H Influenza not serotype b

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i. I was admitted to hospital a month ago cause of a abnormal chest exray. I was there for a week. My sputum test shows h influenza non serotype b. I noticed think yesterday after I went to the lab and asked for all my blood works that was done. Apparently according to the comment on the results it says it is now being cultured and should be back in 5 weeks. I am extremely worried as I have severe chest pains with chronic fatigue and I have reactive lymphocytes and nodules in my lungs and my specialist physician has not discussed this with me. I had to google it. It's been a month now, ,should I not be on some sort of treatment?

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  • Posted

    Hiya

    I confess I am a bit surprised that you've not been given any antibiotics if you've cultured H Inf (i know the bug well, one of my frequent fliers...) But then you say you were in hospital. Did you get IV antibiotics then? What were you given? When was the sputum culture taken? They may feel that it has been taken care of already.

    I suspect however that the doctors are not particularly concerned about the H Inf. I am pretty sure that they are concentrating on your cultures and that these are being done are for a different bacterium, a mycobacterium. The 5 weeks is a give away. I too have had that done, and grew Mycobacterium Avian Complex or MAC - effectively "chicken TB". It's everywhere in the environment but people with lung or immune systems can get properly infected. My chicken TB is just roosting in my lungs without doing too much. This may of course change...

    However, if they saw nodules they probably suspect that you have an active mycobacterium infection. There are many different types of this bug with the obvious one being classic TB. I wonder, did you get the BCG vaccination when you were young? Do you live in an area with TB?

    In any case, the good news is that mycobacteria are treatable. The bad news is that the treatment for any of them is basically the same as TB and is a very very long treatment schedule of multiple pills. 

    The reason you are not on a treatment is that TB and its brethren simply take a long time to grow. I suspect the reason you've not been treated yet is that because the treatment is so long and difficult they need to be absolutely certain and there is simply no way of hurrying up the culture.

    For the moment, look after yourself as best as you can. I hope you get answers soon. Keep in touch and let us know if there's anything else we can do.

    Sam

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  • Posted

    Hi.  It was done in hospital but I was never given any iv drip.  I am really struggling with breathing and chest pain and I suppose I am just worried.  My CRP levels is 22.8 and normal is between 0.0 and 0.5.  My lymph node biopsy results show reactive lymphocytes.  I am so fatique.  I fall asleep at work after being here only two hours.  I am really concerned and it's like I am not getting any answers from my physician.  I also have cysts in almost every organ exept my heart and kidneys.
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    • Posted

      Well it's perfectly reasonable to be worried. Especially when you feel so rubbish. I am so sorry about that.

      I don't know why they haven't kept you informed - however I would also say that they never told me about why they were testing me either. All I can think is that they don't want to freak people out about the  possibility of TB. Never seems to occur to them that not telling us freaks us out as well.

      Anyway, more to the point, do you have any rescue antibiotics? At the very least I would suggest you go to your normal GP, hand in a sample and immediately go on your rescue antibiotics while you wait for the sputum sample to be analysed (3 days).

      H Inf is very often resistant to plain penicillin. It tends to respond well to amoxiclav (ie penicillin plus an extra ingredient that gets around the typical resistance patterns). plus other antibiotics like moxifloxicin and doxycyclin. So if your rescue antibiotics are just penicillin, get an appointment with your GP quickly.

      I hope you feel better soon

      S

      Mycobacteria are very slow growing (hence the long analysis time) and are a long, slow infection in the body as well. There is nothing to be lost in sorting out the H Inf right now

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    • Posted

      Thanks Sam.  I have been to my GP and she together with the specialist physician does not want to give me any medication right now cause I seem to be acting bad towards meds.  I am alergic to penicilin and on my results it shows the R next to anxicillin (or something) which I think means penicilin.  I am starting to think that maybe the TB can be in my bones as I do not cough and I do have lesions on my lungs but my worst symptom yet is pain in the legs, knees, hips and spine (what do you think?).  I am having a bad couple of days with terrible pain in my chest and just feeling very sick (like flu like).  Don't have much energy (nothing actually) and just want to fall asleep.  I have a demanding job (Labour Law) and whatever this is, is starting to effect my job now.  It's been 5 weeks now since the culture started, I think (hope), so hopefully I should have some answers soon.  Yes, I agree, the not knowing makes it worst that maybe them telling me "we are suspecting this or that", at least then you know it's going somewhere and not scare yourself to death everytime you get a flare of feeling like "rubbish".  I also seem to have trouble breathing deeply, almost at times feels like I am struggling to breath.  I am so scared to go back to my GP as I get the feeling that I am starting to bother them which I don't want to do.  It really help being able to talk to someone who has some type of idea what I am going through as my family is trying to be supportive but because they don't really know the extent of my pain and fatique they cannot really relate.  Thanks Sam [smile]
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  • Posted

    Blast - my reply has fallen foul of the moderating goblins... In brief - go to quacks, give sample, start rescue antibis immediately to sort yourself out.

