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Infectious Diseases

Staph infection in the hand

05/23/2006

Question:

Thank you so much for your time. I am a 37yr.female. I have a concern about a hand infection. About 3 weeks ago I punctured my hand. It seemed quite minor, but became infected. I was sent to a hand surgeon who put me on Keflex 4x a day. I was given one day of IV antibiotics. Despite treatment the swelling has moved all the way from my hand over my elbow. About 3 days ago the hand surgeon opened the wound and put a drain in and cultured it. He said if it didn`t improve in a couple of days I would need to be hospitalized. I went back the next day and saw a different hand doc. (mine was out of town). He said the culture showed gram positive bacteria, but no specifics yet. It had only been a day. I go back tomorrow and hopefully find out what the culture grew and whether I am on the right antibiotic. Here is why I am worried. I have had MRSA infections 3x in the last 2 yrs. The first was in my pacemaker. I had to have the entire unit removed and relocated to the opposite side. I also developed a couple of very serious MRSA infections in the bones in my sinuses. I was put on vancomycin for the pacer infection and zyvox for the sinus. I am beginning to fear that this infection in my hand could spread to my pacemaker again if it does not get better soon. Do you think I should try to get back in to see my infectious disease specialist to get her take on the situation, or just stick it out with the hand surgeons. They don`t know my history of serious infections, and I am worried that I should have made it more known. Please share any advice you might have. What are the odds of this spreading to the pacemaker again? Thank you so very much.

Answer:

MRSA infection can certainly cause a deep seated infection of the pacemaker as it has a tendency to cause endovascular infections. I think you would benefit from seeing your infectious disease specialist who already knows about your previous bouts with MRSA infections in addition to following up with your hand surgeon. 

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Response by:

Pamposh   Kaul, MD Pamposh Kaul, MD
Assistant Professor
College of Medicine
University of Cincinnati