Staphylococcus aureus and PND

[George80]

Just got a result of a swab from my tonsil crypts. It says there is a pathogen amount of Staphylococcus aureus:
http://en.wikipedia.org/wiki/Staphylococcus_aureus
Now the ENT made a swab from my sinuses (ethmoids).
Does anybody know something about this stuff?

[hoping]

Had the same experience 'bout a yr ago. ENT gave me antibiotics and it didn't do a thing for my nose odor.

[halitosisux]

Chronic infection in the sinuses can take weeks to eradicate - and its no guarantee that it will.

George how come your ENT is taking swabs from your ethmoid sinuses?

[George80]

I told my ENT to take a swab from my tonsils, because I had tonsil stones and thought a crypt-tonsilitis could be the cause of my PND. This sort of tonsilitis often doesn't show any clear symptoms.
After having the result of a high bacteria count of Stapyhlococcus aureus in my crypts, my ENT told me that tonsil removal would be an option.
In my opinion the tonsils are not the real cause. The PND drips into the tonsil crypts, so there is probably a lot of bacteria dripping from above into my throat.
My CT from 2009 showed slight shadows in the right maxilaris and both ethmoids. So I told my ENT to take a swab from the sinuses.
It's interesting that you have to sort of trigger the ENT to do certain things.
If my ethmoids are full of the germ too, it's pretty obvious, that I have a chronic sinusitis. Which is pretty stupid, because there is almost no way the really get rid of that s*#t and therefore my BB.

Can you suggest any treatment to eradicate the sinusitis?

My ENT told me antibiotics don't help, at least not oraly or as injections. I seem to suffer from this for years. It's a family thing too.
It's getting worse, and if I remove my tonsils, there might be a "level change", may be affecting my lungs etc.

[halitosisux]

Hi George, its interesting that you refer to your ethmoid sinuses because problems with nose/sinsuses usually involve the maxillary sinuses and the other sinuses could well be overlooked as potential problems areas regarding BB.

It will certainly be interesting to hear if your ENT specialist can make any kind of diagnosis from the swabs taken.

Fortunately for me, I never suffered with any type of nasal odour or nasal breath. I dont know anything about nasal flushes nor have I ever tried performing one. I do however have a deviated septum and allergic rhinitis and at times quite considerable post nasal drip, although this never smells or has any colour to it. Its thickness is what I'd expect from mucus coming from the nose.

A few things might be of interest to you though. There is a phenomenon that many people have whereby they release a very bad room-filling lingering odour, but only when they sneeze. Normally there is no odour at all. Some people with this phenomenon describe odour also being released when their heads are turned in a certain position, or lying down, or sitting up. I think there is a very good possibility that there could be a link between whatever causes this and the cause of constant nasal odour/discharge that many people on this forum describe.

The following links might be of interest:-

http://en.wikipedia.org/wiki/Atrophic_rhinitis

http://www.american-rhinologic.org/pati ... ngal.phtml

http://en.wikipedia.org/wiki/Biofilm

If a biofilm has formed in the sinuses, it is very difficult, if not impossible to eradicate with a typical duration of antibiotics. That's why your ENT says antibiotics dont help.

There are many hereditary factors that could be involved, especially any allergic underlying initiators.

[George80]

Thanks for the links halitosisux. I'll check them later.
I don't have a nasal odour, at least neither my friends mentioned nor did I recognize.
I'm always full of mucus and my nostrils are very sensitive to touch. That's all, no cold symptoms or anything tipical for sinusitis. OK, after jogging I really throw up a lot of mucus, tons.

[Ruben]

I told my ENT to take a swab from my tonsils, because I had tonsil stones and thought a crypt-tonsilitis could be the cause of my PND. This sort of tonsilitis often doesn't show any clear symptoms.
After having the result of a high bacteria count of Stapyhlococcus aureus in my crypts, my ENT told me that tonsil removal would be an option.
In my opinion the tonsils are not the real cause. The PND drips into the tonsil crypts, so there is probably a lot of bacteria dripping from above into my throat.
My CT from 2009 showed slight shadows in the right maxilaris and both ethmoids. So I told my ENT to take a swab from the sinuses.
It's interesting that you have to sort of trigger the ENT to do certain things.
If my ethmoids are full of the germ too, it's pretty obvious, that I have a chronic sinusitis. Which is pretty stupid, because there is almost no way the really get rid of that s*#t and therefore my BB.

