kflee00
new member
United StatesDear All members,
I had late onset infection on lumbar spine's implant 8 months post-op. At about 5 months post-op, I had fever for a week then it went away, night sweat......I knew something wasn't right but the last thing that come to my mind was infection. Like most patient, I thought it's just another setback from major surgery.
Finally, MRI confirms enormous abscess (Bio-film) at L5-S1 implant. The bacteria was never found in the blood although CRP was between 8-12 at that time. Surgeon washed out the abscess, removed the infected implant and replace with another implant made of pure titanium.
The bacteria identified as Staphylococcus Aureus (MSSA). At hospital on IV for 4 weeks, followed by daily oral antibiotic Levofloxacin 750mg and Rifampin 600mg. 3 months later, ID doctor switched me to Doxycycline 200mg and Rifampin 600 mg. I have been on oral antibiotic for total of 9 months to the present
Below's the timeline for infection post-op. After the wash out, all my monthly blood work is back to normal, CRP<5. Nothing shows on blood culture either
-2.5 weeks post-op, MRI shows significant smaller collection/inflammation at surgical site
-8 weeks post-op, MRI did not shows finding to suggest organized abscess, osteomyelitis or cellulitis
-3 months post-op, Bone scintigraphy(Tc-99m) and Gallium scintigraphy (Gallium 67): no evidence of residual infection
-9 months post-op, MRI shows no sign of infections
I have gotten a second opinion from the ID doctor outside ........the infectious diseases doctor i consulted have vastly different opinion/ treatment plan
1. Original ID Doctor suggests to stop all antibiotics, said I have a high probability of being cured, continue blood work monthly and MRI every 3 months, if nothing shows after 18 months, you are cured.
2. Doctor B said continue Doxycycline as long as I can tolerate, eg. few years or even lifetime. She said Staphylococcus Aureus is very hard to eradicate 100%, relapse is high.
If the infection returns, I am afraid I will need to undergo another spinal surgery. But taking antibiotics long terms does concern me, I am 40 years old. Any suggestion, comment is much appreciated.......
Questions
1. I live in Dallas TX, does anyone know any good experience ID doctor in this area? RestAssured? I read your one stage revision was done in Plano TX. Can you recommend your ID doctor who work with Dr. Gerhard Maale?
2. Anyone here had successful one stage revision hip/knee?
Regards
Michael
I had late onset infection on lumbar spine's implant 8 months post-op. At about 5 months post-op, I had fever for a week then it went away, night sweat......I knew something wasn't right but the last thing that come to my mind was infection. Like most patient, I thought it's just another setback from major surgery.
Finally, MRI confirms enormous abscess (Bio-film) at L5-S1 implant. The bacteria was never found in the blood although CRP was between 8-12 at that time. Surgeon washed out the abscess, removed the infected implant and replace with another implant made of pure titanium.
The bacteria identified as Staphylococcus Aureus (MSSA). At hospital on IV for 4 weeks, followed by daily oral antibiotic Levofloxacin 750mg and Rifampin 600mg. 3 months later, ID doctor switched me to Doxycycline 200mg and Rifampin 600 mg. I have been on oral antibiotic for total of 9 months to the present
Below's the timeline for infection post-op. After the wash out, all my monthly blood work is back to normal, CRP<5. Nothing shows on blood culture either
-2.5 weeks post-op, MRI shows significant smaller collection/inflammation at surgical site
-8 weeks post-op, MRI did not shows finding to suggest organized abscess, osteomyelitis or cellulitis
-3 months post-op, Bone scintigraphy(Tc-99m) and Gallium scintigraphy (Gallium 67): no evidence of residual infection
-9 months post-op, MRI shows no sign of infections
I have gotten a second opinion from the ID doctor outside ........the infectious diseases doctor i consulted have vastly different opinion/ treatment plan
1. Original ID Doctor suggests to stop all antibiotics, said I have a high probability of being cured, continue blood work monthly and MRI every 3 months, if nothing shows after 18 months, you are cured.
2. Doctor B said continue Doxycycline as long as I can tolerate, eg. few years or even lifetime. She said Staphylococcus Aureus is very hard to eradicate 100%, relapse is high.
If the infection returns, I am afraid I will need to undergo another spinal surgery. But taking antibiotics long terms does concern me, I am 40 years old. Any suggestion, comment is much appreciated.......
Questions
1. I live in Dallas TX, does anyone know any good experience ID doctor in this area? RestAssured? I read your one stage revision was done in Plano TX. Can you recommend your ID doctor who work with Dr. Gerhard Maale?
2. Anyone here had successful one stage revision hip/knee?
Regards
Michael
