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Staphylococcal Infections

What are Staphylococcal (staph) infections?

Staphylococcus (staph) is a group of bacteria. There are more than 30 types. A type called Staphylococcus aureus causes most infections.

Staph bacteria can cause many different types of infections, including:

  • Skin infections, which are the most common types of staph infections.
  • Bacteremia, an infection of the bloodstream. This can lead to sepsis, a very serious immune response to infection.
  • Bone infections.
  • Endocarditis, an infection of the inner lining of the heart chambers and valves.
  • Food poisoning.
  • Pneumonia.
  • Toxic shock syndrome (TSS), a life-threatening condition caused by toxins from certain types of bacteria.
What causes staph infections?

Some people carry staph bacteria on their skin or in their noses, but they do not get an infection. But if they get a cut or wound, the bacteria can enter the body and cause an infection.

Staph bacteria can spread from person to person. They can also spread on objects, such as towels, clothing, door handles, athletic equipment, and remotes. If you have staph and do not handle food properly when you are preparing it, you can also spread staph to others.

Who is more likely to get a staph infection?

Anyone can develop a staph infection, but certain people are more likely to get one, including those who:

  • Have a chronic condition such as diabetes, cancer, vascular disease, eczema, and lung disease
  • Have a weakened immune system, such as from HIV, medicines to prevent organ rejection, or chemotherapy
  • Had surgery
  • Are in the hospital
  • Use a catheter, breathing tube, or feeding tube
  • Have an implanted device, such as a pacemaker or artificial joint or heart valve
  • Have burns, especially if they are deep or cover a large area of the body
  • Are on dialysis
  • Inject illegal drugs
  • Do contact sports, since you may have skin-to-skin contact with others or share equipment
What are the symptoms of staph infections?

The symptoms of a staph infection depend on the type of infection:

  • Skin infections can look like pimples or boils. They may be red, swollen, and painful. Sometimes there is pus or other drainage. They can turn into impetigo, which turns into a crust on the skin, or cellulitis, a swollen, red area of skin that feels hot.
  • Bone infections can cause pain, swelling, warmth, and redness in the infected area. You may also have chills and a fever.
  • Endocarditis causes some flu-like symptoms: fever, chills, and fatigue. It also causes symptoms such as rapid heartbeat, shortness of breath, and fluid buildup in your arms or legs.
  • Food poisoning typically causes nausea and vomiting, diarrhea, and fever. If you lose too many fluids, you may also become dehydrated.
  • Pneumonia symptoms include a high fever, chills, and cough that doesn't get better. You may also have chest pain and shortness of breath.
  • Toxic shock syndrome (TSS) causes high fever, sudden low blood pressure, vomiting, diarrhea, and confusion. You may have a sunburn-like rash somewhere on your body. TSS can lead to organ failure.
How are staph infections diagnosed?

Your health care provider will do a physical exam and ask about your symptoms. Often, providers can tell if you have a staph skin infection by looking at it. To check for other types of staph infections, providers may do a culture, with a skin scraping, tissue sample, stool sample, or throat or nasal swabs. There may be other tests, such as imaging tests, depending on the type of infection.

What are the treatments for staph infections?

Treatment for staph infections is antibiotics. Depending on the type of infection, the antibiotics might be a cream, ointment, medicines (to swallow), or intravenous (IV) medicine. If you have an infected wound, your provider might drain it. Sometimes you may need surgery for bone infections.

Some staph infections, such as MRSA (methicillin-resistant Staphylococcus aureus), are resistant to many antibiotics. There are still certain antibiotics that can treat these infections.

Can staph infections be prevented?

Certain steps can help to prevent staph infections:

  • Use good hygiene, including washing your hands often.
  • Don't share towels, sheets, or clothing with someone who has a staph infection.
  • It's best not to share athletic equipment. If you do need to share, make sure that it is properly cleaned and dried before you use it.
  • Practice food safety, including not preparing food for others when you have a staph infection.
  • If you have a cut or wound, keep it covered.

Stress

What is stress?

Stress is how your brain and body respond to a challenge or demand. When you are stressed, your body releases certain hormones. Hormones are chemicals that travel in your bloodstream and control how different parts of your body work. The hormones that are released when you are stressed make you alert and ready to act. They can raise your blood pressure, heart rate, and blood glucose (blood sugar) levels. This response is sometimes called a "fight or flight" response.

Everyone gets stressed from time to time. There are different types of stress. It can be short-term or long-term. It can be caused by something that happens once or something that keeps happening.