    Hopefully moderators will pass the longer reply soon.

    Look after yourself!

    S

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  • Posted

    Thanks Sam.  I have been to my GP and she together with the specialist physician does not want to give me any medication right now cause I seem to be acting bad towards meds.  I am alergic to penicilin and on my results it shows the R next to anxicillin (or something) which I think means penicilin.  I am starting to think that maybe the TB can be in my bones as I do not cough and I do have lesions on my lungs but my worst symptom yet is pain in the legs, knees, hips and spine (what do you think?).  I am having a bad couple of days with terrible pain in my chest and just feeling very sick (like flu like).  Don't have much energy (nothing actually) and just want to fall asleep.  I have a demanding job (Labour Law) and whatever this is, is starting to effect my job now.  It's been 5 weeks now since the culture started, I think (hope), so hopefully I should have some answers soon.  Yes, I agree, the not knowing makes it worst that maybe them telling me "we are suspecting this or that", at least then you know it's going somewhere and not scare yourself to death everytime you get a flare of feeling like "rubbish".  I also seem to have trouble breathing deeply, almost at times feels like I am struggling to breath.  I am so scared to go back to my GP as I get the feeling that I am starting to bother them which I don't want to do.  It really help being able to talk to someone who has some type of idea what I am going through as my family is trying to be supportive but because they don't really know the extent of my pain and fatique they cannot really relate.  Thanks Samsmile
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    • Posted

      I wish I could help more and I'm so sorry you're having such a tough time of it.

      An allergy to penicillin definitely doesn't help - you're right amoxicillin is penicillin- but I can't help but feel you should be getting treatment. The BTS (British Thoracic Society) guidelines are very clear about early and aggressive reassessment of infections. NICE says exactly the same thing.

      If you Google British Thoracic Society bronchiectasis then the first result will be a pdf with their guidelines. Unless they've a really good reason to wait (like a drug conflicting with the potential TB treatment) you should be getting treated for the H Inf infection.

      To Be honest, I think you should hassle her. Doxycycline has generally good efficacy against that bug and is generally well tolerated and is safe to use with a penicillin allergic patient. It's also pretty cheap.

      Good luck!

      S

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    • Posted

      Sorry that should be "reassessment of infection" not reassessment of infections.

      Obviously...

      S

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    • Posted

      I hear you, but the same treatment principles should apply. I know the Americans have the same protocol. As for that matter do the Japanese. The BTS / NICE guidelines are best practice as provided by experiment and practice.

      Bronchiectasis is worsened by the classic inflammatory cycle - infection leads to inflammation leads to physical damage leads to excess inflammation and mucus production leads to infection. If they don't get this I'm afraid you have to educate them. 

      The problem we on this forum (and all the other patients with bronchiectasis)  face is that we have a relatively unknown disease and worse it is a disease that can be managed well with best practice.

      The rule is - infection -> give sample -> take rescue antibiotics -> sample comes back -> adjust antibiotics if needed -> wait till the next time.

      Basically I wait about 3-5 days once I start seeing  a few  of these symptoms: drop in peak flow, fatigue, malaise (ie that feeling of being ill), bad taste in mouth, excess production of sputum, change in sputum color. I know how it feels now so if I see change in color, increased production, pain in chest then 9 times out of 10 they will grow a bug from my sample. 

      It's also worth noting that sputum samples are only about 80% specific - ie they grow nothing incorrectly 20% of the time.

      If your doctor doesn't "get" bronchiectasis, you have to tell her. It's a comparatively rare disease, so that is not uncommon. And if they don't know about it they can be loathe to prescribe antibiotics. After all, us lot do go through a lot of them! However, I've not yet met a doctor who won't listen (eventually!).

      Show her the BTS  guidelines. Point out the H Inf infection. Point out that this is doing more damage to your lungs, leaving you at greater risk of future infections. That is why the BTS guidelines call for aggressive early treatment. It works!

      You need to get all "informed patient" on her ar$e.

      I'm sorry, I know it's hard, especially when all you want to do is crawl into bed and hope everyone leaves you alone. But the only person in charge of your health now is you.

      Good luck my dear, and whatever else we can do from here, just let us know

      S

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