specuialist needed for potential staphylococcus aureus infection

[THAILIBAN]

Hi all, Hi Sheryl,

 

can anybody recommend a Doctor for infectious diseases who may have a good understanding of potential staphylococcus aureus infections and all that comes with it?

I had a not so great consultation at a rather popular hospital a few days ago and really need to see someone who is familiar with the topic and can suggest proper investigation / examination to find out what's going on.

Location should be either Bangkok or Pattaya, as both are within easy reach for me.

Thanks a lot

[bkkrox]

Dr Krirk Asavametha at BNH hospital specializes in Infectious Disease. Have heard only good things about him. (Believe he also does some hours at Samitivej)

 

 

[Sheryl]

+1 to the above and yes, he is at Samitivej  https://www.samitivejhospitals.com/en/doctors/krirk-asavametha/

 

US trained and board certified

 

There is BTW nothing at all uncommon or unusual about a staph infection, it is one of the most common infectious agents since it is normally present on the skin. Though some hospital-acquired strains are resistant to many antibiotics.

[siam2007]

On 11/04/2017 at 10:38 PM, Sheryl said:

+1 to the above and yes, he is at Samitivej  https://www.samitivejhospitals.com/en/doctors/krirk-asavametha/

 

US trained and board certified

 

There is BTW nothing at all uncommon or unusual about a staph infection, it is one of the most common infectious agents since it is normally present on the skin. Though some hospital-acquired strains are resistant to many antibiotics.

 

 

 I have a similar problem and am not happy with the Docs I have met so far. They all follow their own agenda and are not interested in my specific symptoms at all, even though I documented  everything that happened to me in details, day by day. Maybe they are just annoyed by that, who knows. It is all about selling expensive (blood) tests it seems, week by week.

Can Dr . Krirk be considered an "investigative" Doc, and someone who is able and willing to two-way-communication ? Because this is exactly what I need, and most probably quickly. Thanks

Edited April 28, 2017 by siam2007

[Sheryl]

I have not met him myself but in my experience docs who trained and worked in Western countries are accustomed to two-way communication and the expectations for same by Western patients. Especially the younger ones/ones whose time in the West was more recent.

 

Without knowing anything about your history or symptoms, I would caution that in my experience people with your sort of complaint have often self-diagnosed (completely or in part) and the problem is often that their self-diagnosis, or the group of symptoms they are regarding as all part of a single disease process, do not in fact make medical sense and it is not so much the doctors not listening/having their own agendas as it is their medical training making it impossible for them to agree with the patient's self-diagnosis. Sometimes too this self-diagnosis has also led the patient to consult entirely the wrong type of specialist, and specialists do all tend to have tunnel vision. Not saying this is the case with you but it could be. Staph infections are quite easy to diagnose and it may be that you have a collection of symptoms unrelated to staph (and maybe do not have a current staph infection at all). Also, when people start documenting everything they consider to be a symptom the list almost invariable includes many  things unrelated to each other - some not related to any disease process, some perhaps related to various different, unrelated health issues, but the tendency is always to think it all somehow fits into a single puzzle with a single answer (ala "D. House").  The result of then presenting a doctor with a long detailed list of unrelated things, some of them of no clinical importance at all and others obviously not related to the doctor's area of specialty, is to alienate the doctor rather than help him arrive at a diagnosis.

 

Please be open to these possiblilities. A western-trained doctor will likely be better about explaining things to you, but is no more likely than anyone else to agree with a self-diagnosis that does not make medical sense. (And it is NOT possible to determine what your symptoms might mean from a google search. There is a reason doctors train for 4-8 years rather than just being taught how to use a search engine).

[siam2007]

2 hours ago, Sheryl said:

I have not met him myself but in my experience docs who trained and worked in Western countries are accustomed to two-way communication and the expectations for same by Western patients. Especially the younger ones/ones whose time in the West was more recent.

 

Without knowing anything about your history or symptoms, I would caution that in my experience people with your sort of complaint have often self-diagnosed (completely or in part) and the problem is often that their self-diagnosis, or the group of symptoms they are regarding as all part of a single disease process, do not in fact make medical sense and it is not so much the doctors not listening/having their own agendas as it is their medical training making it impossible for them to agree with the patient's self-diagnosis. Sometimes too this self-diagnosis has also led the patient to consult entirely the wrong type of specialist, and specialists do all tend to have tunnel vision. Not saying this is the case with you but it could be. Staph infections are quite easy to diagnose and it may be that you have a collection of symptoms unrelated to staph (and maybe do not have a current staph infection at all). Also, when people start documenting everything they consider to be a symptom the list almost invariable includes many  things unrelated to each other - some not related to any disease process, some perhaps related to various different, unrelated health issues, but the tendency is always to think it all somehow fits into a single puzzle with a single answer (ala "D. House").  The result of then presenting a doctor with a long detailed list of unrelated things, some of them of no clinical importance at all and others obviously not related to the doctor's area of specialty, is to alienate the doctor rather than help him arrive at a diagnosis.

 

Please be open to these possiblilities. A western-trained doctor will likely be better about explaining things to you, but is no more likely than anyone else to agree with a self-diagnosis that does not make medical sense. (And it is NOT possible to determine what your symptoms might mean from a google search. There is a reason doctors train for 4-8 years rather than just being taught how to use a search engine).

