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GauravMD
GauravMD, Dr
Category: Dermatology
Satisfied Customers: 7941
Experience:  MBBS, DCH, DNB (MD), with special interest in Dermatology
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I had two skin cancer operations and I went back for the 3rd

Customer Question

I had two skin cancer operations and I went back for the 3rd and the doctor would not do it. About two days before I went back for the 3rd operation I hit the spot on my right thigh that had stitches in it. I hit the sharp corner of the desk right on the spot that I had stitches. I have hit the same spot on the corner of the desk before and it bruised so I thought I have done the same thing again. I forgot about the spot with the stitches and it was not until that night when I took the dressing off the wound that I realized I had hit the spot that had the stitches. It hurt so bad as it had done before but like I said I forgot about the wound. Pus was on the part where the stitches were and it was puffed up. I cleaned the wound as usual and covered it up with the bandage. I saw the doctor two days later to get the stitches out and I let her know what had happened. She took a biopsy of the area and I went back about two to three weeks later on Aug. 4th to have it operated on again. The dr. would not do the operation. She said that after looking at pictures and reading the report again that something was wrong. She called in a new pathologist and he called in a disease Dr. I have M. Abscessus according to the disease Dr. She gave me several options, 1. go back to the Dr. who did the Moh's surgery and get her to cut my leg large enough to get out all of the infection, and cancer, 2. take a series of antibiotics in an IV three times a week for a period of time, 3. go completely herbal which I had started while I was waiting for the Dr. to contact me 4. put a port in my leg and put the IV in myself at home. I ruled out the 4th one. I decided on the operation but the Dr. who does the Moh's surgery said that I did not have cancer any more just the infection, so she will not operate. I let the infectious disease Dr. know this so I am still waiting to hear back from her. She wants me on 3 antibiotics that are really, really bad. Amikcin, Chloriythmycin and I forgot the other one. The side effects are horrible, horrible. Can cause Kidney trouble, diarreah, extreme ringing in the ear or loss of hearing, heart trouble, possible death and the list goes on and on. Even if the sympthons do not bother you while you are on the medication it can later. Maybe you can give me some advice. Sorry for the misplelled words. Shelvy Manning, Hampton, Va.
Submitted: 2 months ago.
Category: Dermatology
Expert:  GauravMD replied 2 months ago.

Hi,

I am sorry to hear about your multiple medical problems that have required multiple surgeries without relief.

Here is what I understand about Skin and soft tissue infection (SSTI) with M. Abscessus.

1. It is rare, hence definite treatment protocols are not established

2. Antibiotic sensitivity tests are helpful in deciding treatment

3. General treatment involves clearing the local area of all pus and then using the antibiotics

The treatment of serious M. abscessus complex disease usually involves initial combination antimicrobial therapy with a macrolide (clarithromycin 1,000 mg daily or 500 mg twice daily, or azithromycin 250 mg–500 mg daily) plus intravenous agents for at least 2 weeks to several months followed by oral macrolide–based therapy (2). The drugs of choice for initial intravenous administration are amikacin (25 mg/kg 3×/wk) plus cefoxitin (up to 12 g/d given in divided doses) or amikacin (25 mg/kg 3×/wk) plus imipenem (500 mg 2–4×/wk)

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4550155/

In your case, I believe that these antibiotics should help.

The side-effects that you have read are rare, and we have used Amikacin and clarithromycin even in kids with minimal problems.

Early treatment is the best way to get a cure, so do not delay the treatment, as far as possible,

Also try to improve your immunity with better diet, avoidance of processed foods, and natural supplements with zinc to boost your immunity,

Warm regards

Dr. Gupta, MD