Not all stress is bad. In fact, it can help you survive in a dangerous situation. For example, one kind of stress is the jolt you may feel when a car pulls out in front of you while you are driving. This jolt of hormones helps you quickly hit the brakes to avoid an accident. A little short-term stress can sometimes be helpful. For example, the stress of having a deadline for school or your job may push you to get your work done on time. Once you finish it, that stress goes away.

But stress that lasts a long time can harm your health.

What causes long-term stress?

Long-term stress, or chronic stress, lasts for weeks, months, or longer. As you go about your life, your body is acting as if you're being threatened.

Causes of long-term stress include:

  • Routine stress from the demands of work, school, family needs, money problems, and other daily pressures that don't stop.
  • Stress from sudden, difficult changes in your life, such as divorce, illness, losing your job, or other unhappy life events that often have a long impact.
  • Traumatic stress, which may happen when you're in danger of serious harm or death. Examples include being in a bad accident, a war, a flood, earthquake, or other frightening event. This type of stress can cause a long-lasting problem called post-traumatic stress disorder (PTSD).
How can long term-stress harm my health?

People respond to stress in different ways. If you're stressed for a long time you may notice that you are:

  • Getting sick more often than usual because stress weakens your body's ability to fight germs
  • Having stomach problems or trouble digesting food
  • Having trouble sleeping
  • Having headaches
  • Feeling sad, angry, or easily upset

When stress keeps going, your body acts as if you're always in danger. That's a lot of strain that may play a part in developing serious health problems, including:

  • Depression
  • Anxiety
  • Heart disease
  • High blood pressure
  • Diabetes

It's possible to get used to the symptoms of stress and not even realize there's a problem. So when there's a lot of stress in your life, it's important to pay attention to how it affects you so you can do something about it.

How can I manage long-term stress?

Simple things that improve your mental health may be helpful in managing long-term stress, such as:

  • Get regular exercise. A 30-minute daily walk can help you feel better and help keep your immune system strong, so you don't get sick.
  • Try relaxing activities. You could look for an app or wellness program that uses breathing, meditation, or muscle relaxation exercises.
  • Get enough sleep every night.
  • Avoid too much caffeine.
  • Decide what you need to do now and what can wait. And focus on what you got done each day, not on what you weren't able to do.
  • Ask your family or friends for support.
When should I ask my health care provider for help with stress?

Get help if you're having severe symptoms for 2 weeks or more, including:

  • Trouble sleeping
  • Changes in your eating that cause unwanted changes in your weight
  • Troubles getting out of bed because of your mood
  • Difficulty focusing your thoughts
  • Losing interest in things you usually enjoy
  • Not being able to do your usual daily activities

Always get help right away if stress is causing you to:

  • Have thoughts of suicide
  • Feel you can't cope
  • Use drugs or alcohol more often than usual

Your health care provider may refer you to a mental health professional such as a psychologist or social worker.

NIH: National Institute of Mental Health

Swallowing Disorders

If you have a swallowing disorder, you may have difficulty or pain when swallowing. Some people cannot swallow at all. Others may have trouble swallowing liquids, foods, or saliva. This makes it hard to eat. Often, it can be difficult to take in enough calories and fluids to nourish your body.

Anyone can have a swallowing disorder, but it is more common in older adults. It often happens because of other conditions, including:

  • Nervous system disorders, such as Parkinson's disease and cerebral palsy
  • Problems with your esophagus, including GERD (gastroesophageal reflux disease)
  • Stroke
  • Head or spinal cord injury
  • Cancer of the head, neck, or esophagus

Medicines can help some people, while others may need surgery. Swallowing treatment with a speech-language pathologist can help. You may find it helpful to change your diet or hold your head or neck in a certain way when you eat. In very serious cases, people may need feeding tubes.

NIH: National Institute on Deafness and Other Communication Disorders

Sweat

Sweat is a clear, salty liquid produced by glands in your skin. Sweating is how your body cools itself. You sweat mainly under your arms and on your feet and palms. When sweat mixes with bacteria on your skin, it can cause a smell. Bathing regularly and using antiperspirants or deodorants can help control the odor.

Sweating a lot is normal when it is hot or when you exercise, are anxious, or have a fever. It also happens during menopause. If you often sweat too much, it's called hyperhidrosis. Causes include thyroid or nervous system disorders, low blood sugar, or another health problem.

Sweating too little, anhidrosis, can be life-threatening because your body can overheat. Causes of anhidrosis include dehydration, burns, and some skin and nerve disorders.

Teen Depression

What is depression in teens?

Depression in teens (ages 13-17) is a serious medical illness. It's more than just a feeling of being sad or "blue" for a few days. It is an intense feeling of sadness, hopelessness, and anger or frustration that lasts much longer. These feelings make it hard for you to function normally and do your usual activities. You may also have trouble focusing and have no motivation or energy. Depression can make you feel like it is hard to enjoy life or even get through the day.