 

 

Hi Sheryl,

 

thanks for your reply and I am very well aware of the things you mentioned and that I have to be cautious not to be agitated. Facts are that my blood clearly showed an infection weeks ago, I got antibiotics and it got slightly better, without any doctor able to tell me what it actually is. Now a few days ago, my blood test suddenly was very bad again, for the first time I had too low Neutrophils, Lymphocytes, Eosinophils, and too high "atypical Lymphocytes".

So this is what worries me, it actually got better first (the suspected Staph or whatever infection, cause by some sort of abscess on my head), and then something new (???) developed, maybe caused or helped by a weak immune system. I was on a trip outside TH during Songkhran and had seen two great and investigative Docs in KL, but I could not continue to stay there. That time, the blood was getting better. Now my main symptom is absolute extreme sweating, which started a week ago or so always when sitting on my desk. Then it continued to sudden night sweating, and when I am out in public as well. It comes and goes virtually from one second to the other. I always have to carry extra shorts with me when in public, and it is getting very dangerous if you sweat like hell and then come from a hot environment into an AC cooled environment (public places or BTS, MRT, Shopping mall). And then after 1 or 2 hours, it stops from one second to the other, in a way that there is not a single drop of sweat on my body out of a sudden, not even under my armpit. I have then completely "dried out". Of course, when I am at the Doctor's examination room, I am always 100% okay, no fever, heartbeat normal, so the Doctor thinks I am crazy. This is exaxtly what happened yesterday. Two hours after I was out of the Doctor's room, that sweat shock set in again. And extreme sweating actually indicates that the body is trying to fight something but maybe is not strong enough. At night I am waking up because of some sort of "hot flash" going through my body suddenly, starting at the head, spreading to other parts of the body. Like the feeling of kontrast during a MRI scan. In KL I had a brain scan were nothing was found, no infection or anything, no abscess, but that was now 10 days go already, and the sweating thing started only after this. Yep that why I am worried - some viruses are slow, but some could be potentially dangerous and need quick response, not waiting weeks for yet next another result or test. Elton John experienced such thing only  a few days ago http://www.bbc.com/news/entertainment-arts-39700952 .

Not sure what was actually found in his case, but there is no doubt sometimes a quick response is absolutely needed. And I am left in the dark and being told I am more or less alright or even a hypochondriac.

Edited April 29, 2017 by siam2007

[Sheryl]

It is very, very  unlikely that this sweating has anything to do with an infection let alone what sounds like a prior one that has already resolved. In which case seeing an infection specialist will be a waste of time.

 

Extreme sweating does not in fact indicate that the body is trying to "fight something and is too weak", and is not an indication of infection unless it is associated with a measurable fever (in which case the sweating occurs as the fever comes down, either on its own or after taking aspirin or paraceremol).

 

Extreme sweating usually just means your body is trying to col off because it is exposed to heat (and it has been extremely hot lately, unusually so for Thailand). It can also occur as a result of vasomotor instability which in turn can have a number of causes, many (but not all) of them endocrine in nature.

 

Do I understand correctly that at the time your blood "showed an infection" you had an elevated white blood count (?how much) and a visible/palpable abscess on your head? And that the abscess is now gone? And that you do not have a fever?

 

Because if so you are definitely barking up the wrong tree in talking about a staph infection (which you may not have had but even if you did, you do not now) and may be on the wrong track in seeking an infectious disease specialist, though on tat point I need more info as below

 

When you say that "my blood test suddenly was very bad again, for the first time I had too low Neutrophils, Lymphocytes, Eosinophils, and too high "atypical Lymphocytes", I need more details, can you provide the exact numbers or a picture of the result?  Be aware that the white blood count differnetial (% neutrophils, lymphocytse etc) is of no meaning if the total WBC count is not elevated. Because the results are machine generated they will go ahead and show these percentages regardless and also give a reference range, but it has no meaning if the total WBC count was normal. Many people misunderstand this and think that they have low or high neutrophils, eosinophils etc because they are comparing the % against the reference numbers when they should not because the WBC count is normal.

 

However, if you have a large number of atypical lymphocystes that could be imoritant. So I ened to see the full results.

 

It would also help to see the prior blood test report from when you were told you had an infection and there was an abscess.

 

Are you male or female? Age? On any medications?

 

 

 

 

[Sheryl]

P.S. Please also indicate what the other blood tests that have been done were and the results, positive or negative. This will help rule some things out.

 

And indicate what the problem was that led you to have the initial blood test to begin with (the one that, together with an abcess on your head, led first doctor to suspect a staph infection).

[siam2007]

13 hours ago, Sheryl said:

P.S. Please also indicate what the other blood tests that have been done were and the results, positive or negative. This will help rule some things out.

 

And indicate what the problem was that led you to have the initial blood test to begin with (the one that, together with an abcess on your head, led first doctor to suspect a staph infection).

 

 

Sheryl, thank you a thousand times for making such an effort. As this is a complicated and private matter, which is most likely not interesting to most of the members, I am sending you a PM