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Thread: cellulitis complication?

  1. #1

    cellulitis complication?

    Went to the ER with a hot red swollen lower leg and even a bit up in the groin. Diagnosis was cellulitis. Doppler studies were fine. Was on IV vancomycin for three days after which time swelling and redness had virtually disappeared and the physicians thought it was safe for me to go home and be on oral antibiotics (doxycycline) for another week.

    No sooner had I got home that night than the swelling, redness and heat had returned. At times it would get a little better, then worse. I'm beginning to think that perhaps the vancomycin kept the infection down, but once it was stopped the infection resumed. The oral antibiotic was supposed to be just a safeguard against recurrence, but is not to be capable of fighting the cellulitis if IV antibiotics couldn't. Today is day 2 after discharge. I've had no fever.

    I now have to have my primary care doctor look at it to give me his opinion and since it is the weekend if it gets worse I may need to go back to the emergency room, get readmitted and start the whole process over.

    I am praying that I do not have a problem with an antibiotic resistant organism.

    For any of you that have had cellulitis and were treated in the hospital did you have a recurrence shortly after discharge? Did the redness and swelling persist for a while afterwards?

    Thank you.

  2. #2
    i took antibiotics for 6 weeks i think after being released but ya there was some swelling and redness when i left the hospital i think i was there 4 days
    to alcohol the cause of-and solution to-all of lifes problems [homer simpson]

  3. #3
    Senior Member ~Lin's Avatar
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    I've been on oral antibiotics for up to 2 months after hospital discharge for cellulitis, they were definitely to treat the infection and not just a safeguard like you mention. In my case I was usually discharged on at least 2 antibiotics and then weaned down to one until none. Thats going down from 3-4 different ones while hospitalized, but I can't take vancomycin so that may make a big difference.
    Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

    I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

  4. #4
    Senior Member lynnifer's Avatar
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    Vancomycin is like pulling out a cannon to shoot a duck. Any reason they put you on that? Besides the dangerous side effect of losing your hearing!

    In any case, 3 days doesn't seem long enough for a cellulitis that involved almost your entire leg. Ask to see an infection specialist, instead of just the ER doc next time. Any redness at all, I would go back immediately. That's a systemic infection.
    Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

  5. #5
    There is simple cellulitis or first time then there is the chronic reoccurring cellulitis . Unless there is a wound of puncture area then Cellulitis is a combination of infection but the culprit or what might have started problem but definitely contributes to the reoccurrence is the edema or fluids accumulating. So if reoccurring and not healing, most of the time have to look at managing the edema and stop smoking, wear the special hose, and possibly if continues look at the vascular component i.e. Circulation( or lack of adequate blood flow and or drainage, no smoking, keep blood sugar and blood pressure under control, etc... Lymphedema (special wraps and treatment ) and what is term "elephantitis of legs".
    Bactrim, Doxycycline, Vancomycin best for skin infections.
    So important to stay on top of it as you re. And always rule out blood clot etc..
    CWO

  6. #6
    Thanks for the prompt replies. It was better than the two attending physicians who never called me back and whose covering physician didn't know my case and wouldn't offer any advice other than to go to the ER if I felt so concerned.

    I did however reach my primary care physician who said that as long as the redness is not worsening or expanding and as long as there is no fever present, then there is no need to be alarmed at this time and run to the ER, so I will go to his office tomorrow and have him look at it in person.

    The major area affected was the foot, ankle and the lower leg almost up to the knee. I did have a little warmth and redness on my inner thigh high up near the groin but my entire leg wasn't on fire as by lower leg was. I did not have any open wound though my aide did say I had a small fissure in the web space between my small/next toe, typical of a minor foot condition. Though I take meticulous care of my feet and toes it is quite possible that this opening allowed bacteria in. I have also tried to control the edema, which was moderate but not severe, in my feet and legs through the use of a sequential compression pump that I have been using for close to 20 years to help move the fluids back up out of the feet and into the general circulation. One thing for sure is that the skin has been stretched very tight due to the swelling and one has to be careful once the swelling goes down as it is now more fragile than before. In addition, I always wear booties in the house and even when I am on the commode chair.

