Anyone here with Psuedomonis in the sinuses?

JEllen:
Your post brought back memories of my horror with a virulent strain of MRSA that colonized in my sinuses. It was a nightmare.

I picked up the strain of MRSA working in a hospital and doing wound care on an elderly woman with venous stasis ulcers with cultured MRSA infection. The first inkling was a pimple-like sore that appeared on my face. The infection quickly took hold in the soft tissues of my face, resulting in a dense cellulitis. The next pit-stop was my nasal sinuses.

It took over a year of IV vancomyocin and regular anti-bacterial solution lavage of my nasal sinuses to clear the infection. The infection would ease, only to later find that residual bacteria would once again flourish and I would suffer through another acute flare.

The sinuses are a warm, moist and inviting home for pseudomonis - just as it was for the strain of MRSA that made a home in my nasal passageways.

The concern, always, is that the sinuses are in close proximity to the brain and to the meninges.

I would think that you would benefit from a pairing of both an infectious disease physician and ear-nose-and-through (ENT) physician. Keep a watchful eye on your situation and keep on the defensive. Sinus based bacterial and fungal infections can be difficult to reign in.
- K -

I've had pseudomonas pneumonia 2x, both requiring hospital transfers, and one icu stay.
I'm also immunocompromised, which is why I couldn't fight the bug.

An infectious disease specialist was involved.

I guess my question is why do your Drs think you can't kick this, and who have you seen?

Doc didn't know why my infections became more frequent after surgery. One factor could have been that my septum wasn't straightened and still blocked the medial sinus on one side. Frankly, I don't think the infections were ever "cured" from day 1, ... for years. I started getting infections after a bad accident in which my nose was broken by the airbag. I got no treatment except antibiotics for the infections for a couple of years.

Then my ENT did the sinus balloon thing and my infections didn't go away but needed antibiotics more often. I finally got rid of the infections when I was hospitalized for an bowel infection which was treated IV.

As far as I can find from reading scientific studies, we get bacterial plaques in the sinuses that are not easily cured. One doctor told me that only the sulfa drugs get to the sinuses well, because there isn't much circulation there. I don't tolerate sulfa in the amount it takes to do the job.

I would think it should be possible to get into the sinuses from inside the nose. I don't know why we don't get antibiotic put in there before going to surgery.

My treatment was several years ago, so maybe newer treatments are available today.

Now I keep my sinuses washed (Neil Med squeeze bottle of saline) if they seem the least bit clogged. That may not work as well if your passages are not opened, but the surgery is h...

Seashell, what was the antibacterial nasal rinse? Something the doc ordered?

Hi. Is Pseudomonas airborne? How long does it live on an object? I'm in a school till June as a teacher when I retire. What about people who come here to visit? I'm not sharing my situation. My son and his GF come for dinner once a week. They obviously know.

My allergist did IGE immunity testing. All my numbers then were good except for Subclass 3. That was about 4 months ago. She said I did not have an immunity issue. If you did around on the net, subclass 3 of IGG testing relates to the sinuses. I am just sucepticle to sinus infectious I guess. She told me that I should forget about the subclass as no one looks at that. I really think I am going to talk to an infectious disease doc.

Thank you for all your suggestions. I can't find the answers to how long this bacteria lasts on objects on the internet

If you are not seeing an infectious disease physician, by all means consult and meet with an infectious disease physician before agreeing to surgery.

Purchase Hibiclens (antibacterial soap) and use this when washing your face and in the shower. This should begin to decrease the fungus load.

Keep your hands away from your face. Be mindful of not touching your nose and your eyes during the day - it is second nature that we reach up and touch our scalp, fuss with our hair, touch our nose. Keeping your hands away from your face, nose, and eyes will be more helpful than you may think.

Keep hand sanitizer available. Wash your hands frequently throughtout the day - be thorough, spend at least 1 minute lathering with running soap and water. Be careful not to let water drip down your forearm and elbow after washing your hands - that runs the possibility of bacterial and fungus running down your forearm to the elbow. Grab a paper towel and dry your hands/arms after hand washing.

Wash your pillow cases every day or every other day.

Start using paper towels judiciously. Use them in the kitchen and bathroom. Toss away after a single use. I am a big user of paper towels since my MRSA infection.

Toss away your kitchen sponge and use a small washable kitchen cloth when cleaning dish ware. Wash towels with increased frequency. Fugus and bacteria linger on towels and sponges.

I do not think that your fungal infection is contagious in the sense that you can directly pass it to someone else. You are not inherently contagious. We all have MRSA and fungus and bacteria in your sinuses and intestinal tracts. For whatever reason, fungal inhabitants have over-populated and your body is not able to rally with an effective counter-offensive. Your fungal problem is more a problem with your body's lack of sufficient immune response and less a problem of being contagious.

That I acquired the virulent MRSA was owing more that I was already immunosuppressed. An otherwise health person would not have been as overwhelmed by the exposure as I was.

Bottom Line: Do get a referral to a competent infectious disease physician. Looking into your body's immune response will be essential in clearing this assault.

