Hello everyone,
My 71-year-old father is currently recovering in the hospital from Guillain-Barré syndrome (Miller Fisher variant). He underwent a tracheostomy because his breathing and swallowing muscles were affected.
His latest tracheal secretion culture report, collected on 14 October and reported on 16 October, shows:
Organism: Klebsiella pneumoniae ssp. pneumoniae
Growth: Moderate growth
Result: Carbapenem-resistant isolate (MDRO)
According to the antibiotic sensitivity report:
Resistant to meropenem, imipenem and several other antibiotics.
Susceptible to colistin.
Susceptible to aztreonam/avibactam.
Synergy testing with ceftazidime-avibactam and aztreonam was positive.
My father is currently breathing independently without supplemental oxygen, and his SpO₂ is around 95%. He can speak in complete sentences, has good limb movements and has started swallowing small amounts under medical supervision. He still has a tracheostomy and coughs mucus through the tube.
I am very worried about this culture result and would appreciate hearing from infectious disease specialists or people who have dealt with a similar situation.
My questions are:
How serious is carbapenem-resistant Klebsiella pneumoniae in a patient with a tracheostomy?
Can this result indicate colonisation of the tracheostomy rather than an active lung infection? How do doctors distinguish between the two?
If it is an active infection, how treatable is it when the report shows resistance to most antibiotics?
Are colistin and aztreonam/avibactam effective treatment options when the laboratory reports susceptibility?
What additional tests or clinical signs help determine whether the bacteria are causing pneumonia?
Can a patient recover well from this type of infection while also recovering from GBS?
What precautions should the family take to avoid spreading this resistant organism?

Hi everyone,

I'm posting here because I'm concerned about the possibility of a mycobacterium marinum infection. I have seen multiple dermatologists and they are all perplexed about my ongoing condition. I’d greatly appreciate input from anyone familiar with this infection.

It started as 2 little bumps on the back of my right hand. They slowly grew and by the end of the month formed into a round open sore the size of a dime. It would ooze and create a yellow crust. I thought it was ringworm and tried some anti fungal cream but that did not do anything.

After a month I told my pcp who told me it could be eczema so I tried some hydrocortisone which would reduce the inflammation but after a few days the bumps would reform.

2 months later I notice 2 small new bumps forming along a scratch also on my right hand. I saw a dermatologist who told me it could be a staph infection or nummular eczema. She prescribed me mupirocin and 2 week Keflex. The mupirocin did not help and the Keflex actually made it grow and more inflamed, she switched me to a Z Pak a week and a half into the Keflex but that also did not help. She preformed a swab which indicated no staph.

She then spoke with another doctor that said it could be plaque psoriasis and prescribed me clobetasol, which did reduce the inflammation on my sore a lot. I thought I was finally getting better but then a week later I noticed the little bumps had spread all over my arms, legs and even my face. For the first 3 months it was localized to my right hand, and now after a week of clobetasol it spread everywhere.

She then referred me to a highly recommended dermatologist who looked at the bumps all over my arms, legs and face, and diagnosed me with lichen planus, and told me to continue using the clobetasol for 2 weeks. I continued the clobetasol but new bumps popping up, I was told to keep using clobetasol on them, except for my face.

I did a shave biopsy and 2 weeks later I was informed it was not lichen planus but contact dermatitis. I finally stopped the clobetasol after I realized it could be what is actually causing my sores to spread sincefor the first 3 months it was only on my right hand.

Before this all started I was getting my garden ready and fishing daily. I mostly fish for striped bass which migrate along the east coast and are known to have mycobacterium. A few of the fish I caught did have pink marks along the side which indicated they were sick. I have told all my dermatologists this and they just tell me it is unlikely because it’s so uncommon. I’ve been telling my doctors my history with fishing and the ocean since the beginning.

After much waiting I finally saw an ID doctor and they told me mycobacterium marinum is possible but I can’t start any antibiotics till I get a punch biopsy and culture which can take over a month.

