Tag Archives: Staphylococcus aureus

Straight, No Chaser: Abscesses (Boils)

September 29, 2016Skin/Dermatology, Infectious DiseaseCellulitis, streptococcus, Straight No Chaser, SterlingMedicalAdvice.com, Sterling Medical Advice, Staphylococcus aureus, Staph, Methicillin-resistant Staphylococcus aureus, Incision and drainage, Folliculitis, Behind the Curtain, Abscess, 844-SMA-TALKJeffrey Sterling, MD

Whether you call them boils, pus pockets or abscesses, they hurt. Abscesses are infections that localize and collect pus beneath the skin. Although previous Straight, No Chaser posts have addressed MRSA, this one will highlight your frequently asked questions about abscesses.

Why do I get an abscess?
Something causes an injury or sufficient irritation to your skin to allow bacteria to enter, and/or your lowered immunity can’t adequately fight back. Examples of circumstances causing skin infections that can develop into abscesses include ingrown hairs (folliculitis), insect bites and IV drug use. You are at increased risk for developing an abscess if you have diabetes, are obese, use IV drugs, have a weakened immune system or have an untreated skin infection (cellulitis).

What causes abscesses?
Bacteria such as Staphylococcus aureus (Staph) and Streptococcus are common causes of abscesses. I’ll remind you that MRSA stands for methicillin-resistant Staph Aureus; this is an indication that traditionally used antibiotics don’t work against this particular strain of bacteria. MRSA should be a reminder of the dangers of inappropriate antibiotic use.

How do I know if I have an abscess?
Trust me. You’ll know. Typically you’ll develop a skin infection first, which could simply include pus-filled bumps that worsen to become red, warm, swollen and tender. You may develop a fever, and you will have a significant amount of pain.
Can I treat these at home?
Generally not unless you’re a physician or have access to one at home… What you can do is prevent them. Stop picking at your skin; in fact, learn to keep your hands off your skin. Use clean equipment (e.g. razors, clippers) if you shave hair from your skin.
In terms of treating abscesses at home, it is not advisable for you to attempt to cut yourself or otherwise deal with these once one has formed. Abscesses often have deep tracks under the skin that need to be explored. Whatever you’re doing to delay getting evaluated is increasing the risk that things will worsen.

So how are abscesses treated?
There are two approaches to treating abscesses: “from the inside out” and “from the outside in.”

From the inside out refers to receiving antibiotics. Most abscess do respond promptly to antibiotics if you don’t wait too long to get them treated.
From the outside in refers to a procedure called incision and drainage (I & D). You’ll recognize this as your physician having to cut open the abscess, clean the area out and place gauze in the wound for a few days. Doing this in most cases eliminates the need to also take antibiotics. Unfortunately, I & Ds often must be done on higher risk abscesses, and in some instances, it’s necessary to have it done by a surgeon.

When should I see a doctor for one of these?
These generally aren’t getting better on their own. In particular, if you have one of the risk factors previously mentioned (diabetes, IV drug use, obesity, decreased immunity), the abscess is on or near your genitalia, is spreading fast or is extremely painful, you should be seen sooner rather than later.
Feel free to ask any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: MRSA, the Big, Bad Staph Infection

September 28, 2016Infectious Disease, Skin/DermatologyStaphylococcus, Spider bite, MRSA, Methicillin-resistant Staphylococcus aureus, Infection, Behind the Curtain, Antibiotic resistance, 844-SMA-TALK, Staphylococcus aureus, Straight No Chaser, SterlingMedicalAdvice.com, Sterling Medical AdviceJeffrey Sterling, MD

One of the things that’s changed a lot from when I first started practicing medicine is people show up every day to the emergency room for mosquito and spider bites. The local news has done a number on you, as now everyone is afraid of MRSA.
Methicillin-resistant Staph Aureus (MRSA) is a bacterial infection that’s resistant to the penicillin family of drugs that we used for decades to treat many infections. Staph Aureus itself is a bacteria akin to flipping a light switch. Normally, it resides within us (approximately 30% of us have it in our nostrils but only 2% of us carry the MRSA variety), not causing any problems, but it is also the source of many dangerous and life-threatening illnesses if it enters your bloodstream.
Over the last 50 years of treating Staph infections, resistance to many different antibiotics has occurred, meaning that when a serious infection occurs, it’s potentially very harmful. The emphasis there should be on potentially. Most MRSA infections are community-acquired skin infections that resemble a spider or other insect bite but are still mild and are treatable with different antibiotics than historically used. Regular Staph and MRSA infections are even more likely to occur in those institutionalized (i.e. in hospitals, nursing homes, etc.) and have tubes and wounds. Consider and discuss the risk with your physician when you see someone on a breathing device, a urinary catheter, needing gauze for surgical wounds or on feeding tubes. Amazingly, MRSA causes approximately 60% of hospital-acquired Staph infections now.
My primary goal today is to inform you of what you need to know to prevent obtaining these infections and when to be especially diligent in seeking treatment. It’s really a simple task of maintaining hygiene. Just prevent that ‘light-switch’ from flipping to the on position and most times you’ll be ok.
1. Staph is everywhere. You can best protect yourself by simply practicing good hygiene. Wash your hands early and often.
2. MRSA is spread by contact. Don’t be so quick to feel and squeeze on someone’s (or your own) boil. Wash your hands before and after such contact. Don’t share towels or razors.
3. Keep any cuts, scratches, nicks or scrapes covered until healed.
If you do see or develop signs of a skin infection (redness, warmth, tenderness, pain and possibly discharge from the wound site), it’s worth contacting your physician to see if s/he’d like to start antibiotics or drain a possible abscess.
So… don’t be afraid, be smart. Prevention is key.