I can understand your fatigue with an ongoing infection. The MRSA infection was a low period of my life. I would look in the mirror in the morning, frozen in fear and anxiety of finding another lesion on my
face. It was a long year. With the help of a good infectious disease MD, I made it through.

The good news is that once my body was able to assault the MRSA and get the bacterial load down, I was on my way to wellbeing. I have not experienced a recurrence although I know that I have residual MRSA and always will. I am very mindful of supporting my immune system, especially since I am on life-long corticosteroids.

My sense is that you need a physician who can look at the totality of the pseudomonois colonization and your body's immune response. Surgery will not give you a long-term solution until the underlying reason for the colonization is identified.
- Karen -

Ellen:
Sharing that you are asthmatic and using inhalers regularly adds important information. Your inhalers likely have a corticosteroid component. Corticosteorids suppress the immune system.

I have been on corticosteorids for Addison's disease and mixed connective tissue disorder for 25 + years. That is a lot of exposure to corticosteroids. But I have no option. I rely on corticosteorids to survive.

But recognize that corticosterids come with a steep price.

You may want to include an endocrinologist as part of your medical team owing to your long-term relationship with coritcosteorids. Pituitary suppression often accompanies steroid use. Low pituitary hormones play havoc on the body in subtle and less than subtle ways.

Bottom Line: While you may not feel that you are immunosuppressed, you likely are immunosuppressed simply due to the corticosteroids that you depend upon to keep your asthma in check.

Given you long-term history of corticosteroids, your pseudomonis colonization begins to make sense. You are not contagious to other people. The colonization is beyond what your body can mobilize defenses against . . . corticosteorids are likely at the center of the long-standing inability of your body's to keep the pseudomonis in check.

Being aware of keeping your environment clean and your hands/face clean will help you in the fight.

I am purposefully a "minimalist." I keep a clean living space without clutter. I have hard wood flooring instead of extensive carpeting that retains allergens. I have mite-proof cases on my mattress and pillows. I use paper towels judiciously. All in an effort to keep allergens and retained bacteria/fungus to a minimum so that I am healthier. My health is fragile enough as it is.

I think you are on a better pathway already in the few postings on this thread. You have my sincere best wishes,
- Karen -

Ellen:
What are you referring to when you ask me "What do you do when friends and family come over?"

Again . . . you are not contagious. You will not give anyone a pseudomonis colonization. Everyone has fungus, bacteria, yeast in their nasal passageways and sinus. Everyone even has MRSA in their nasal passageways and sinuses.

The difference between you and someone else is that your immune system is suppressed from the years of corticosteroids. An otherwise healthy person is able to keep the natural flora of bacteria, yeast, et. al in check without falling ill to an overabundant colonization.

You are actually continually reinfecting yourself. That is the culprit that you are facing, just as I was facing with my MRSA colonization. Once I had been exposed and the MRSA took home in my warm nasal passageways, the bacteria were free to reproduce without any limit due to my compromised immune system. My immune system, like yours, was suppressed due to long-term corticosteroid use.

Self-reinfection is why I am advocating that you have a ready stack of wash cloths and use a wash cloth on yourself one time . . and then toss the wash cloth into the laundry and wash. You will want to wash your towels and bedding with hot/warm setting on the washing machine (do not use the cold wash cycle). You can add bleach to your all-white linens.

Self-reinfetion is why I am advocating that you use paper towels with abundance. You decrease the likelihood that in washing or drying your face that fungus is lingering on the toweling - fungus that would then re-enter through your nose and mouth when you next use the towel.

You are needing to limit reinfection from yourself.

Keeping your hands away from your face. Touching your nose and then rubbing your eyes, for example. Portals of entry into your body are your nose, your mouth, and especially your eyes.

In using the Hibiclens soap, I did use it on my face with care not to get any of the soap suds into my eyes. I also used the Hibiclens to gently clean the easily accessible areas of my nasal passageways. Ex. I would take a sudsy Kleenex and clean the readily accessible nasal passageways and end by blowing my nose into a fresh Kleenex to flush the moisture out. Bag up any used Kleenex and tie with a twist-em.

You have little risk of infecting anyone because everyone in the general public has the same microorganisms in their noses, sinuses, mouths.

Your problem has evolved because your immune system is unable to regulate a normal flora population. Steroids are the cause.

That you have been on corticosterorids as long as you have is also troubling from an endocrinology standpoint. Your pituitary gland is likely suppressed to varying degrees. It would be wise for you to have a consultation with an endocrinologist to vet and discuss your long-term dosing of corticosteroids. I would definitely place this on your "To Do" list. Take this advice to heart from someone (me) who has broad endocrine failure.

I think all things will work out for you once you are in the hands of an infectious disease MD. Partnering an infectious disease MD with an endocrinologist would be ideal. Corticosteroids are both beneficial and detrimental. The effects of corticosteroids on the endocrine system are complex and complicated and need the focused knowledge of an endocrinologist. It is best if you seek an endocrinologist who practice is specific to the pituitary gland. You do NOT want an endocrinologist who practice is centered on diabetic care and treatment (which is often the bread and butter of endocrinology group practices). Take your time to research the scope of practice of the endocrinologist - you want an endocrinologist with pituitary expertise.
- Karen -