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October 15, 2009

MRSA Sinusitis


There seems to be an increasing number of patients I see with MRSA sinusitis. Not many, but definitely not rare. These patients are understandably very concerned with how to treat their MRSA sinusitis.

Beyond the usual protocol that applies to any MRSA infection, if the sinusitis is severe, sinus surgery is recommended for 3 main reasons.

1) Get the infection cleaned out surgically (much like draining an abscess of the skin)
2) Enlarge the openings of the sinus cavity to allow good post-op topical treatment in order to potentially avoid oral and IV antibiotics (though they still may be needed)
3) Sinus infection can be carefully followed endoscopically in the future

By opening up the sinuses, topical treatment can be performed that is sometimes more effective that IV or oral routes as higher concentrations of medication can be delivered right to the area of concern (instead of oral or IV routes which go throughout the entire body causing side effects).

Such topical treatment include:

Saline flushes (Neilmed Sinus Rinse is our preferred method though irrigation devices shown below are also fine)
• Bactroban Cream or Cortisporin Ointment injection directly into the sinus cavity
• Antibiotic flushes to the sinus cavity
• Chemical saline flushes to the sinus cavity (my favorite being No-Tears Johnson's Baby Shampoo - 1 tsp in 250 cc of saline)

Debridement of the sinus cavity can also be easily performed after sinus surgery in the office.

Once the active MRSA sinusitis infection has cleared, continued topical treatment with daily saline nasal flushes help prevent future sinus infections.




Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids. Google+ Christopher Chang, MD Bio

4 comments:

  1. Really good post. Sinus infections (especially chronic ones) are no fun at all and can definitely lead to other issues (not to mention pretty much take over your life).
    Dealing w/ chronic sinusitis is another story. Sinus surgery has long been the only option when all else fails. However there are now some other ways to turn. Balloon sinuplasty is gaining traction – lots of info out there.
    Anyway. Knowledge is power – do your homework and talk to your doctor. Find the solution that fits your condition best.
    Take care.

    ReplyDelete
  2. There is also a product that can be used to disinfectant and clean all areas to help significantly reduce the spread of one of the nastiest infections out there. It will kill MRSA quickly and effectively and at the same time it will do no harm to humans,animals or the environment in the least. For more info go to
    www.dmcdistributors.com

    ReplyDelete
  3. This is by far the most depressing thing that has ever happened to me. I am afraid the MRSA will come back. I am paranoid about germs now. I hate this!

    ReplyDelete

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