Feel free to ask any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Abscesses (Boils)

July 22, 2014Skin/Dermatology, Infectious Diseasestreptococcus, Straight No Chaser, SterlingMedicalAdvice.com, Sterling Medical Advice, Staphylococcus aureus, Staph, Methicillin-resistant Staphylococcus aureus, Incision and drainage, Folliculitis, Cellulitis, Abscess, 844-SMA-TALKJeffrey Sterling, MD

So how are abscesses treated?
There are two approaches to treating abscesses: “from the inside out” and “from the outside in.”

From the inside out refers to receiving antibiotics. Most abscess do respond promptly to antibiotics if you don’t wait too long to get them treated.
From the outside in refers to a procedure called incision and drainage (I & D). You’ll recognize this as your physician having to cut open the abscess, clean the area out and place gauze in the wound for a few days. Doing this in most cases eliminates the need to also take antibiotics. Unfortunately, I & Ds often must be done on higher risk abscesses, and in some instances, it’s necessary to have it done by a surgeon.

Straight, No Chaser: Toxic Shock Syndrome

June 24, 2014Obstetrics and Gynecology, Infectious DiseaseSterling Medical Advice, toxic shock syndrome, tampons, streptococcus, Straight No Chaser, SterlingMedicalAdvice.com, Staphylococcus aureus, Staph, Conditions and Diseases, Burns, 844-SMA-TALKJeffrey Sterling, MD

Straight, No Chaser has addressed Staphylococcus (aka Staph) infections on several occasions; in fact, Staph is the microorganism that is responsible for all those MRSA (methicillin-resistant Staph Aureus) infections that the general public holds in such fear. Toxic shock syndrome is also primarily caused by Staph. The early take home message is you just don’t want to get this infection, and you would really do well to learn and practice preventive measures to avoid Staph infections. You may not have known it, but part of your big talks with your children about hygiene (e.g. feminine hygiene and keeping object out of your body) occur with this in mind.
Toxic shock syndrome (TSS) is a very serious disease combining fever, shock and dysfunction of several bodily organ systems. There was a time when TSS was a much bigger deal, back when extra absorbent tampon usage was very high. Tampon usage has declined as the dominant cause of TSS, but TSS cases are still around and are every bit as dangerous. The toxic part of the name refers to Staph (or in a similar syndrome, an organism called Streptococcus) releasing a toxin that travels through the body causing havoc. Picture a microorganism releasing a series of hand grenades into your blood stream, and you’ll get the picture.
Having an infection is not enough to develop toxic shock syndrome; not everyone with a Staph infection develops TSS. Here are risks for developing the disease.

Burns
Menstruation
Presence of foreign bodies or packings (e.g. “lost” tampons, surgical tissues or any other objects in your body parts, nasal packings used to treat nosebleeds)
Recent childbirth
Staph infection
Surgery
Tampon use (especially if you leave one in for a long time)
Wound infection after surgery

There’s not a lot of guesswork with a patient with toxic shock syndrome. The other meaning of toxic in the name is patients are very ill. By the time they come in for treatment, they tend to be confused with a low blood pressure. They may exhibit nausea, vomiting and diarrhea. High fever, chills, muscles, headaches and a violent-appearing rash resembling sunburn are to be expected. Untreated, the toxins can cause seizures and failure of multiple organ system of the body.
Treatment of toxic shock syndrome is complicated and critical, addressing a critically ill patient in shock, preserving the body’s organ systems, treating an infection, removing any foreign objects found and draining any infections (such as a surgical wound). Patients with toxic shock syndrome often find themselves in intensive care units, and the mortality rate (those who die) approaches 50%.
Your best bet in avoiding toxic shock syndrome is practicing good hygiene and avoiding the use of highly absorbent tampons. If you do use tampons, change them frequently (as directed); it’s just not a good idea to leave them in for extra periods of time trying to be frugal. Similarly the presence of any other cloth material retained anywhere inside of you (e.g. objects broken off in the ear, certain types of vaginal or anal instrumentation) is to be avoided. If you ever receive a nasal packing for a nosebleed, you should be placed on antibiotics at the same time. Be diligent after surgery, looking for any signs of fever or infection at the surgical site. Get significant burns treated.
This is something you should think about. Your simple steps of prevention really can be life-saving. I welcome your questions.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: Hot Tub and Barbershop Folliculitis (Yep, Even More Staph Infections!)

