infection. ...Read more

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What happens to colonized resistant bacteria (eg: esbl kleb) when trachee decannulated? Technical & references/links appreciated.

What happens to colonized resistant bacteria (eg: esbl kleb) when trachee decannulated? Technical & references/links appreciated.

Varies with patients: If a person had a trach and got it removed, and then healed up and resumed normal, natural clearing of mucus and microorganisms, that person should be able to be free of bacteria in the trachea and lungs (regardless of whether the bacteria is antibiotic resistant or not, because the human body doesn't know about antibiotic resistance). If the person remains abnormal, then some bacteria may remain. ...Read more

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Living with clear cell ovarian cancer 3 years but PET scan shows activity in right breast retroareolar region. Ultrasound showed nothing 4m ago?

Living with clear cell ovarian cancer 3 years but PET scan shows activity in right breast retroareolar region. Ultrasound showed nothing 4m ago?

Recommend further ev: If there is sufficient update in the PET scan(SUV of >2.5), I would advise you to have another breat imaging study done. You have a choice to have mammography, repeat Ultrasound test or repeat PET scan once again, if the last PET scan was done >3 months earlier. Good luck. ...Read more

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My 5yo trachee has been positive for esbl kleb o. Now each aspirate also is + for "staph" - is it MRSA & docs are evasive? Isn't MRSA just esbl staph

My 5yo trachee has been positive for esbl kleb o. Now each aspirate also is + for "staph" - is it  MRSA & docs are evasive? Isn't MRSA just esbl staph

Colonizers?: The major question in trach cultures is always whether the organisms are causing illness. Sputum cannot be sterilized and always has colonizing organisms, with staph being most commonly found; resistance patterns in colonizers is less important. Discomfort with this complexity may account for the perception that a doc is not giving a "straight" answer. ...Read more

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I'm an SLP in a skilled nursing facility. Just received dx of MRSA on my skin, received topical bactroban; 13 weeks pregnant, is the MRSA dangerous?

I'm an SLP in a skilled nursing facility. Just received dx of MRSA on my skin, received topical bactroban; 13 weeks pregnant, is the MRSA dangerous?

MRSA skin infection: MRSA can certainly be a bane to health care workers like you. It sounds like your case is mild, since u were only given topical therapy. Bactroban is fine in pregnancy, so with this you'll be able to clear it up. MRSA sometimes can crop up later - but if so, I recommend reaching out to an Infectious Diseases doctor who can certainly guide you. Once I treated a whole family with MRSA. See doc if Qs ...Read more

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Alan, 40 has bowel cancer, told mon, probably spread to liver & lymph nodes, told 2 fear worst. Is there any hope? Any trials? What is the survival %?

Alan, 40 has bowel cancer, told mon, probably spread to liver & lymph nodes, told 2 fear worst. Is there any hope? Any trials? What is the survival %?

There is hope: There are a multitude of systemic and liver based therapies that can treat bowel cancer both in the eu and us. . Survival is a function of will, tumor biology and cancer physician resources/expertise. Shun those who don't think outside the box. ...Read more

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Mother is 65, had pericardiocentesis 500ML. F/U showed some fluid. Dr says perm drain by subxiphoid method. Danger? Risks? How? is proced.life threat

Mother is 65, had pericardiocentesis  500ML. F/U showed some fluid. Dr says perm drain by subxiphoid method. Danger? Risks? How? is proced.life threat

Pericardial effusion: When fluid builds up in the sac around the heart it is called pericardial effusion. Causes include an inflammatory illness, an auto-immune illness, an infection, a tumor, or other reasons. The right treatment would depend on the diagnosis, & may include medicine, drainage (pericardiocentesis), or surgery to remove part of the sac. While this is usually a low risk surgery, it's still surgery. ...Read more

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Mrsa staph infection skin problems normal in nursing homes?

Mrsa staph infection skin problems normal in nursing homes?

Wrong word: "normal" isn't really the proper descriptor - serious infections are never normal. Mrsa is, however, a *common* problem in nursing homes -- unfortunately. Good facilities are always on the lookout for infections of any kind in their residents, and when they find them, they treat them promptly. ...Read more

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Hep a vaccine Havrix 1440 for adults is out of stock. They prescribed me 2 Havrix 720 (jr). Epidemiologists say taking 2 junior has no protection?

