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Medical Forum / Diseases and Disorders / Sinusitis / March 2007

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first bacterial sinus infection - a couple of questions

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Jen - 30 Mar 2007 18:43 GMT
I developed an acute bacterial sinus infection (frontal and behind
eyes) following a cold...waited 13 days (to make sure it wasn't viral)
to get first antibiotic. 10-day course of Augmentin helped a bit but
symptoms came back, worse.  Then prescribed cefpodoxime - had no
effect and symptoms worsened significantly.  Finally Levaquin, which
worked dramatically.  A few questions:

I'm curious whether others have had this reaction to Levaquin (which I
took as a good sign that the antibiotic was working) - 6 1/2 hours
after taking the first dose I got the worst pain of my life -
incapacitating pain (could not speak) felt as if my sinuses were being
dissolved. I could also feel the pain in what felt like my optic nerve
(where it had hurt to move my eyes) and strong putrid taste and smell.
This lasted for 2 1/2 hours and the next day the pressure was nearly
gone. I could still taste the putrid taste and smell sporadically that
next day. I've read that Levaquin concentrates greatly in the sinuses,
which helps it work better - could that be it? Also what nerves were
being stimulated? My doctor had not heard of this reaction before.

Fever did not go away until the 10th day of Levaquin (two days ago).
In days preceding it varied 99 to 101.  Right before temp increased
each time I would get pain either in frontal sinus or in the middle of
my back, then waves of heat and it would go up 1.5 or 2 degrees in a
couple of minutes - it felt as if the infection was strengthening or
trying to strengthen.  Anyone know whether this could mean the 10 days
of Levaquin would not be enough?  Also what would cause the pain in my
back?  Do I need to be concerned that the infection is strengthening
overall?  CT scan was negative for chronic infection - no
abnormalities - taken 48 hours after beginning Levaquin (it felt as if
most of the infection was gone at this point).

Today (two days after last Levaquin dose) I experienced dizziness
while sitting.  First instance of that.  Causes? Concerns?  Not
Levaquin as I didn't get it early in the course?  Also had a couple of
instances of sharp pain over my eye, which went away quickly.

Finally, if in fact the Levaquin didn't kill all of the bacteria, how
concerned do I need to be about the speed with which the infection
comes back?  I'm fine with waiting to see what happens but am
concerned that if it's gotten stronger I could develop complications
suddenly?  Unlikely I hope once I've had 10 days of such a strong
antibiotic?

Thanks in advance.
Steven L. - 30 Mar 2007 20:48 GMT
> I developed an acute bacterial sinus infection (frontal and behind
> eyes) following a cold...waited 13 days (to make sure it wasn't viral)
[quoted text clipped - 38 lines]
> suddenly?  Unlikely I hope once I've had 10 days of such a strong
> antibiotic?

Sinus infections are stubborn.  Often 10 days worth is nowhere near
enough to kill all the bugs.

The fact that your fever continued till the FINAL day of Levaquin
suggests that the bugs are resistant and there are still plenty of bugs
left in your sinuses.  (Long after the fever breaks, there are still
bacteria remaining.)

I think you need to explain all this to your doctor.  The one thing you
don't want is a rapid relapse.

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Steven D. Litvintchouk
Email:  sdlitvin@earthlinkNOSPAM.net
Remove the NOSPAM before replying to me.

Murray Grossan - 31 Mar 2007 04:44 GMT
On 3/30/07 10:43 AM, in article
1175276617.336218.285860@y66g2000hsf.googlegroups.com, "Jen"
<lynn_scott@earthlink.net> wrote:

> I developed an acute bacterial sinus infection (frontal and behind
> eyes) following a cold...waited 13 days (to make sure it wasn't viral)
[quoted text clipped - 40 lines]
>
> Thanks in advance.

This does not sound like a sinus infection at all. I would suggest a
thorough evaluation to try to get a diagnosis.
truehawk - 31 Mar 2007 06:49 GMT
> On 3/30/07 10:43 AM, in article
> 1175276617.336218.285...@y66g2000hsf.googlegroups.com, "Jen"
[quoted text clipped - 47 lines]
> This does not sound like a sinus infection at all. I would suggest a
> thorough evaluation to try to get a diagnosis.

Jen:

Take a look at the side effects of Levaquin.

http://www.medicalnewstoday.com/youropinions.php?opinionid=6421
It is nice to be able to distinguish the symptoms of the disease from
the side effects of the drug..

Zithromax or Clindamycian, and Sporanox and Bactrium and Serrapeptse,
Artemisinin, and Vitamin C plus a nitrite
to break up the extracellular polysacride and amyloid bonds in same,
for a minimum of three weeks
are currently the best that is widely available and will often get the
job done.
My experience is that ENTs would rather preform surgery and will not
prescribe a combo of drugs including an antifungal.
My best luck was with military doctors who had to get me well enough
to fly, an Internist, and most recently a GP that actually is familiar
with the work on biofilms.
Murray Grossan - 31 Mar 2007 16:18 GMT
On 3/30/07 10:49 PM, in article
1175320164.028213.257290@n59g2000hsh.googlegroups.com, "truehawk"

>> On 3/30/07 10:43 AM, in article
>> 1175276617.336218.285...@y66g2000hsf.googlegroups.com, "Jen"
[quoted text clipped - 67 lines]
> to fly, an Internist, and most recently a GP that actually is familiar
> with the work on biofilms.

The symptoms described here are not typical of sinusitis or Levaquin
reaction. It is important to get a correct diagnosis.
Jen - 31 Mar 2007 16:52 GMT
> On 3/30/07 10:49 PM, in article
> 1175320164.028213.257...@n59g2000hsh.googlegroups.com, "truehawk"
[quoted text clipped - 76 lines]
>
> - Show quoted text -

Many thanks.

The initial symptoms for which I got the antibiotics were severe
frontal and behind-the-eyes sinus pressure and pain (increased over
time), thick yellow discharge, growing fatigue. I don't have
allergies; this followed a severe cold (I improved from cold and then
got worse and got the antibiotics 13 days in).

It was my body's first exposure to Levaquin (I've rarely taken
antibiotics) and it felt like it was working against a severe
infection (anaerobic bacteria, I'm told, produce putrid smell) in
those hours after first taking it and a bit the next day.

Which symptoms I describe don't you think are sinus-related?

Could pain above eye be the infection trying to penetrate bone?
Likewise the fever could be the infection trying again?  Particularly
concerned if the infection is trying to spread...I'm aware of sepsis
and meningitis (which this obviously isn't..none of those clear-cut
and severe symptoms) but curious is there a beyond-the-sinuses spread
that's possible that *isn't* sepsis or meningitis?  Wouldn't a bone
scan be negative if a CT scan was negative, i.e. if it doesn't even
show inflammation, infection couldn't have gotten to bone?  It just
felt like a really virulent bug.

My doctor was not at all concerned about fever as she considers the
real fever to be closer to 102. I agree that 102 is a bad sign (maybe
sepsis or other complication) but don't understand why lower fever is
not also a (less immediate) concern.
 
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