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Dr. Hive: Cellulitis?


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My husband woke up last Wednesday morning with a sharp pain in his elbow, which was somewhat swollen. He went to the Dr. that afternoon, by which time the swelling had increased considerably and the area around the elbow was very red and inflamed looking, within about a six inch diameter. Dr. said it was an infection, and gave him both an antibiotic injection and a prescription for antibiotics to take 4 times a day. 

 

It's been a week, and while he has continued to make follow-up visits to the dr. and to take the antibiotics faithfully, his entire forearm is now swollen. The nurse mentioned cellulitis, the dr. has just continued to call it an infection without being more specific.

 

I'm worried that this is not improving with treatment. We're going to try to get him to another dr. for a second opinion tomorrow. 

 

Has anyone experienced something like this? I'm hoping the Hive has some wisdom to share!

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My DH had cellulitis in his instep--completely random, no break in the skin or damage to the foot or anything. He just had oral abx, and that did solve the problem for him, but his doctor told him it was very likely that he'd need another round or something stronger. Cellulitis can get extremely serious, and I would definitely find another doctor to look at it. He might end up needing an ER trip or worse :( I hope tomorrow's visit will get him the help he needs. If he can't get a regular doctor tomorrow, I'd take him to urgent care at a minimum. Don't wait any longer than that.

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I had it a few months ago. Hospitalized and was on six rounds of antibiotics, steroids, and the heavy duty pain relievers. Two followup trips to the ER because I spiked nasty fevers and the infection was visibly spreading. Don't skip a dose of those antibiotics and don't skip any followup appointments. I was given a surgeon's marker to mark the infection. When it got beyond the lines marked, I ended up in the ER. Both times. If he can handle the pain of marking around it, do. All of the doctors who attended me also cautioned me that because I've had it once, I'm at a higher risk to get it again. Keep that in mind. Any small cut or abrasion, take care of it straightaway. 

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My DH got an infection in his knee a couple of months ago.  They first put him on Clindamycin (sp) and it didn't work.  It took switching to Cipro before he had any improvement.  I would definitely get him back into a doctor ASAP!

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It is getting worse not better-- he needs a different treatment NOW-- I'm not sure I would wait until tomorrow... can you get him to an Urgent care or ER tonight?

The longer you wait the more the infection will spread-- this is an arm!

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It is getting worse not better-- he needs a different treatment NOW-- I'm not sure I would wait until tomorrow... can you get him to an Urgent care or ER tonight?

The longer you wait the more the infection will spread-- this is an arm!

Yep - an arm is close to the heart.  You do not want this traveling in the bloodstream.  It is obviously not responding to the antibiotics that he is on.  

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I would get him help ASAP because it is spreading.  He may need IV antibiotics to stop the spread of the infection.  I was thought to have Cellulitis and eventually MRSA because the antibiotics didn't seem to be working.  They didn't mess around about treating me with stronger and stronger stuff. I was told if it showed any sign of spreading to get back to the doctor or ER stat.   In the end the reason the antibiotics weren't working on me (3 trips to the ER and multiple antibiotics) was because I actually had a blood clot in my leg which was just as serious at that point. Please don't wait!!!

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Go to an ER. My husband had something similar this summer and ended up in the hospital on multiple IV antibiotics. He had MRSA and he was very ill.

 

Even after he got out, he was on antibiotics for months with frequent appointments to have his wound packed. I could literally insert a needle inches into his sore.

 

Obviously the antibiotics are not working. At the least, he needs cultures run to make sure he's on an appropriate antibiotic.

 

ETA: This is three weeks after his hospital admission. Don't watch it if you're at all squeamish. here

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Does he have a fever?  Any red streaks?  If either of those - ER tonight - no question at all.  Otherwise go to another doctor tomorrow (though honestly the fact that it has been a week makes me nervous).  If the swelling and redness spreads more tonight, I would actually go to the ER anyway.  

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He has had three injections of Rocephin and is taking Clindamycin.

 

My DH's infection did not improve on Clindamycin but at the same time the infection stayed localized in the knee joint.  He ended up in urgent care when he had an allergic reaction to the Clindamycin 12 days into the medicine.  That's when they switched to the Cipro.

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I'm so sorry. last month one side of my face started to swell and I was beginning to look noticeably lopsided (I assumed it was the beginning of cellulitis). I decided to try some essential oils to see if that would help before getting medical attention. So I put doterra's onguard in some carrier oil and rubbed it on my face and the swelling went down noticeably that night. Within days it was gone. I'm not suggesting that you do this instead of antibiotics but maybe it can help?

If you do decide to give essential oils a try I've read that Tea Tree (melaleuca) is good for cellulitis. Aura Casia is also a good brand that you can get in any health food store. If you want the doterra's blend I just order mine from amazon

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I talked to BIL on the phone (ER doc) and emailed some pictures, waiting to hear back from him. I'm not jumping to go to the ER tonight unless he tells me to, since that would involve packing up 5 tired kids and taking them as well. 

 

Feeling frustrated that he has been to the same doctor three times and the dr. hasn't tried anything different...will definitely be seeing a different dr. at least tomorrow.

 

I appreciate the experience and advice, I will keep you posted.

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My DH had something similar. He went to the doctor one day with instructions to follow up in 24 hours. When it was larger at 24 hours, he was admitted to the hospital for 4 days of IV antibiotics, spent another month or two (I can't remember precisely) recovering at home, and even has lingering effects with that leg being more prone to swelling generally and the foot on that leg now about a half size larger than it was/his other foot is.

 

I vote a different doctor or the ER right away.

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ER...IV antibiotics...stat.  Possibly more than one.  Go to the ER now.

 

Edited to ask:  Is he allergic to penicillin?  Because Augmentin usually works great for this.  If he is, then Clindamycin and Cipro IVs, given one right after the other should do the trick in a few days.

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My daughter has had cellulitis three or four times, and each time, the response to abx has been apparent within a couple of hours. It is clear to this Dr. Mom that your husband needs another antibiotic. Certainly not all infections are going to react within hours, but some time between hours and a week would certainly be more typical if the abx is going to work at all.

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I'm shocked your doctor has been so passive, and glad you have an ER doc in the family on board now. I'd definitely be leaning toward ER. IV antibiotics are probably necessary. Localized infections don't stay localized forever.

 

Keep us posted.

 

Beck

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So the new diagnosis is olecranon abscess, per BIL and confirmed by the new dr. today. He drained the abscess and prescribed a different antibiotic, there is still a possibility of needing hospitalization etc. but at least we're on a more proactive course.

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