What causes depression in teens?

Many factors may play a role in depression, including:

  • Genetics. Depression can run in families.
  • Brain biology and chemistry.
  • Hormones. Hormone changes can contribute to depression.
  • Stressful childhood events such as trauma, the death of a loved one, bullying, and abuse.
Which teens are at risk of depression?

Depression can happen at any age, but often begins in the teens or early adulthood. Certain teens are at higher risk of depression, such as those who:

  • Have other mental health conditions, such as anxiety, eating disorders, and substance use
  • Have other diseases, such as diabetes, cancer, and heart disease
  • Have family members with mental illness
  • Have a dysfunctional family/family conflict
  • Have problems with friends or other kids at school
  • Have learning disabilities or attention deficit hyperactivity disorder (ADHD)
  • Have had trauma in childhood
  • Have low self-esteem, a pessimistic outlook, or poor coping skills
What are the symptoms of depression in teens?

If you have depression, you have one or more of these symptoms most of the time:

  • Sadness
  • Feeling of emptiness
  • Hopelessness
  • Being angry, irritable, or frustrated, even at minor things

You also may also have other symptoms, such as:

  • No longer caring about things you used to enjoy
  • Changes in weight, such as losing weight when you are not dieting or gaining weight from eating too much
  • Changes in sleep, such as having trouble falling asleep or staying asleep, or sleeping much more than usual
  • Feeling restless or having trouble sitting still
  • Feeling very tired or not having energy
  • Feeling worthless or very guilty
  • Having trouble concentrating, remembering information, or making decisions
  • Thinking about dying or suicide
How is depression in teens diagnosed?

If you think you might be depressed, tell someone that you trust, such as your:

  • Parents or guardian
  • Teacher or counselor
  • Doctor

The next step is to see your doctor for a checkup. Your doctor can first make sure that you do not have another health problem that is causing your depression. To do this, you may have a physical exam and lab tests.

If you don't have another health problem, you will get a psychological evaluation. Your doctor may do it, or you may be referred to a mental health professional to get one. You may be asked about things such as:

  • Your thoughts and feelings
  • How you are doing at school
  • Any changes in your eating, sleeping, or energy level
  • Whether you are suicidal
  • Whether you use alcohol or drugs
How is depression in teens treated?

Effective treatments for depression in teens include talk therapy, or a combination of talk therapy and medicines:

Talk therapy

Talk therapy, also called psychotherapy or counseling, can help you understand and manage your moods and feelings. It involves going to see a therapist, such as a psychiatrist, a psychologist, a social worker, or counselor. You can talk out your emotions to someone who understands and supports you. You can also learn how to stop thinking negatively and start to look at the positives in life. This will help you build confidence and feel better about yourself.

There are many different types of talk therapy. Certain types have been shown to help teens deal with depression, including:

  • Cognitive behavioral therapy (CBT), which helps you to identify and change negative and unhelpful thoughts. It also helps you build coping skills and change behavioral patterns.
  • Interpersonal therapy (IPT), which focuses on improving your relationships. It helps you understand and work through troubled relationships that may contribute to your depression. IPT may help you change behaviors that are causing problems. You also explore major issues that may add to your depression, such as grief or life changes.

Medicines

In some cases, your doctor will suggest medicines along with talk therapy. There are a few antidepressants that have been widely studied and proven to help teens. If you are taking medicine for depression, it is important to see your doctor regularly.

It is also important to know that it will take some time for you to get relief from antidepressants:

  • It can take 3 to 4 weeks until an antidepressant takes effect
  • You may have to try more than one antidepressant to find one that works for you
  • It can also take some time to find the right dose of an antidepressant

In some cases, teenagers may have an increase in suicidal thoughts or behavior when taking antidepressants. This risk is higher in the first few weeks after starting the medicine and when the dose is changed. Make sure to tell your parents or guardian if you start feeling worse or have thoughts of hurting yourself.

You should not stop taking the antidepressants on your own. You need to work with your doctor to slowly and safely decrease the dose before you stop.

Programs for severe depression

Some teens who have severe depression or are at risk of hurting themselves may need more intensive treatment. They may go into a psychiatric hospital or do a day program. Both offer counseling, group discussions, and activities with mental health professionals and other patients. Day programs may be full-day or half-day, and they often last for several weeks.

Let us know what's on your mind. We will help. Whether now is the right time for hospice or later, at your request, we will schedule a meeting with you at the place of your choosing: your home, the hospital, your doctor's office, etc.

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