Dr. Naresh Kumar M.
Internal Medicine
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I have MRSA and severe spinal stenosis. I was in hospital 8 months ago. Since leaving the hospital I have had rashes, burning, itchy and twitching in my face and neck areas. About 5 months after hospital visit I had severe burning feeling in muscles and major muscle atrophy and increasing muscle spasms. A MRI was done on my spine and 3 areas with severe spinal stenosis was found. I first thought it was autoimmune but bloodwork was negative. I then insisted to see an infectious disease doctor who just found MRSA in my nose.
Is it possible the MRSA is in my spine causing this stenosis. I am 46 years old and very active and I have never had muscle or back pain and now all of a sudden neurologist is saying I have radiculopathy and MRI showing severe spinal stenosis in multiple places with significant symptoms. So after being active for 46 years I now have these back problems during an 8-month period where I have no activity?
Hello,
Welcome to icliniq.com.
MRSA occurs asymptomatically as a carrier in many people. MRSA is not related to your spinal stenosis problem. Kindly tell the exact MRI report as if there are no hyper intensities in spinal cord we will not suspect autoimmune etiology also. Spinal stenosis is commonly caused by intervertebral disc prolapse which causes narrowing of spinal canal and produce symptoms like radiculopathy pain, neurogenic claudication and if severe can cause muscle atrophy. The occurrence of symptoms are not related to your hospitalization and minor symptoms might have been ignored previously.
If spinal stenosis is severe, it requires surgery. Kindly consult neurosurgeon or spine surgeon for further management. Iif you are on in my no suppression therapy like steroids or if you are going for surgery then medication for MRSA carrier state may be required, discuss with your doctor regarding this and take antibiotics appropriately.
Patient's Query
Thank you doctor,
Sounds like good advice. I did not see hyperintensities mentioned in any of my reports. Just a lot of osteoarthritis. and narrowing. One doctor says that taking antibiotic while MRSA is in a dormant state is a waste of time. Another doctor says if I have had minor outbreaks it may be worth it to take Baktrim for 10 days. I have had a lot of gastritis so I am on the fence about it. I am worried that the MRSA has been all over my face causing rashes and minor pimples but nothing severe luckily. I am not sure if I should take the antiobiotics now as a precaution or wait until I have a more severe manifestation.
Hello,
Welcome back to icliniq.com.
It is better to take prescribed antibiotics now itself. You need not wait for severe manifestations. Why I told to take anitbiotics now was if at all you go for surgery, as you have MRSA in body, then infection at surgical site with MRSA will be very difficult to eradicate. So it is better to go for antibiotics now.
Patient's Query
Thank you doctor,
MRI spine results: It sounds serious to me.
Reversal of Lordosis at C6-C7 and C5-C6, heterogenous marrow signal to the visualized osseous structures, osteophyte complex with irregular disc protrusion, significant mass effect on thecal sac with significant spinal stenosis, marked narrowing of both nueral foramina C4-C5 same but moderate stenosis, C2-C4 just both narrowing nueral foramina. I had almost no symptoms and then all this with a lot of muscle cramps and neck pain and mucinosis and MRSA found on lip nose region.
Hello,
Welcome back to icliniq.com.
I had gone through the report you have posted. The problem appears severe. There is significant mass effect on thecal sac which compresses the nerves and causes symptoms. Disc protrusion is a mechanical phenomenon and I do not have any doubt to suspect autoimmune etiology in this. You need to consult a neurosurgeon or spine surgeon as it needs surgery. Surgery should not be delayed as the recovery may get compromised if you get operated late.
Patient's Query
Thank you doctor,
I did not understand what you said about autoimmune. Did you mean it is a result of autoimmune or it is not a result of autoimmune and can you please explain why? I am seeing a spine doctor tomorrow.
Hello,
Welcome back to icliniq.com.
I mean to say your spinal stenosis is not caused by any autoimmune pathology. Autoimmune pathologies will not distort anatomy and cause stenosis. Because of autoimmunity there may be inflammation and surrounding edema that would be seen as hyperintensities. Your problem is clearly mechanical due to slipped intervertebral disc that is pressing upon the cal sac. As it is in cervical position you can have problems with 4 limbs as nerves that supply all 4 limbs will be present there.
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Internal Medicine
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