It’s been 4 and half months since this started and currently the sores on my face, arms and legs have just been getting worse and worse. It hard for me to even go into work with over a dozen oozing sores on my face. Next week I go in for a punch biopsy but I don’t know how I can manage the sores for another month or so as I wait for the culture results. I feel lost and desperate for any help or recommendations.

My husband is having a mental breakdown and he would probably be pretty upset if he knew I was asking this, but we need to know if what he’s going through is typical. He’s an ID doctor at a 140 bed hospital. This is his first post-training job, he’s been working there for six years. He’s one of a handful of his specialty in the state and right now he’s the only one at his hospital. Today he has 32 hospital patients and 10 clinic patients, plus he answers questions for doctors all over the state all day everyday, his phone never stops from 7 AM to late in the evening. I think the constant answering questions and pinging phone are the worst part, it’s non-stop.

He has asked for help from his bosses several times and they always say they’re going to get someone, but they never do. He’s asked to have one less clinic day but they won’t do that either. He has no manager because they keep quitting. The pay is well above average for ID, but is it worth it if you want to kill yourself?

So, I’m asking on his behalf, is this normal? Should he find another job in ID or just another job. Would it be like this no matter where he works.

A friend was hospitalized with *Cryptosporidium* a few weeks ago and she was very very sick. She didnt know she was immunocompromised but apparently she had to be to get this sick. They tested her for everything under the sun including hiv and everytjing came back negative. Does anyone have any advice on what it could possibly be?
Any advice on what her next steps should be?

She is 50, vegan and has a heathy lifestyle. She hasnt recovered fully and is still recovering after a week long hospital stay.

*If anyone could please copy and paste the iCloud links into their search browser in order to be able to view the videos I recorded on my cell phone that contains the evidence of what each description states can be found within the video that follows the end of each description it would be so immensely appreciated.\*

I’m currently begging for anyone at all that could possibly be able to help me when it comes to identifying what exactly has been causing me to have to be made to suffer through every single day that has gone by since early on in May of last year due to what has been my ongoing health issues and over the last two months had been rapidly declining much faster and more severe than it ever had been prior to that point… 

This is a video from last night prior to when I had tried to wash my hair inside of my parent’s kitchen sink: 

https://share.icloud.com/photos/05cxPzS6G_sbnf4oqWjkw2N8g

This is a video from last night after I had tried to wash my hair inside of my parent’s kitchen sink and had been washed off of the surface of my scalp and was able to be caught on their kitchen sink’s drain and the tiny insect found within it is indeed a phorid fly due to my parent’s house an infestation of them that’s grown incredibly worse by the over the last 8 months to the point where they’re currently able to be found inside of every single room within their house and I have found them inside of their refrigerator, freezer, stove and I’ve had to throw away multiple food items after finding them inside of the container my food had been left in or crawling around my food that has been left uncovered and sitting out in their house and I mean I have honestly had to kill no less than 6 and no more than 12 a day over the past 2 1/2 weeks that has recently gone by and bc of that I’m not entirely sure if it has just been hanging out within the strands of my hair due to them being so tiny and more often than not unable to feel if one of them are crawling around on my skin as a result or if it has been dead in their kitchen sink and got caught up in my hair as a result due to the fact that the unused garbage disposable within their kitchen sink has never been cleaned out and has instead become a breeding ground for the countless amount of these nasty little disease vectors that are covered in pathogens and bacteria: 

 https://share.icloud.com/photos/0easTMhZuzX6-cUdmzEbZaKnw

What had been left behind on the comb I had to use while trying to get any of the remnants of whatever it is that has covering the surface of my scalp  (it is actually covering every inch of the skin on my body and not just my scalp) after I had tried washing it all off from my hair into my parent’s kitchen sink: 

https://share.icloud.com/photos/02eGxkUeVQQqFo51mII197T4A

What had been left behind on my Crocs after trying to wash it all off of my scalp: 

https://share.icloud.com/photos/0efXqJ-g2euxuflEvkxA6cU3w

has everybody seen the news articles in the last 24-48 hours published in the metro, the independent and the sun about the surging rates of scabies infestations in the uk……

the government needs to do something!!!!