e-coli infection and leaky gut

Graham

Graham

Senior Member (Voting Rights)
Late at night on April 26th I was carted off to hospital with a pretty bad infection. No, not COVID, although I had to go into the COVID A&E side to play safe, but with an e-coli infection in the blood (sepsis). I was given IV antibiotics, sent home after 10 days.

Five days later, and rushed back again. Another course of IV antibiotics, then sent home.

Seven days later, and rushed back in again. Started with IV antibiotics, then on to oral antibiotics so that I could be on them for 4 weeks.

Now back home. (Utterly steamrollered by the system! I'd give you the details, but it's just the same old story.)

They discovered one 2.5cm "cyst" on my liver, and a number of smaller ones. These could be infected: I had an MRI scan, but they aren't completely sure. They thought that perhaps I had an e-coli infection on the heart that was seeding it, but couldn't find one with ultrasound. They suspected bladder/kidney problems, but tests were fine.

So now I wait for the antibiotics to run out and wonder whether it will strike again.

I know Ian Lipkin was talking about the problems of a leaky gut and possible leakage of gram negative bacteria (such as e-coli). I also know that most of the doctors I saw just regard ME as a fatigue problem: one even suggested I saw a physiotherapist and tried graded exercise – he regretted that pretty quickly.

I've tried a trawl, but my brain is battered and will take a while to get back to its usual gormless self, so does anyone have a suitably academic link for me to give the one doctor dealing with me who actually has a friend with ME?

Muchly gratitudelinesses.
 
I am not aware of any good evidence for "leaky gut" being a meaningful explanation for e coli septicaemia. The idea has been popular for three decades or more but never established an evidence base as far as I know.

It doesn't really fit as an explanation for a septicaemia with a single organism anyway. If cultures yielded a particular e coli that indicates that a clone derived from a single e coli somehow managed to survive the blood or in some tissue locus. That could be explained by a failure of the immune system to deal with that particular strain or some one-off event that allowed colonisation a tissue. General gut leakiness might be expected to give rise to a mixture of organisms and that does not happen as far as I know.

I( actually think that septicaemia is something quite distinct from the speculations about bacterial lipopolysaccharide getting through gut wall and maybe stimulating cytokines that has been talked about by people like Maureen Hanson.
 
Really sorry to hear that you’re having such a tough time Graham.

I wonder if it might be worth contacting Prof Simon Carding at the Quadram Institute: simon.carding@quadram.ac.uk

After his Zoom lecture to the Sheffield ME group on gut microbes I posted a question about published evidence for the discoveries he listed of gut abnormalities in pwME (see image below). @Gecko kindly offered to pass my questions on to Prof Carding but I’ve not heard any more.

1F4D76EA-03A7-4B00-B912-76DDE3343EAA.png
 
Firstly, I am very sorry to hear of your hospital visits @Graham - many supportive hugs to you, George (the dog) and the rest of the family.

I sincerely hope you have now been given sufficient AB’s to stop the “little bug...” in its tracks.

This may be of no use whatsoever, but my (final straw that broke the camel’s back) relapse was from an EColi infection which caused Sepsis. I had to have both oral and IV antibiotics at the same time in hospital, then drop to just oral, before I was finally released to continue oral AB’s at home.
It was the combination of the two which finally brought my daily CRP figures down.

I hope this has been third time lucky for you and I will keep everything crossed.

Finally, were you aware that you have now appeared in Dialogues Severe ME film #2 (with the very moving tribute to Bob :heart: )?
 
Thanks all. I was somewhat sceptical of the leaky gut idea, and, as you quite rightly point out @Jonathan , the logic of a single infection doesn't hold out. But to be honest, I'm so steamrollered I'm not confident in my own ability to think things through, I knew the best thing was to ask here.

I keep trying to apply logic to the various ideas that a steady procession of one-off doctors produce (talking to their colleagues of course: not to me). Then they disappear, and sometimes something happens, sometimes not. It's hard to keep track in PEM. But it's clear that no-one knows why this keeps recurring when there is no clear source.

I haven't had a combination of antibiotics though: on the first two occasions it was IV only, and on the third, two days of IV then 4 weeks of oral.

(I typed UV instead of IV: perhaps Trump had the solution all along!)

Fingers crossed, but I confess I'm not looking forward to another midnight dash – the pain is pretty awful, and it takes hours to get things in motion.
 
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It's M.E. Linda said:
It was the combination of the two which finally brought my daily CRP figures down.
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Wow, "daily CRP"!!!
I'm home, had an outpatient appointment yesterday, took blood, CRP around 30 (I had to ask the doctor and that's what he thought it was), and aren't going to see anyone until after an MRI scan, which is scheduled for one week after the antibiotics run out.
 
Thanks all!

Barry said:
Are you sure the IV was only a single antibiotic? In the past I've had a cocktail of several fed in via a single IV.
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I went in around midnight: cannula fitted, drugs kick in, 1:00. X-ray of lungs, 2:00 first doctor examines and asks questions, 3:00 second doctor asks same questions plus more, and examines, 4:00 moved up to COVID ward, 5:30 woken up for blood pressure etc., then blood samples, then medication, then breakfast, then another doctor, same questions, then coffee, then room check and tidy, then order meal, then lunch – finally collapse. I couldn't be sure if I was still on this planet. Certainly my brain was not.

But my discharge notes say a week of tazocin when I went in on the second time around, and just a couple of days on IV "antibiotic" third time around, then changed to oral co-amoxiclav.

Just to make clear, all the medical staff were very caring, professional and thorough. They were human, taking risks to save my life. And they did: it would have been a very unpleasant way to go!

It's just that the doctors (apart from two) lived in their own little fiefdoms, and appeared to have the communication skills of a class of autistic children. I think the specialists regard the gap between them and the rest of the staff and patients as reflecting respect, but from what I could see, it was fear. The management structure is archaic and the communication or sharing of information pretty much non-existent (or they have so little to say, they have to keep repeating the same old questions). So I could be hit by three different decisions made by three different doctors all on the same day, and not find out about them until they happen.
 
Dear @Graham, I hope you'll recover soon! :hug:

Your story reminded me of the current episode of a German TV series called "Abenteuer Diagnose" (diagnosis adventure?):
A small hole in the stomach (which had already nearly healed by the time they did a gastroscopy) had let to sepsis, liver abscess, and inflamed gall bladder in a patient.

The root cause (for the inflammation and perforation of the stomach lining) was that the patient had NOT been prescribed gastric acid inhibitors although he took a lot of pain killers and steroids for a rheumatic disease.

So in that case not a leaky gut, but a leaky stomach...
 
MEMarge said:
Sorry to report that Graham was taken back into hospital this morning.

Does anyone have any ideas of who to contact?

@Jonathan Edwards
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I am very sorry other this problem has not been sorted and I wish Graham a speedy recovery.

This is a standard medical problem that should be within the expertise any general emergency physician. The problem is that it can be very difficult to know when the infection has been cleared. I shouldn't give an opinion on diagnosis but a localised abscess can certainly present like this but it can be hard to find.

I don't think it has anything to do with ME.
 
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