Diagnosis of bacterial infection leaves patient with questions

DEAR DR. GOTT: I have had COPD (chronic obstructive pulmonary disease) for many years and recently have been diagnosed with pseudomonas aeruginosa that has colonized. I have looked it up on the Internet, and what I find is very technical to read and not very encouraging. Does it ever go away? Will antibiotic treatment get rid of it? Will exercise, vitamins, minerals, diet changes or anything else be of assistance? What is the prognosis for this disease? What medical centers are doing research or trials?

DEAR READER: Pseudomonas aeruginosa is a form of bacterium responsible for severe infections acquired primarily in a hospital setting, in people with compromised immune systems, and is responsible for some of the chronic infections in people who suffer from cystic fibrosis. All infections caused by pseudomonas are treatable and potentially curable.

The infection can involve any part of the body — the respiratory tract, heart, bones, joints, central nervous system, skin, urinary and gastrointestinal tracts. Because you indicate you have COPD, it is my guess that the respiratory system is involved. If this is the case, you should be under the care of a pulmonology specialist.

After the colonization phase of the disease, the infection evolves either to a chronic or acute phase. Following colonization, substantial tissue damage and invasion of the bloodstream can occur.

There are a number of medical conditions that can predispose a person to this form of infection, including diabetes, meningitis, cystic fibrosis, cancer, drug addiction and more. Care is geared toward the best-known antibiotic available for the area of the body affected. Pseudomonas infections are often treated with a combination of penicillin or cephalosporin and an aminoglycoside. Surgery may be required for diabetic foot ulcers, perforated bowel or drainage from an abscess. Diet should be addressed by people with cystic fibrosis.

The prognosis for this condition varies, depending on the area of the body affected. For example, the early recognition of malignant otitis responds well to antibiotic therapy. Septicemia, meningitis, eye infection, pseudomonas bacteremia and sepsis from burn wounds can carry a poor prognosis — the pneumonia can progress to the degree that respiratory support is necessary; bacteremia can lead to septic shock and death; endocarditis may cause brain abscess and more.

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