Sunday, March 1, 2009

01. What Is Staph?

Staphylococcus aureus ("Staph") is a common skin bacteria named for its microscopic, grapelike appearance. Staphylo & coccus mean "bunch of grapes & spherical bacterium" in Greek.
Now, about 1/3 of people are colonized with Staph somewhere in their outer orifices (nostrils, vagina, anus, etc). And this is generally not a problem...except when they are the more pathogenic and opportunistic strains on the spectrum.

There has long been such a continuum and these more virulent varieties have actually been around...for quite a while now. Although, they have also certainly gotten progressively worse over time!

Back in 1929, this Listerine ad referred to it as the "stubborn (pus) germ." Quite an apt description!

More recently, in the 80s, it was the culprit behind Toxic Shock Syndrome (TSS).
And now, it has unfortunately resurfaced yet again as an antibiotic-resistant "superbug" from our overusage of commercial antibiotics (in both medical and livestock settings).

These new mutant strains include Methicillin-resistant Staphylococcus aureus (MRSA) and Vancomycin-resistant Staphylococcus aureus (VRSA). 14 years ago, about 30% of people carried some form of Staph, while .8% had MRSA on them. Those numbers have now crept up to around 33% and 2%, respectively. Typical high-risk hotspots include hospitals, gyms (workout, MMA, boxing), locker rooms, etc. So, it is likely that you will eventually encounter some (knowingly or not) in your practice...and just general life! While fortunately, at least VISA/VRSA (the most dangerous strains), are still considerably rarer...with just handfuls of known cases thus far.

Symptoms

A localized Staph skin infection typically first starts off as a small (~3/16"), bright red/pink, prickly spot. It may resemble a bug bite, except that it is typically brighter in color and may often have a prickly sensation (or sometimes none at all). So, you may feel it before you visually notice it. Whereas if it's a duller tone and itchy, it may just be an ordinary bug bite...and not Staph. If properly treated at this time, it could disappear within an hour or so.

But if allowed to progress untreated beyond this stage, it may form a whitehead. This is technically called a boil or furuncle and would look basically just like a whitehead pimple...except again, it would likely have a prickly or sore sensation. If properly treated at this point, it could still disappear within a week or so.

Beyond this point, the infection could continue to grow into a larger boil. Which would resemble a spider bite. Except that there are no fang marks. Instead, the reddened mound is caused by a hard buildup of pus underneath. Hopefully, you did not let it reach this stage - as this could require a medical surgical incision to drain it. That could take a week just to heal and close back up...but the resulting scar could take a year to disappear. Not to mention may cost a few hundred as even outpatient procedures aren't cheap.

Past that, carbuncles (clusters of furuncles), cellulitis, more severe infections, and possibly even sepsis could potentially develop - eventually leading to some of the "worst case" scenarios you might see elsewhere on the net. Or opportunistic infections may also skip straight to this phase if they penetrated the skin and started internally somehow... But hopefully, you didn't let it get that far. Infections are like fires. If you detect and fight them early, they are easy to put out. Wait until your whole house is in flames though...and you may be fighting an uphill or losing battle!

Now, if any of these symptoms sound like what you have...please get checked at a local clinic to confirm your diagnosis.

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