Hello and a question about MRSA...

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Hello everyone! I used to post here a bit ago, but since having the

baby a year ago and dealing with all his issues in addition to my

older son's, I have not had a lot of time for posting. I hope it is

ok to jump back in to ask a question...

My son developed a small red mark next to his gtube stoma on Fri

night. After a couple of hours it started spreading and developing a

knot. In the mean time, we called a bunch of drs (none of whom were

OUR dr and our immuno has no answering service...just a machine he

checks over the weekend, so no help to us) and kept getitng offed

onto someone else until we finally had the surgeon send us in to the

ER. He dx an abcess/cellulitis and said it was too deep/solid to

drain and to take oral bactrim for a week. By the next afternoon

(under 18 hrs), the cellulitis had spread from thumb-tip sized to

tennis ball sized and the abcess went from pea sized to golf ball

sized. We called back and were told to return to the ER. The

surgeon saw us immediately and admitted us to Tx Children's within

the hr. We were d/c on Tues, but got the final lab reports today.

had an MRSA infection on his g-tube stoma that abcessed and

spread rapidly in under 18 hrs. He went through 36 hrs of IV

Clindamycin, Vancomycin, and Gentamycin. Because of his immune

deficiency, the ID believes it possibly spread more rapidly than

normal and he did not run a fever really (probably because of his

immune deficiency - his fever mechanism has never really worked right

anyways) but he was really sick. He is home now on oral Bactrim and

topical Bactroban ointment. We have a follow up with the Infectious

Disease dr on the 24th. He believes another factor that lead to the

rapid spread is that is probably colonized with the Staph

bacteria. If that is the case, the rest of the family is most likely

colonized as well as it is spread through skin contact. We are all to

underdo skin testing then to determine who needs to undergo the

treatment protocol for colonization. Thankfully, is doing

better now and almost feeling himself again, although the abcess is

still not gone yet.

Sorry for the novel, but this brings me to my question... has

only been tentatively dx with THI (transient hypogam) and they were

thinking he was outgrowing it, though his numbers have not shown

this. He has not run " out of the ordinary " infections really besides

RSV, but when he does get sick, he can have recurrent infections for

some time and has a much harder time resolving illnesses. Does

having an infection like MRSA requiring hospitalization change his

immune status? His Ig levels are still in the toilet (IgG from the

hosp stay was 358 and he is 3.5 y o) and have shown basically no

change in the almost 2 yrs we have been testing. I am not sure I am

happy with our current immuno and really like the ID dr we saw

inpatient and we found out he does infusions in his office. He

seemed really surprised was not on infusions or even

preventatives at this point, especially with ' counts being

what they are. We are seriously considering getting another opinion

from him at the follow-up appt. In your experiences, do you think

IVIG is warrented at this time if it is suggested to us? We have

been trying to avoid it up until this point, but after this last

scary hospitalization and seeing how sick he was, I am not opposed to

anything at this point. How worried should I be about reoccurance?

The ID said his risk went up " exponentially " since he has had this

infection. Is this true? Advice? Suggestions? I would really

appreciate anything you can share with me. Thanks for your help!

Melody, mom to 3.5 yr old (THI, GERD, RAD,

DGE/Gastroparesis, gtube/pump fed, hypotonia) and 12.5 mo old

(GERD, DGE, Global Dev Delays, AFO's, Hypotonia, Myopia, ear tubes,

possible undx neuro issues and possible undx genetic issues -

awaiting testing results)