1. < Ear, Nose & Throat (ENT)

Pseudomonas in sinuses

Posted by betsey @betsey, Jun 9, 2023

About 10 days ago sinus culture culture came back, showing I have a heavy growth of pseudomonas. Other pathogens of questionable significance also showed up, but unfortunately, the order was not written in such a way that they would identify those. I have a primary immunodeficiency, which is the reason I would be interested to know what other organisms were present but, for now, all I know is that I have pseudomonas.
My ENT prescribed Tobramycin rinses twice a day which I have been doing for about a week and unfortunately I don’t feel like I’m getting any better.

Has anyone else experienced a pseudomonas sinus infection or know about it?

What treatment did you follow?

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billie22 | @billie22 | Aug 7 10:10pm
In reply to @meli2024 "@betsey I too have been diagnosed with pseudomonas in my sinus (right maxillary) after a few..." + (show)
@meli2024

@betsey I too have been diagnosed with pseudomonas in my sinus (right maxillary) after a few years of chronic sinusitis. Did you find an antibiotic that worked to eradicate it? I recently had oral surgery to remove infection from the bone above a root canal (and the root debris left in there), had a bone graft, and it seems to be healing. However the infection in my sinus is not gone. I've been on several antibiotics (now on colistimethate in a rinse which isn't doing anything). I'm beginning to think I need to find a different doctor that will have more of a sense of urgency in eradicating it. I mean it was in my jaw bone...what is to say it hasn't spread to other bones in my sinuses! Anyway, any news on your journey would be appreciated.

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I’ve known I had pseudomonas in my sinuses for 13 years. I was on IV antibiotics then for 3 months but they were improperly given I later learned from Infectious Disease at our hospital. It remains dormant until triggered. I knew 2 years ago it was active but couldn’t get a culture to show it. It has a neon biofilm around it. If you are getting drainage with an almost clear sticky neon color, that’s biofilm. I was again diagnosed about 3 months ago. I took Cipro for 6 weeks (recommended by the lab) and the Pseudomonas GREW. Then I was but on IVs of Impenum and that is 3 times daily for 5 weeks and my drainage is still green. I go to Infectious Disease tomorrow. I am not playing around with this any longer. It can be fatal. If it’s in your bone you need to go somewhere like Cleveland Clinic. Mine has shown up on two MRIs over the past 3 years. I have lost all my teeth but 4 with the explanation it was dry mouth! Let me know anything you know. My research said only 13% of sinus infections are this bacteria.

REPLY
billie22 | @billie22 | Aug 7 10:15pm
In reply to @caltex "@meli2024 What symptoms did you have with the Pseudomonas in your maxillary sinus? I had sinus..." + (show)
@caltex

@meli2024 What symptoms did you have with the Pseudomonas in your maxillary sinus? I had sinus surgery for a complete blockage of my left maxillary sinus and the doctor said it was one of the worst he has seen, but keeps insisting it wasn't in the bone. The infection has not gone away, and he just did a culture. Waiting for results. He did mention possible Pseudomonas. I have a horrible smell in my sinus all of the time, to the point where it makes me nauseated. I'm doing saline rinses with baby shampoo, but he has so far declined to do any antibiotic rinses. I'm not sure why. I have been on 6 courses of antibiotics over the past 4 months, and he has prescribed my 7th course, but I have refused to take it. I'm currently battling side effects from the many courses of antibiotics, and am just not willing unless I have systemic effects from the infection. He finally referred me to someone else, but I can't get in until August. Did the bone infection show up on a scan? Thanks!

Jump to this post

I’ve known I had pseudomonas in my sinuses for 13 years. I was on IV antibiotics then for 3 months but they were improperly given I later learned from Infectious Disease at our hospital. It remains dormant until triggered. I knew 2 years ago it was active but couldn’t get a culture to show it. It has a neon biofilm around it. If you are getting drainage with an almost clear sticky neon color, that’s biofilm. I was again diagnosed about 3 months ago. I took Cipro for 6 weeks (recommended by the lab) and the Pseudomonas GREW. Then I was but on IVs of Impenum and that is 3 times daily for 5 weeks and my drainage is still green. I go to Infectious Disease tomorrow. I am not playing around with this any longer. It can be fatal. If it’s in your bone you need to go somewhere like Cleveland Clinic. Mine has shown up on two MRIs over the past 3 years. I have lost all my teeth but 4 with the explanation it was dry mouth! Let me know anything you know. My research said only 13% of sinus infections are this bacteria.