September 9, 2013Skin/Dermatology, Health PreventionSkin infection, Shopping, Pseudofolliculitis barbae, Hot tub folliculitis, Hot tub, Home and Garden, Folliculitis, Antibacterial, Staphylococcus aureus, Swimming poolJeffrey Sterling, MD

Follulicitis. You know it well as hot tub rash, barber bumps, ingrown hairs and many other names. The first thing you need to know is the ‘itis’ means inflammation, and the follicle is the pouch from which your hair grows. Any inflammation of that area is folliculitis. You’ll typically see white-headed pimples with or without itching, pain and redness. So what? Let’s quickly run through causes, problems, prevention and treatment.
Causes

It’s usually caused by microorganisms (usually bacteria, including Staph and others, but also yeast, fungi and viruses may do the same).
Blocking skin pores will also get you there (think heavy application of make-up or oils, or heavy sweating in tight spandex-type clothing).
External irritation can be a cause (think long-term topical steroid use, tight clothing, untreated scratches or lacerations, improperly chlorinated hot tubs, whirlpools or swimming pools).

Problems
It’s inflammation that most commonly is an infection. The irritation can progress to a skin infection (cellulitis) and/or a boil (abscess). These can range from annoyances to ‘not-fun’ to outright problematic, particularly if you’re diabetic, have HIV or otherwise have a compromised immune system.
Prevention
I’m just going to give you a list of healthy hygiene tips that will serve you well in many circumstances, including prevention of folliculitis.

Use antimicrobial soap.
Don’t share towels, and avoid using the same towel multiple times (Sorry, hotel chains!).
Shower immediately after getting out of the swimming pool, whirlpool or hot tub.
Don’t shave (and avoid otherwise irritating) areas where razor bumps exist.
Be moderate with application of lotions, makeups and other moisturizers.

Treatment
Most cases of folliculitis, whether an inflammation or an infection, resolve in 1-2 weeks, assuming you don’t further irritate it to the point where an substantial skin infection sets in. Consider the following a treatment progression for the overwhelming majority of cases; cases more severe (or any you may be concerned with) require consultation with your individual physician.

Warm compresses (clean, hot towels) to the area do a world of good.
Wash with antimicrobial soap, and consider using medicated shampoo, particularly if the discomfort is on the scalp and/or beard.
Your physician may consider topical or oral antibiotics if the situation warrants or worsens. That means you need to be alert for spreading of the bumps, fever, drainage or worsening of pain, swelling or redness.

Straight, No Chaser: MRSA, the Big, Bad Staph Infection

September 8, 2013Skin/Dermatology, Infectious DiseaseStaphylococcus aureus, Staphylococcus, Spider bite, MRSA, Methicillin-resistant Staphylococcus aureus, Infection, Antibiotic resistanceJeffrey Sterling, MD

One of the things that’s changed a lot from when I first started practicing medicine is people show up every day to the emergency room for mosquito and spider bites. The local news has done a number on you, as now everyone is afraid of MRSA.
Methicillin-resistant Staph Aureus (MRSA) is a bacterial infection that’s resistant to the penicillin family of drugs that we used for decades to treat many infections. Staph Aureus itself is a bacteria akin to flipping a light switch. Normally, it resides within us (approximately 30% of us have it in our nostrils but only 2% of us carry the MRSA variety), not causing any problems, but it is also the source of many dangerous and life-threatening illnesses if it enters your bloodstream.
Over the last 50 years of treating Staph infections, resistance to many different antibiotics has occurred, meaning that when a serious infection occurs, it’s potentially very harmful. The emphasis there should be on potentially. Most MRSA infections are community-acquired skin infections that resemble a spider or other insect bite but are still mild and are treatable with different antibiotics than historically used. Regular Staph and MRSA infections are even more likely to occur in those institutionalized (i.e. in hospitals, nursing homes, etc.) and have tubes and wounds. Consider and discuss the risk with your physician when you see someone on a breathing device, a urinary catheter, needing gauze for surgical wounds or on feeding tubes. Amazingly, MRSA causes approximately 60% of hospital-acquired Staph infections now.
My primary goal today is to inform you of what you need to know to prevent obtaining these infections and when to be especially diligent in seeking treatment. It’s really a simple task of maintaining hygiene. Just prevent that ‘light-switch’ from flipping to the on position and most times you’ll be ok.
1. Staph is everywhere. You can best protect yourself by simply practicing good hygiene. Wash your hands early and often.
2. MRSA is spread by contact. Don’t be so quick to feel and squeeze on someone’s (or your own) boil. Wash your hands before and after such contact. Don’t share towels or razors.
3. Keep any cuts, scratches, nicks or scrapes covered until healed.
If you do see or develop signs of a skin infection (redness, warmth, tenderness, pain and possibly discharge from the wound site), it’s worth contacting your physician to see if s/he’d like to start antibiotics or drain a possible abscess.
So… don’t be afraid, be smart. Prevention is key.

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