Re: Vulvar MRSA
From: ainsron (ainsron@sbcglobal.net)
Tue Jul 26 09:15:46 2005
I think it is probably simply one of her skin flora.
Ronald E. Ainsworth, MD, FACOG
-----Original Message-----
From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of art
fougner, md
Sent: Tuesday, July 26, 2005 5:36 AM
To: Multiple recipients of list OB-GYN-L
Subject: [Norton AntiSpam] Re: Vulvar MRSA
Do you think that MSRA is the causal agent of this patient's vulvitis or
a fellow traveller?
art
At Tue, 26 Jul 2005, Robert J. Carpenter, Jr. MD wrote:
>
>Treatment with Bactrim DS, Cleocin, before delivery are reasonable.
Postdelivery
>depending on degree of infection then Tetracyclines work. What is her
gestational
>age.
>
>You can call Seb FAro at 713-799-8994. What are the in vitro sensis
>
>On 25 Jul 2005 at 13:55, ainsron wrote:
>
>> I haven't even had a chance to talk to her yet, I was gone the end of
>> last week and the culture was sitting on my desk today. She had an
>> appointment today, but cancelled it because she had to go out of town.
>> I'll have her call me when she gets back. I wish an ID consult was
>> an option, there are none in Northern CA, she would have to go 90+
>> miles to Sacramento.
>>
>> Ronald E. Ainsworth, MD, FACOG
>>
>> -----Original Message-----
>> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
>> RModugno@aol.com Sent: Monday, July 25, 2005 11:39 AM To: Multiple
>> recipients of list OB-GYN-L Subject: Re: Vulvar MRSA
>>
>> In a message dated 7/25/2005 12:43:34 PM Eastern Standard Time,
>> ainsron@sbcglobal.net writes:
>>
>> I saw a OB patient last week with a markedly erythematous vulva with
>> multiple excoriations and linear ulcerations. She was positive for
>> trichomonas and treated with Flagyl. I also did a routine vaginal
>> culture that came back positive for MRSA. How would you treat it,
>> Vancomycin? The hospital will go crazy unless I document clearance
>> before labor. Would you do vaginal and nasal cultures?
>>
>> This patient needs hospitalization, aggressive IV antibiotics, with
>> I.D. consultation.
>>
>> Know of 2 patients at our hospital with MSRA secondarily infectied
>> vulvar ulcerative disease ( one from HSV) She subsequently had to have
>> a hindquarter amputation!
>>
>> Is your patient doing OK?
>>
>> Robert Modugno MD MBA FACOG
>>
>> Marietta, GA
>>
>--
>Robert J. Carpenter, Jr. MD
>6624 Fannin, #2720
>St. Luke's Medical Tower
>Houston,TX 77030-2339
>713-795-4600
>
--
art fougner, md
"If you don't know where you are going, you will wind up somewhere else."
Lawrence Peter Berra