Hep a vaccine Havrix 1440 for adults is out of stock. They prescribed me 2 Havrix 720 (jr). Epidemiologists say taking 2 junior has no protection?

Hepatitis A vaccine: Havrix comes in adult and pediatric doses. The adult vaccine contains 1440 EL.U. (ELISA Units) of viral antigen, while the pediatric dose contains 720 EL.U. So two doses of the pediatric vaccine given at the same time, should be equivalent to one needle injection with the adult vaccine. These are highly effective vaccines, so I don't know what information you've been told-but I think it's fine. ...Read more

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Husband has Benign cystic peritoneal mesothelioma Oncologist wants yearly CT no removal suggested now. Maybe HIPEC/surgery later. Any thoughts?

Husband has Benign cystic peritoneal mesothelioma Oncologist wants yearly CT no removal suggested now. Maybe HIPEC/surgery later. Any thoughts?

Ethical oncologist: Your husband is triply-fortunate. He has a lesion that's best left alone and will most likely not be a great problem. He has an oncologist who's told you the truth and not suggested unnecessary treatment. And best of all, he has a devoted and resourceful wife. Be sure that at least two pathologists signed off on the diagnosis of this rare entity. ...Read more

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My dad 81yr has fluid in lungs.Keeps forming & breathless on oxygen & weak.Tests show no cancer.On symptoms being given meds for Tb & pneumonia.Help?

My dad 81yr has fluid in lungs.Keeps forming & breathless on oxygen & weak.Tests show no cancer.On symptoms being given meds for Tb & pneumonia.Help?

Shortness of breath: Shortness of breath can happen from lung and heart disease, fluid in the lung indicates heart failure and heart disease. He may have associated pneumonia also. He may have some clinical indication to be on anti tuberculosis treatment. you can call our consult line with all the lab and x- ray results to get a better understanding of your fathers condition. ...Read more

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Cat has / had rabies, vet hasn't confirmed bc samples go to south africa, what course of action?

Cat has / had rabies, vet hasn't confirmed bc samples go to south africa, what course of action?

May need rabies shot: After an animal bite, the area should be washed well to get the animal germs out. If the wound is large, deep, or painful, the staff at the emergency room can wash it out. Prescription antibiotics may be needed, as well as a tetanus booster. If bitten by a raccoon, skunk, fox, coyote, bat, or any salivating/drooling strangely acting pet/animal, rabies is a possibility (see dr. Within a day or so). ...Read more

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Diagnosed- malignant melanoma 5/2017 Diagnosed - treated for anal cancer 5/2016. Pet scan done in March '16. If MM has spread, wouldn't PET scan show?

Diagnosed- malignant melanoma 5/2017 Diagnosed - treated for anal cancer 5/2016. Pet scan done in March '16. If MM has spread, wouldn't PET scan show?

PET scan is a good t: PET scan is a good test to detect metastatic cancer. In fact it is our best imaging test to catch metastases early. Yet it has some limitations in that it can not show microscopic tumors/ small # of cells in the body...it only shows tumors that are bigger than half a centimeter (>5 mm). That is why this test has to be repeated every 3 to 4 months when there is a risk for the tumor to come back. ...Read more

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Repeated CT&US show dermoid & cysts on ovary. New gyn& us 2day, dermoid gone, now corpus lutem. Can dermoid change, be mistaken for cl? CT misread b4?

Repeated CT&US show dermoid & cysts on ovary. New gyn& us 2day, dermoid gone, now corpus lutem. Can dermoid change, be mistaken for cl? CT misread b4?

Can not say: Without reviewing all of the images it is not wise for us to try and guess which report is right and which report is not. If you are not comfortable with the doctors interpretation it is perfectly reasonable to get a 2nd opinion. ...Read more

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My urinalysis states: enterobacter cloacae 25, 000-50, 000 colony forming units per mlrec'd results but having heard from my doc yet. Serious?

My urinalysis states: enterobacter cloacae 25, 000-50, 000 colony forming units per mlrec'd results but having heard from my doc yet. Serious?

See below: It may indicate that you have a uti. Usually positive urine cultures have greater than 100, 000 cfu/ml but repeated urines with the same organism in lower numbers are significant. If you have symptoms of a UTI or if you have a significant number of wbc's in your urine you would probably benefit from a course of antibiotic treatment to which the enterobacter is sensitive. ...Read more