    Have any of you folks who have had it had a recurrence? Is there anything you were told to do to prevent its recurrence?

    Thanks once again for the information.

  7. #7
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    I've had it 5 or 6 times over the last 15 or 16 years, and my doc gives me 10 500mg Keflex to keep on hand. As soon as I get redness with heat I take one and get in touch with him. I have 10 in case it happens on a weekend. I wear compression stockings every day, and seldom have a problem with edema, though the affected area does swell a bit.
    Don - Grad Student Emeritus
    T3 ASIA A 26 years post injury

  8. #8
    Senior Member ~Lin's Avatar
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    In my case I rush to get it looked at immediately, and draw a pen line around the red area on a daily basis to track the progression. The most recent time it started on a Friday night, I circled pen on Saturday, went in to an off hours walk in clinic Sunday, I'd been on antibiotics for uti when it started so they gave me different ones to take in addition, Wednesday I went to the er where I got another change of antibiotic and iv started, Thursday I was admitted when I returned to the er. The very first time it happened I didn't know what the big deal was, when I was sent to the er I kept repeating I'd been told to come because I felt it was a waste. Then was shocked at the seriousness of it all. It was a resistant infection that time as well so they started me off on iv vanco and I had multiple awful reactions, they didn't want to stop the iv drip and kept trying to give me other meds to get it under control for what felt like a lifetime. In my case the infections weren't even large patches of skin, small areas but grew rapidly and were unresponsive to multiple antibiotics. I see redness and warmth the size of a quarter and I'm circling it in pen to be safe.
    Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

    I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

  9. #9
    Cellulits can recur if the original antibiotic was not the right one, or the duration of treatment insufficient. It can become a very serious septicemia if not properly managed. In addition, "flesh eating bacteria" can cause a very specific type of cellulitis (necrotizing fasciatis) which can be life threatening and lead to major loss of tissue (such as amputations).

    In people with SCI and other paralyzing conditions (MS, etc.) we can't always identify the cause of the cellulitis. There may or may not be open wounds on the legs or even other parts of the body. Regardless, the cellulitis itself needs treatment.

    If your symptoms return, you need to go back to the ER if you cannot immediately get in to see you provider.

    (KLD)

  10. #10
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    Last year I had pretty much the same thing as you. My foot ankle and lower leg up to the knee... I also had a little redness in my inner thigh but the infection specialist Dr. said that was not the infection spreading. He said that you have a lymph node (or something) there that was draining the infection and the redness was from that.

    Like you, I didn't have any open wounds except for a small crack between my toes, so I assume that is where it started. Now I am paranoid about any little crack and I check between my toes every morning.

    I first went to my Dr. on a Saturday when it was just my foot and ankle and he gave me some oral antibiotics and said if it gets any worse to call him. The next day, it was all the way up to my shin so he said to go to the hospital. When I went to the hospital they started me out on vancomycin which didn't work. The redness was still getting worse. They tried a couple other antibiotics before they found one that started to work so I was in the hospital for about a week. I can't remember the name of the antibiotic... Then once they had the antibiotic that worked, they put in a pic line and let me go home and give myself the IV antibiotics for the next couple of weeks.

    Then the redness went away but for some reason my leg was still really swollen and the swelling wouldn't go down. So they sent me in to get an ultra sound and it turned out that I had a blood clot in my leg. So then I had the joy of injecting Heparin blood thinner into my own stomach. Then I was on Warfarin blood thinner pills for a while after that. You have to constantly go in for blood tests to make sure you are getting the correct dose.

    The whole experience has turned me in to a bit of a germaphobe. but luckily I have not had any recurrence yet.

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