Can you suggest any treatment to eradicate the sinusitis?

My ENT told me antibiotics don't help, at least not oraly or as injections. I seem to suffer from this for years. It's a family thing too.
It's getting worse, and if I remove my tonsils, there might be a "level change", may be affecting my lungs etc.

Since most of you have insurance, tell you ENT to do a test for Pseudomonas Aeruginosa, see if it exceeded 'normal' levels in your tonsil area.

[George80]

I checked the information. I don't think it's atophic rhinitis, and they would have found fungus, in the swab, if it was a fungus?
I'll have the results of my ethmoid swab next week, let's see.
(To be precise it's not directly from the ethmoids, but from the closest point to them).
If it is Staphylococcus Aureus I will try antibiotics as a spray. I'm thinking of giving me a hit of this stuff first: http://www.nasodren.com/
It opens everything, so the antibiotics will have a chance to pass through.

[George80]

so, the swab from my sinuses area came up with the same bacteria that was in my tonsils "staphylococcus aureus". I'm having to nasal sprays now, one curing the ethmoid swelling and one supporting the tiny hairs transporting the musus. Furthermore I will start taking antibiotics.
This will not help. I'm sure, but I'm trying.

[halitosisux]

Good luck George. Please keep updating.
Fascinating that the sinus swabs show the same abnormal bacteria found coming from your tonsils. Sounds like you have a good doctor willing to take this problem on.

What spray are you using for your nasal cilia? I didnt know such medication existed. I have often wondered if some abnormality relating to the sweeping action of these tiny hairs might be allowing PND and bacterial situations to lead to BB.

I made a thread on it once but not one single person responded.

[George80]

I started a 5 days treatment with Levofloxacin yesterday. I'm taking probiotics each day to compensate the antibiotics.
The one sprays contains "xylometazolinhydrochlorid" which can lead to addiction if you take more than 7 days. It should decrease the swelling. The other one is "nasodren" which contains cyclamen: http://www.nasodren.com/
No results yet. And there will be no results, I know already :-(.
The Doctor is quite OK, at least he's patient. He thought I'm a "psycho" I guess, until he found the bacteria in my sinuses.
I have a public insurance which is quite good compared to other countries basic insurances. But I could have far better treatment with a private one.

[halitosisux]

Hi george. I just looked into some of these meds.

Here's what wikipedia says about Levofloxacin:-

"Levofloxacin is a synthetic chemotherapeutic antibiotic of the fluoroquinolone drug class and is used to treat severe or life-threatening bacterial infections or bacterial infections that have failed to respond to other antibiotic classes"

"Levofloxacin interacts with a number of other drugs, as well as a number of herbal and natural supplements. Such interactions increase the risk of cardiotoxicity and arrhythmias, anticoagulation, the formation of non-absorbable complexes, as well as increasing the risk of toxicity.

Levofloxacin is associated with a number of serious and life-threatening adverse reactions as well as spontaneous tendon ruptures and irreversible peripheral neuropathy. Such reactions may manifest long after therapy had been completed and in severe cases may result in life-long disabilities. Hepatoxicity has also been reported with the use of levofloxacin."

Serious stuff, but hopefully a good sign that your doctor is actually serious about trying to help you.

The xylometazoline is a decongestant which will allow your sinuses to aspirate and improve drainage.

The nasodren, I'm not too sure what that is. I'm guessing this is what acts on the nasal cilia and helps the process of mucus drainage. If you have chronic sinusits, then the cilia of the sinus linings will have been damaged anyway.

Worth doing some research into biofilm formation inside the sinuses. There have been a number of threads on here that discuss this too. They are bacterial "growths" that do not respond to standard antibiotic therapy. The slime that can grow where water stagnates is a biofilm, such as sink drains. Think about how they smell.

