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My 5 year old grand daughter has pseudomonas in the sinuses.

She was treated for sinus...
My 5 year old grand daughter has pseudomonas in the sinuses. She was treated for sinus infection from late August. To November with antibiotics and steroids before culture revealed bacteria. Treated with 1week broad spectrum IV melds then 3 weeks orally and 4 weeks of oral levoquin. 8 days after stopping levoquin complete blockage of sinuses. Ct scan shows thickening in all sinuses. Back on levoquin almost 2 weeks. What else can be done? Her little body created blood clots which caused vision loss which landed her in hospital. What can be done to prevent body from developing clots again and eradicating the bacteria forever?
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Answered in 32 minutes by:
12/28/2016
Dr.Saleem
Dr.Saleem, Doctor
Category: Medical
Satisfied Customers: 3,290
Experience: MBBS
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Hello , Dr Saleem here .Welcome to JA.I am revewing your query, will be right back.

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Is there anything else that bothers your kid, like breathing issues or Asthma? Any allergies? Has she been worked up for immunity or Ig levels?Any investigations other then CT done ?

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Customer reply replied 1 year ago
Mari and lumbar puncture. No asthma or allergies. Going to go to immunology dr next. What are lg levels
Customer reply replied 1 year ago
Mri
Customer reply replied 1 year ago
Initially had abscess near bone of right eye. That is now gone.
Customer reply replied 1 year ago
Mri showed no bleed, LP negative

Ig levels are done for checking body's immunity. These are antibodies which if found deficient can precipitate recurring or resistant infections in a person. Thats why you are going to immunology i guess

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Customer reply replied 1 year ago
All bloods were unremarkable in hospital. 8 day stay in hosp
Customer reply replied 1 year ago
Checking for autoimmune issue

So an abscess first and then sinusitis that has been quite resistant till now might point towards an issue with immunity.

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Customer reply replied 1 year ago
Sinusitis first, then abscess
Customer reply replied 1 year ago
Sinusitis, ear infection, then abscess

These are specific tests for immunoglobulins that are not routinely done , i guess your blood work up might be having that till now.

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Customer reply replied 1 year ago
Infectious disease felt 3 rounds of antibiotics plus steroids reduced immun

Another important thing is any abnormality with the air passages starting from nose. Any block to outlet of sinuses can result in recurrent infection. Has she been evaluated by ENT people for that

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Customer reply replied 1 year ago
ENT says adenoids are huge when not infected, they were moving toward surgery when she ended up in hospital
Customer reply replied 1 year ago
She's been to ENT biweekly since august
Customer reply replied 1 year ago
Deviated septum seen on scans
Customer reply replied 1 year ago
Fluid in ears long time

Yeah its quite right if adenoids are the underlying cause causing obstruction and recurrent infection then surgery is surely recommended to remove the basic thing precipitating sinusitis.

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Customer reply replied 1 year ago
The day she was released from hospital the culture showed pseudomonas
Customer reply replied 1 year ago
what do they do for the bacteria since drug resistant

So you have told about two of the main causes

1. Deviated septum

2.adenoids

M pretty sure if these two get fixed it will increase the likelihood of her getting rid of this recurrent/resistant infection.

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Customer reply replied 1 year ago
What about sinus surgery?

They can do culture with drug sensitivty for checking out which antibiotic is the germ sensitive against so that helps in the choice of appropriate medicaton.

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Customer reply replied 1 year ago
That's how they chose levoquin.
Customer reply replied 1 year ago
Anything can be done to build immunity while on antibiotics? She takes probiotics daily

To cure any condition we need to treat its cause , i am afraid the cause is still there in shape of deviated septum and adenoids.

Low immunity either naturally or due to long term steroids use may also be one of the factors.

In order to see how effective surgery might be i recommend absolute eosinophil count before that. A persistantly raised count despite medical treatment is predictive of less favourable response to surgery .

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Customer reply replied 1 year ago
What is absolute eosinophil count?

Its a blood test to count eosinophils and is a very useful index in allergies, active infections etc. It can also tell or predict how useful more aggressive measures like surgery would be in sinusitis already treated with medications.

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Customer reply replied 1 year ago
Anything to raise immunity while on levoquin?

Well its all about diet for now . Make your kid eat well, a wholesome diet containing appropriate balanced amounts of carbs, proteins, fats, fibre, vitamins and minerals. Nothing drastic can be brought about but eating well is the way go .

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Customer reply replied 1 year ago
Thank you. She goes to the infectious disease doctor tomorrow. Now I have several more questions to ask

You are welcome . I hope it was helpful. Please do ACCEPT with a 5 star rating.

Wishing your kid a healthy life and quick recovery.

Dr.Saleem
Dr.Saleem, Doctor
Category: Medical
Satisfied Customers: 3,290
Experience: MBBS
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Customer reply replied 1 year ago
Thank you
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