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Date of last update: 10/12/2017.

Forum Name: Other infections

Question: Best treatment for Enterococcus boil/cyst infection

 idee - Sat May 30, 2009 12:06 pm

I've had a cyst on my thigh for @ 20 years . It got infected once, swelled up and resolved itself, but the cyst remained.
Dr.s tell me there is no reason to worry about it if doesn't cause a problem

@two weeks ago, it started hurting. I thought it was just because of my monthly cycle as a similar one under my arm tends to get sore around that time.

I used heat over the first weekend to try to get it to come to a head, but it didn't. By the time I got to the doctor on monday, they said i should have gone to the ER. It was that swollen and infected. I actually saw a PA who numbed it with novacain, opened it and some fluid came out. They sent off for a culture, drew blood work and gave me Bactrim, expecting that it was Staph. I ran a fever of 100.5 that evening and then back to normal.

The next day she wanted to see it agian. She thinks it is not the cyst. Just coincidentally next to the cyst?! Hmmmmmmmmm.
It wasn't getting much better and she wanted to try to squeeze it out...without anesthetic??!!?!
Noooooooooo!!! I was barely able to walk as it was and I had been reading that you should not squeeze them. I mentioned that my bladder was also sore and she told me that the bactrim would take care of that also.

A few days later, a core started to appear and actually popped out when I pulled the skin tight around it....about the size and appearance of a large hominy grit.... ... =12nlshfp0
....and then a smaller one the next day. After that, it did start to drain better and the swelling started going down. I think it was plugged like a cork. I have pics of it sticking out of my leg, but I don't know how to post it here.
Did I mention this thing smells bad?

When the culture came back, it was not was enterocuccos.
The blood work was ok.
I looked enterocuccos up and saw that it seemed to be a bad one also and asked a nurse friend of mine about it. She told me to ask for the report and see what it is suseptible to because it was not treatable with Bactrim. So I called to ask if I needed a different antibiotic since enterocuccus is not suseptible to Bactrim. I also wanted to know if it was VRE. (voicemail)

When I didn't get a call back, I went to the office and asked for the PA. Her aide said the PA was out, so I asked her to take it to one of the DR.s and ask. I also asked for a copy of the report. A Dr. came and looked at it, saw that it was still draining, said it was not Vancomycin resistant and prescribed Vancomycin.

I got the report which said it was (S) suseptible to Penicillin and Vancomycin.
I thought I was good to go now, but, my nurse friend said it wouldn't work because is isn't absorbed well in the intestines. And she questioned why they would use Van instead of a first line antibiotic.I also read
Vancomycin must be administered intravenously because it is not absorbed through the gastrointestinal tract


Antimicrobial Resistance in Enterococcus spp
Penicillin should not be used; use Ampicillin if MIC indicates (S)susceptible

because it is only suseptible to Pen in vitro...not in humans.

I am now wondering if I should be on Van. Since it is not absorbed well and little will actually ge to the infection site, am i just increasing the chances of the infection becomeing VRE? Does a local boil?cyst enterococcus infection merit IV Van?

Q.1: Should I ask for Ampicillin instead?

I read an article about enterococcus that said it had been transmitted through infected persons sitting on chairs.

" ** The chairs believed to be the source of the problem were coated in a fabric that was very hard to clean. The hospital has set aside $50,000 to buy new vinyl chairs for the renal ward and the liver transplant unit, the areas where patients are most vulnerable. It will progressively get rid of thousands of chairs throughout the hospital. The new chairs have been delayed and the hospital is hiring vinyl chairs in the interim."

Q. 2: Am I being overprecautios having my Husband use our other bathroom and shower?
Q. 3: Can I spread this infection by using public toilets as the infection is on my inner upper thigh?
Q. 4: I know it isn't VRE, but isn't it just as easily transmitted even though it's not resistant?
Q.5: Should I get a urinalysis to see if there is entrococcus in my urininary track. I am still sore....though not excruciatinfgly as with cystitis.
Q.6: I see where Staph can live in nostrils. Does enterococcus do this as well? Should I use an antibiotic in my nose? Like I said, this stuff smells [b]bad
Q. 7: The doc does not intend to see me anymore. Should I have any follow up bloodwork or other testing done to see if I still have colonization or VRE after this round of Van? The original bloodwork was done before the draining and squeezing. Can that make it move to the bloodstream?
Q.8: Also, I was diagnosed with Lymphoma in 2005. Is this a factor in my immune system that would make a difference in how agressively the infection should be treated?[/b]

The Doc is not gonna listen to all these questions. He already gave me a weird look when he saw my leg wrapped,(in plastic shrink wrap-I saw it somewhere on the internet) but my dressing gets saturated and the edges pucker after I've been walking and moving around and make little openings that can leak. **He should be glad I stood while I was in the waiting room.
 Dr.M.jagesh kamath - Wed Oct 07, 2009 3:15 am

User avatar Hello,So long that it is not a resistant strain of enterococcus only standard precautons need to be taken for prevention.The only indication for oral vancomycin I am aware is pseudomembranous colitis caused by broad spectrum antibiotics.Your immune status might be responsible for the infection.
 kursivewriting - Wed Mar 03, 2010 6:25 pm

I don't know answers to your question, but I have the exact same thing going on in a lesion on my back. Great description with the hominy. Thanks for that, because I was having a hard time describing that thing that came out!

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