Research has shown that sinus infection almost always involves biofilm formation that never fully resolves which leads to constant recurrances.

The plaque on your teeth is an example of a biofilm. This requires mechanical removal.

This is why doctors are reluctant to get too involved when the odour is clearly coming from the nose, if the only complaint is bad breath, because treatment is not straighforward.

A biofilm is similar to what grows in your sink drain pipes.

Worth gathering some info together on this and mentioning it to your doctor.

Also, anyone who is currently trying nasal irrigation, has anyone ever tried using probiotics in their nasal flush? Probiotics are used together with antibiotics to fight infection in the gut for example, so why not in the sinuses?

[George80]

I hesitated a long time to take Antibiotics. But I'll give them a try. I don't think they will work.

My ENT told me: When the sinuses are blocked/swollen, then the tissues produce mucus, since that's what they are supposed to do. So you have to get the sinuses free again to stop the mucus. There is a Ostiomeatal complex (OMC) that is crucial, called the key to the sinuses.

So my ENT advises me to make a small local surgery to get the sinus passage free again. All people who had surgery tell you, problems come back again. You carry more bacteria into the sinuses and you scar the tissue, so the cilia can't work properly.

I don't have many options left, except surgery. And this is a vicious circle anyway.

[aydinmur]

Just got a result of a swab from my tonsil crypts. It says there is a pathogen amount of Staphylococcus aureus:

Now the ENT made a swab from my sinuses (ethmoids).
Does anybody know something about this stuff?

You may be S. aureus portor.
For nasal S. aureus portor treatment, I prefer Procain Penicillin 800000 IU 1x1 IM, for 10 days. Benzatin Penicillin 1200000 IU IM one time at 11th day. Drop 5% vancomycin containing eye drop into your nose for 2 weeks.
Repeat microbiological examination after 1 month.


btw:
Its difficult to enter ethmoid sinus cavity without give damage tissues. Furthermore, its difficult to localise bacterial colonisation such as ethmoid / frontal / Spheonid / maxillar sinus etc. Meanwhile, If there is growth, its assumed every sinus is contaminated by the same bacteria.

p.s.: until you get negative culture, dont kiss babies, hospitalized patients, elder people, cancer patients, or people who use cortisol or other immun deficit people .

- Murat Aydin

[sadman]

George80

the swab from my sinuses area came up with the same bacteria that was in my tonsils "staphylococcus aureus"

Is there a sensitivity done ?

In most countries, penicillin-resistant strains of SA is extremely common ( >90 %)]and first-line therapy is most commonly a penicillinase-resistant β-lactam such as Methicillin or newer drug quinolones such as Levaquin (levofloxacin), but there is an increasing strain of SA that is resistant to β-lactam antibiotic ( MRSA, Methicilin resistant SA). If you have MRSA sinuses infection , Bactroban Nasal ointment 2 % might be a good choice

Analysis of six U.S. clinical trials designed to evaluate the effectiveness of Bactroban Nasal in eliminating S. aureus from the nostrils in health care workers showed that of the volunteers evaluated for efficacy, nasal carriage of S. aureus was eliminated in 91 percent (130/143) of volunteers receiving Bactroban Nasal but in only 6 percent (8/142) of volunteers receiving placebo. In addition, 74 percent (96/130) of the volunteers treated with Bactroban Nasal who were free of S. aureus at the end of therapy (five days) remained free of the bacteria four weeks after treatment compared with 12.5 percent of the placebo volunteers. No serious side effects were reported. Only one of 339 participants withdrew from the study due to a side effect. The most frequently reported side effects associated with Bactroban Nasal were headache (9%), rhinitis (6%), and respiratory disorder including upper respiratory tract congestion (5).

[i]Patients colonised with MRSA

Patients colonised with MRSA may have a special antibiotic called mupirocin applied onto their skin (Bactroban) or the inside of their nose (Bactroban nasal). This helps to eliminate the MRSA and reduces the risk of the bacteria spreading either to other sites on the patient's body, where they might cause infection, or to other patients. Some strains of MRSA are, however, resistant to mupirocin.[/i

aydinmur:

You may be S. aureus portor.

Do you mean carrier