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Do you have the FINAL culture result from the second specimen from 10/6 ?
( The first came out final as a diphtheroid, the second is only the interim result showing gram positive cocci in chains- this is not a diphtheroid and is a different organism).
Do you know if your aortic endocarditis is thought to be from the viridans strep?
Also, as an infectious diseases physician, I would not be content with a culture result just stating "viridans strep"- that is actually not an identification of a bacteria- it is just a description of a whole group of bacteria-
Did they actually give a final identification ( genus and species) to the bacteria you had in Oct - assuming the second culture was the same- and the third on Dec 19 ? -
By this I mean- Strep mitis, or mutans, etc etc etc...
I think I understand what you are asking. The 1st you see is actually the older of the two cultures. As you look at them:
1. Wed, 10/06/2010 08:27 - Collection Time: 6 Oct 10 0827 -
Final ID: Quantity: Organism: diphtheroids
2. Wed, 10/06/2010 09:38 - Collection Time: 6 Oct 10 0938 - Wow...no Final ID, I have my actual records....but they did notify an LPN of the gram positive cocci in pairs and chains at 28 hours old.
Is that where the booboo occurred. Someone should have requested Final ID? I promise it is no where on the page?
OK- First thing.
Unless you have other cultures that you did not include, the nurse may have just misspoken in saying you had a "Staph" infections. ( This is a very common bacteria, and she may have just assumed it - doesn't mean she is right).
Second- that second culture- I would need to clarify with the microbiology lab.
Yes, I would insist on a final culture result which you have not included here.
The lab may have meant to include a note that it was the same as the first one- ie a diphtheroid. I can almost guarantee you that the lab did identify it- just your report , as you wrote here is incomplete. That doesn't mean that is a problem- just incomplete.
Now- as far as endocarditis- if you have a normal native valve, then the strep would be a more common cause of endocarditis than the diphtheroid- that diphtheroid may in fact be unrelated- it could have been from a central line, or even your appendix, and does not necessarily have anything to do with your subsequent strep infection. I just cannot be entirely sure without knowing for sure what that second culture was. ( If that second culture in fact was a strep as well... then I would be more suspicious).
Always ask if you need clarification/more information.
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Again, in a top level lab, especially when endocarditis is considered and it is not thought to be a contaminant, "strep viridans" is an incomplete identification.
this is not a bacterial identification, it is a description of the appearance of the bacteria.
The bacteria would need more specific identification in Dec ( and as well in Oct if that second culture was the same)- to be able to know more clearly if this was the same infection from Oct.
Thank you...Would the fact that they had me on Zosyn during the 3 days, and then Cipro and I think Cephalexin(sorry for spelling) when I got out tell you anything?
I had a hive reaction on my back and chest within 2 days of getting out....they thought it was from the Cipro so they had me stop it. Turns out it was the Zosyn I was allergic to.
But based on the Anti-Biotics and the Power Level....does that tell you anything?
Those antibiotics I assume were for your appendicitis.
It doesn't tell me much about your problem now.
I would add, however, that I always do follow up blood cultures in those who are positive- so if you had positive cultures in Oct, I would repeat them again- after you were off antibiotics, to assure clearance ( and not 2 months later in Dec.).
Bingo....you are awesome. I do feel better.....my gut was telling me, please...why didn't they just follow up just to make sure after the positive blood cultures on the appendix and knowing I had pain in my middle and upper left chest area. They would have caught the Endocarditis and killed it before it killed my Aortic Valve.
It is always hard to know the sequence and results.
As I noted there are some missing pieces of information not included, so I cannot say for sure about the relationship to the Oct cultures and if it had anything to do with Dec., or if your endocarditis could have been prevented.
I did not say that, and could not be sure of that, without the missing information provided.
Good luck with your surgery.