Resources for immunocompromised patient and pseudomonas infection

@johncf Welcome to Mayo Clinic Connect. I am sorry to hear your friend has been having this ongoing situation with no relief at this point.

Pseudomonas infection can be tricky to deal with. There are many variations and sometimes trying to get the correct form of antibiotics in place is a challenge. Here is an excellent article from the Cleveland Clinic about this type of infection: https://my.clevelandclinic.org/health/diseases/25164-pseudomonas-infection It appears a concise answer for what/where/cause of the infection is important to really get rid of it.

Has your friend recently undergone a transplant, and this is why you posted within the transplant support group? If so, what type of transplant did they receive?
Ginger

Hi, sorry, looks like I accidentally posted to the wrong group.
Not sure if it can be moved. Otherwise I may try to repost in a couple of days.

Although my understanding is that people with transplants may also be susceptible to similar infections.
Thanks for the link above. I have done some research, and as a lay person am familiar with the general topics. I was trying to find out more/learn from people that have gone through similar situations, although it could be that each case is unique

@johncf, I moved your discussion to the Infectious Diseases and MAC & Bronchiectasis support group where many members are talking about pseudomonas bacteria.

John, where is the bacteria appearing? Just in the wound? Or the lungs or urinary tract as well?

Thanks for moving the post to the correct groups.
Infection is only in the wound area, but it has spread to various areas of the leg where it started. Supposedly through the lymphatic system

Hello John, I'm not finding much "easily digestible" information on extra-pulmonary pseudomonas, but here is on recent study :
https://pmc.ncbi.nlm.nih.gov/articles/PMC8572145/
My takeaway from it is that once acquired, it is very difficult to treat in immuno-compromised people, and repeated rounds of multiple antibiotics are often required. Do you know if she is in a hospital that does a lot of treatment of resistant infections? If not, does she have access to one?

Maybe some more specifics of the situation.

My friend is taking B cell depleting medicines as an MS treatment.
The infection started as a Cellulitis infection near the groin area. There are no clues as to how it got in there. Speculation is some kind of micro cut, and skin bacteria got in there. From there it moved to the back of the leg/knee and the front lateral knee area. The original groin area seems to be getting under control and created its own drainage. The other spots required intervention to create a drainage path.
At least for now, the infection has been contained to the right leg.
Not clear if the Pseudomonas is hospital acquired, or if the original infection is different. But it's the only thing they have been able to grow so far.
The medical/hospital team is very good, we get CT scans as we suspect the infection has moved.
I'm just concerned that this has been going on for a few weeks, requiring more and more pain management, and no path to resolution. With this kind of thing probably being unique to each individual, I just wanted to check if there were other similar situations we could draw some experience from.

Just one more question, which may be a measure of how experienced the hospital is in treating opportunistic infections - has she been isolated in a wing or a room with negative pressure, extra water filtration and other infection precautions to prevent any further bacterial invasions? And what precautions are being taken to limit her exposure like masks and gowns for all staff and visitiors?

The ID team is actively monitoring the situation with regular visits and follow-ups.
According from her primary treatment doctor, the ID staff at the hospital is quite knowledgeable of treating infections in immunocompromised patients, from transplants, etc ...
We are not in isolation. Staff wear masks and gowns.