I got to the point the pain is go terrible for a saline rinse or tobramycin. I have a high pain tolerance.

REPLY
1 reply
happyfamilyman | @happyfamilyman | Sep 10 5:30pm
In reply to @billie22 "I’ve known I had pseudomonas in my sinuses for 13 years. I was on IV antibiotics..." + (show)
@billie22

I’ve known I had pseudomonas in my sinuses for 13 years. I was on IV antibiotics then for 3 months but they were improperly given I later learned from Infectious Disease at our hospital. It remains dormant until triggered. I knew 2 years ago it was active but couldn’t get a culture to show it. It has a neon biofilm around it. If you are getting drainage with an almost clear sticky neon color, that’s biofilm. I was again diagnosed about 3 months ago. I took Cipro for 6 weeks (recommended by the lab) and the Pseudomonas GREW. Then I was but on IVs of Impenum and that is 3 times daily for 5 weeks and my drainage is still green. I go to Infectious Disease tomorrow. I am not playing around with this any longer. It can be fatal. If it’s in your bone you need to go somewhere like Cleveland Clinic. Mine has shown up on two MRIs over the past 3 years. I have lost all my teeth but 4 with the explanation it was dry mouth! Let me know anything you know. My research said only 13% of sinus infections are this bacteria.

I got to the point the pain is go terrible for a saline rinse or tobramycin. I have a high pain tolerance.

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Hello,

Any updates on your pseudomonas? My wife is having surgery tomorrow.

REPLY
drs1975 | @drs1975 | Oct 23 8:19pm

I was just diagnosed with Pseudomonas in my sinuses today, been battling a horrible sinus infection for about two weeks. I just started the Gentamicin nasal rinse on Monday and I'm taking Clindamycin which I just found out Clindamycin does not work against Pseudomonas in the sinuses. I'm seeing an ENT that has prescribed all this and did the cultures to diagnose. I don't understand how I got this and I'm very concerned if I should be worried about anything else. This was an upsetting diagnosis to me as I did read on it and its very scary all the info on it.

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1 reply
Mentor
Sue, Volunteer Mentor | @sueinmn | Oct 24 9:07am
In reply to @drs1975 "I was just diagnosed with Pseudomonas in my sinuses today, been battling a horrible sinus infection..." + (show)
@drs1975

I was just diagnosed with Pseudomonas in my sinuses today, been battling a horrible sinus infection for about two weeks. I just started the Gentamicin nasal rinse on Monday and I'm taking Clindamycin which I just found out Clindamycin does not work against Pseudomonas in the sinuses. I'm seeing an ENT that has prescribed all this and did the cultures to diagnose. I don't understand how I got this and I'm very concerned if I should be worried about anything else. This was an upsetting diagnosis to me as I did read on it and its very scary all the info on it.

Jump to this post

New diagnoses like these can be very scary, especially when we resort to Dr. Google to learn more. You will find this community on Mayo Connect to be very helpful, as we are patients who have been through what you are dealing with. I wonder if @betsey can share her experience, and what finally worked for her.

If your ENT did cultures, there was also probably a sensitivity test done, which showed them that Clindamycin and Gentamycin are effective on your particular strain of pseudomonas. If you do not improve in a month - yes, it takes at least that long for sinuses - they may opt for different drugs. The rule of thumb is to start with the safest medication likely to be effective and move on to the "bigger guns" is needed. If you do not feel your doc is familiar enough with this, you could ask for a consult with an Infectious Disease doctor as well.

How did you get Pseudomonas? It's everywhere, and usually just gets trapped in your nose where it doesn't cause an infection. But, if you have and autoimmune disease or get a virus or other infection that knocks down your body's immune defenses, it can colonize and cause a symptomatic infection. If you get a cold, and blow your nose too vigorously to remove thick mucus, you can force the germs up into your sinuses, where they grow in the nice, dark, warm moist environment.

Have you started the antibiotics, and are you feeling any better?

PS I have had pseudomonas in my lungs, but not my sinuses.

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theadora3295 | @theadora3295 | 22 hours ago

I was prescribed oral cipro but had allergic reaction. Prescribed Levoquin
sinus irrigation, 😟allergic reaction! Prescribed
Tobramycin😟 ears ringing, eyes swollen. Stopped!

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