Mom diagnosed with MRSA & has complications?

April 10, 2008 4:33 AM

Long story, starting with a diabetic having an infected kidney removed, ending with MRSA.

MRSA. WTF. My diabetic mom went to the hospital in December with vomiting, and extremely high temperature (106). It turns out she had a kidney infection so badly, that it was non-functioning, pus filled sac which was promptly removed. After some time in the hospital, she has come home and recovered amazingly quick, returning to work only a few weeks out of the hospital. Visiting nurses were seeing her within the duration of when she was released from the hospital until she went back to work. She had a "blister" on her foot from what she thought was ill-fitting slippers. At the time her feet and practically entire body was bloated from what she has went through previously. This blister was "diagnosed" by the "nurse" saying it was Cellulitis for which her primary care physician put her on antibiotics for which crusted up and healed pretty quickly.

Fast forward a couple of months, she wakes up unable to move her knee which has become swollen. Upon a trip to the ER (suggested by her doctor she was not showing many symptoms besides the swelling), it was found she had fluid in her knee and it was cultured to see if it was infected. It was. With MRSA. She was admitted to the hospital for days on intervenous antibiotics and released and felt pretty decent for what I assumed to be a pretty nasty infection.

She came home about 2 weeks ago, and for the past week or so has been struggling with a hacking cough and shortness of breath upon lying down. She had received a pnemonia & flu innoculation before leaving the hospital. It is 7 am. I am panicking over whether or not to worry about this, because she does have a nurse that visits everyday (she receives antibiotics to combat the MRSA, and must for the next 6 weeks or so intervenously), whom says she is fine, and her doctor put her on Codeine cough syrup and mucinex.

Has anyone else dealt with this sort of thing, and WTF do I do? Reading the interwebs certainly doesn't help, some sites shrug it off as nothing, and others as life-threatening. Should I take her to the ER? Or trust them? I am so worried about this, I can't sleep so I ask advice from the hivemind, knowing I will probably get snarked for something, but typing it down, getting it off my chest helped anyways :).

PS I haven't found out what this bacteria was until she had the stitches removed from where they drained her knee (2 weeks later). Is there a chance I may have contracted it by hugging her or anything before she went for surgery, or have a reason to sanitize her surroundings? Or is there a way she can keep infecting herself, from cats or the like? (she has 3)

Sorry so long and thanks for any insight.

posted by phox to health & fitness (6 comments total)

She came home about 2 weeks ago, and for the past week or so has been struggling with a hacking cough and shortness of breath upon lying down.

I have a coworker who is fighting MRSA, and he ended up with pleurisy, and has had to have fluid drained from his lungs twice. In the long term, his respiratory problems have been more of an issue than the infection itself. I would vote for having her see a doctor today and specifically requesting a chest Xray.
posted by anastasiav at 4:47 AM on April 10, 2008

A non-productive cough and SOB on lying down (known as orthopnea) is suggestive of pulmonary edema -- fluid in the lungs. One of (probably many) things it could be is heart failure. It's time to take her to the ER. Insist on a BNP test (it's a blood test -- b-type natriuretic peptide) along with a chest X ray.
Note: I am not a doctor. I am someone who was misdiagnosed and given codeine cough syrup for 2 months before someone sent me to the ER, where I had near end-stage heart failure. I am a little over-sensitive on these issues, but I think SOB in someone whose had your mother's health problems is something worth treating as an urgent situation.
I hope it's nothing and I'm overreacting, but it it were me (or my mother) I'd be going to the ER right now. Best wishes for you and your mom.
posted by katemonster at 5:02 AM on April 10, 2008

I'm sorry to hear about your mother, and I hope for the best for her. With regards to you being a carrier, you shouldn't waste too much of your energy worrying about it but do keep it in mind. Let your doctors know of your concern before having surgery, and they can advise you if further steps are needed such as nasal sprays or bathing in antibiotics.
posted by fermezporte at 5:16 AM on April 10, 2008

IANAD but I am a medical student... though only in second year. I have no personal experience with anything like this but this is what strikes me:
Does the shortness of breath go away when she stands up? Does it wake her up at night? Anything coming up when she's coughing (especially something pink)? If the answer to any of these is yes, I would second katemonster in that it sounds like pulmonary edema and she should get it checked out very soon. Presumably at the doctors they would have checked her heart, but maybe not and if not this could be a significant sign. There are many other conditions that can cause it but I think better safe than sorry.
As far as the MRSA goes, I think it's unlikely you would have gotten it from her from before the surgery, as she most likely would have picked it up in the hospital. I wouldn't worry about the cats :)
posted by shokod at 5:36 AM on April 10, 2008

IAAD, but IMNYD. There are many possibilities here, and the fact that things are worse in the last week is cause for concern. Pulmonary congestion of some type seems likely, but the possibilities of why that might be are numerous: primary heart failure, fluid overload from kidney problems, MRSA infection in the lung, or the heart valve, or the spaces around the lung, Fluid build-up around the lung, reactions to the medications, anemia from the infections, from the medications, from something else ... yada yada.

I know I'm not being reasssuring, but I think at the very least, someone should be calling her doctor and describing the new symptoms, and seeing what the best venue for an examination might be. An ED visit might be necessary, but it's not the place to start. And careful about insisting on certain tests, like a BNP. BNP is not specifically diagnostic of congestive heart failure, and I've seen doctors stop pursuing investigations with an abnormal BNP, when the underlying reasons for the heart failure isn't known.

Good luck.
posted by cameradv at 12:01 PM on April 10, 2008

I know it's easy to say but try not to panic. It sounds like your mom has clearly had a pretty rocky time these last few months, and I sense your yearning for things to get back to the way they were before -- who wouldn't want that. But the simple fact is that it sounds like she really hasn't bounced back yet. It only takes one bad infection to set off a domino effect of recurrent illness and complications in someone who was apparently fine a few months ago, and diabetics unfortunately are exceedingly prone to this sort of thing. We see it all too often in practice.

Right now, playing a guessing game of what's going on and letting your anxiety get the better of you isn't going to help anything. It could be nothing or it could be something more serious, but the only way to get her better and get both of you the peace of mind you sound like you really need is to seek care from a physician. In particular, the new onset of trouble breathing is something that should never be taken lightly, and there is absolutely nothing on the internet including even the medical folks here who can give you reliable advice on this. She needs to be seen as soon as possible, and not by a home health nurse but a doctor. If you can access her primary doctor in time, by all means do so, but my intuition tells me that that might ultimately just be a detour on the way to the ER/hospital where she'll potentially need an expedited evaluation or even rehospitalization. If he/she blows you off without giving you a very good reason for her trouble breathing, don't settle for that. Get a second opinion and go to the hospital.
posted by drpynchon at 7:12 PM on April 10, 2008