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Contracted Mersa After A Sinus Surgery. Now Have Low IGG Levels And Klebsiella Serratia. Allergic To Mold. Cure?

Posted on Wed, 13 Jun 2012

Question: i have been coping with numerous sinus and bacterial infections since last February. On doctor's advice, I had sinus surgery in XXXXXXX and subsequently contracted Mersa as a result of the surgery, after hospitalization and extensive coyndmiaciin and rifampin and fluconazole treatment, I was pronounced healthy enough to return to work as a teacher and told that I was Mersa free in September. Since then, my health has continued to decline, with extreme fatigue and low IGG levels and I was referred to an immunologist who preliminarily has told me that I am not getting enough oxygen to my lungs, though my sinuses are now clear (with the current use of Nasonex and Patanase) and he prescribed Simbicort to get extra oxygen and took additional blood tests. I have another appointment for results in two weeks. However, today I received a phone call from my sinus doctor informing me that the last culture he took approximately 10 days ago reveals that I now have klebsiella serratia. He tells me that I must now contact the infectious disease doctor to get treatment but left a voicemail message suggesting that that perhaps I am "colonized" with this infection which appears to be hard to treat. He is out of the office tomorrow and I am left wondering how to proceed and what to do in my own best interest as it doesn't seem that the care plan that I've been on is yielding any results. Rather than remediating the original problem, I seem to have swapped it for a multitude of new problems. In addition, the immunologist yesterday took 40 allergy tests and concluded that I was non-reactive to 39 allergens but severely reactive to the 40th which is mold. There was mold found at my school site last year which has now been removed and remediated, but I am wondering if all of my problems originated there or are currently being exacerbated by some potential exposure to mold whether it be in my workplace or, unbeknownst to me, in my home. I am wondering if I should have my home checked for mold, I am wondering if a mold allergy is affected adversely by comsumption of mushrooms, which is something that I often enjoy eating and I am wondering if I have inadvertently been making things worse. Any and all counsel at this point will be gratefully received as I am running out of confidence in my own insurance-dictated treatment and I want to be well informed to be my own best advocate in moving forward from here. Please advise. XXXXXXX

Answered by Dr. CS Narayan (1 hour later)

Hello Ms XXXXXXX and thanks for your query.

I shall make an effort to provide you with good professional recommendations specific to your questions.

I understand you would want to know what was/is really happening with your medical management and what are the options available further.

MRSA (Methicillin-resistant Staphylococcus aureus), Klebsiella serratia are 2 resistant bacteria that are indeed difficult to treat. And let me start this by saying, you recovered well fighting MRSA first of all. Because it takes many months of treatment to get cured of that for many patients.

The sinus is a place that can get infected by both. In fact multiple infections are common with MRSA, and that is where the issue lies - that is the main concern for many patients. Multiple infections does not mean multiple of diseases, but that that particular set of symptoms associated with the site (sinus in your case) get carried on to the newer bacteria. (Klebsiella from MRSA)

Molds are composed of fungi (a collection of fungus colonies) and are known to cause respiratory allergies. It is for this reason those IgG levels have raised the concern and doubt to find the allergen in the tests you have undergone. Allergy to the mold has added to your sinus bacteria infection that was going on for a while as you mentioned, further lowering the levels of your immunity. So that MRSA has allowed Klebsiella to proliferate underneath.

Now, the way ahead for you is the eradication of the allergy symptoms - you are already on track with those antihistaminic drugs and beta adrenergics for your respiratory tract which are good.

And, also the treatment of Klebsiella, which is indeed difficult to treat as many antibiotics are resistant to it. Although, few options still exist which are the newer ones of the Penicillin group that have proven useful in studies. Your doctor would try the best available option for you after the culture tests in vitro (where the test of superiority is tested in the lab).

I think you are right on track with you treatment and should have faith on the management for now. Yes, for a while make some changes in your lifestyle and diet curtailing any mushroom intake, avoiding outdoor moist environments, dust, pollution, dusting in the house etc.

Yet again, I duly appreciate your query to me, I do hope that you have found something useful to help you and I shall be glad to answer any further apprehensions.

Sincerely,

Above answer was peer-reviewed by : Dr. Radhika

Follow up: Dr. CS Narayan (3 days later)

Can you tell me the name of the blood test that identifies mold toxicity? Also, can you verify whether there is any medical wisdom in following what has been described as an anti-mold diet for individuals who are identified as having mold allergies? The anti-mold diet says that molds feed on sugar and therefore people who are allergic to mold should eliminate sugar in their diet and also should eliminate things like diet soda because of the citric acid and should eat only fresh fruits and vegetables and meat and fish - not eating leftovers, not eating breads with yeast base, etc. Is there any benefit, in your opinion, to going on such a diet based on my physical condition?

Thank you for your help! XXXXXXX

Answered by Dr. CS Narayan (13 hours later)

Dear XXXXXXX

Thanks for the response.

A blood test (radioallergosorbent test/ RAST) can measure your immune system's response to mold by measuring the amount of certain antibodies in your bloodstream, known as IgE antibodies.

I have to admit, I am not authoritative on diet. But, can tell you foods that are XXXXXXX in mold content that you would do you good if you avoid: Cheese, Mushrooms, Vinegar and foods containing vinegar, such as salad dressing, catsup and pickles, Sour cream, sour milk and buttermilk, Beer and wine.

Meat or fish more than 24 hours old, Sour breads, such as pumpernickel, and other food made with a lot of yeast, Sauerkraut, Pickled and smoked meats and fish, Dried fruits such as dates, prunes, figs and raisins. Yes, this is medically right that it makes sense to avoid such food altogether.

Yes, anything fresh but clean will do with regards to food.

Wishing you good health.

Sincerely,

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Radhika