...Infections, toxins, physical trauma, or, indeed, anything that stirs up an immune reaction of the WG kind. I haven't seen any papers specifically on Bactrim and WG. But there are studies suggesting Staph aureus may, sometimes, be a proximate trigger for WG flares. (The ultimate trigger is a tougher nut to crack.) And it is true that chronic sufferers of sinusitis and rhinitis are often carriers of S. aureus. It is also true that chronic carriers of Staph are somewhat more at risk for WG flares than non-carriers. Unfortunately, this correlation is not terribly strong: There are many chronic Staph carriers who have never had WG flares. I think a more useful bit of information would be what proportion of WG flares is preceded by certain types of infection. In my case, both major flares had been preceded (with a lead-time of four weeks or so) by some bronchial infection (of what kind, whether viral or bacterial or fungal, I do not know--that was never tested). Alternatively, my shingles flare (surely made possible by the cytoxan treatment) may have greased the wheels for the second flare. If so, there was about a 3-4 month offset.
Along these lines, I can report that I visited the pulmo yesterday for an update. My cough (and sinus congestion) has gotten worse in the last couple of months (indeed, after Drac took me off Bactrim, as my creatinine was edging up, and Bactrim can influence that number). The pulmo thought that the cough was almost entirely related to nasal dripping. He took a culture, so I may have a data point soon....
Al
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