Can Steroids Increase My Risk Of Infections?

7/7/2014

Here is my question:
Hello, I have had MS for 14 years and I am 43 now. I was diagnosed with RRMS and have been on Copaxone since 2000. My MRI scans have been stable. I have had a lot of problems stemming from bladder infections after the use of steroids. I had a really bad relapse after I took liquid steroids in January. I finally got rid of the infection in March and have recovered pretty well with the help of PT. My question is, I am having trouble with my body deciding if it wants to stand up or not. Sometimes yes and other times it is like something is pulling me back. I am in a manual wheelchair. I have had one since 7/2000. I urinate etc. on my own. I do almost everything but walk. Which leads me to another question. In July of 2000 I had a big infection not treated right away and that led to paralysis for 7 months. Would that cause a lesion in my spine to not let me walk for 14 years? Sorry for the long question(s).

Answer:
Steroids can certainly increase your risk of infections including urinary tract infections. More importantly, repeated and frequent infections are associated with more rapid worsening of MS, especially in more disabled patients such as yourself. I know you mention urinating on your own but it is highly likely that your bladder function is abnormal because of your MS. This will increase your risk of urinary tract infections even further. You need to be seen by a urologist specializing in patients with MS and spinal cord disease. An evaluation is likely to find ways to decrease your future risk of infections.

Good luck
-Rip Kinkel, MD

4 Comments

Laura McCutcheon

7/8/2014 05:28:45 am

Thank you

Rip Kinkel, MD

7/8/2014 09:01:11 pm

I realized you had a second part to your question. It is hard to imagine how a urinary tract infection could be responsible for a spinal cord lesion. It is more likely that you already had involvement of your spinal cord by MS with urinary retention which predisposed you to a urinary tract infection that in turn worsened you MS, but this is pure speculation on my part.

Laura McCutcheon link

8/9/2014 12:32:44 pm

Thanks for your reply. I had a spinal MRI recently and it was spot free. So, the mystery continues.

Dr Kinkel

8/10/2014 01:21:58 am

I would definitely need more information about your case to make any further comments. For instance, it is very unusual for a person to require a WC with MS and have a totally normal spinal cord on MR imaging. Certainly problems above the spinal cord involving the cerebrum, cerebellum and/or brainstem can also give rise to both problems urinating and walking but there are usually many other associated neurological problems.

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