Re: Vulvar MRSA
From: Robert J. Carpenter, Jr. MD (zygote@icsi.net)
Thu Jul 28 06:04:44 2005
Seb is world class. Pull him up on pubmed. plus 3-4 books on ID
On 26 Jul 2005 at 9:15, ainsron wrote:
> She is 15 weeks. It is sensitive to Bactrim and that is what I plan
> to treat with. It's also sensitive to Gentamycin, Rifampin,
> Vancomycin, Linezolid and Moxifloxacin. Resistant to TCN, Cefazolin,
> Emycin, Oxacillin, and intermediate to Levofloxacin. Is Faro an
> OB/Gyn ID specialist? Where's he at? Thanks for the suggestions.
>
> Ronald E. Ainsworth, MD, FACOG
>
> -----Original Message-----
> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
> Robert J. Carpenter, Jr. MD Sent: Tuesday, July 26, 2005 4:33 AM To:
> Multiple recipients of list OB-GYN-L Subject: RE: Vulvar MRSA
>
> 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
>
--
Robert J. Carpenter, Jr. MD
6624 Fannin, #2720
St. Luke's Medical Tower
Houston,TX 77030-2339
713-795-4600
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