I have now required antibiotics for cellulitis 4 or 5 times since the actual infection (from a fall down some steps) last year. Because of my diabetes and worrying that it would get into my bone, they admitted me and did IV antibiotics. The spot was never large (less than an inch) and never very red…but, definitely infected. I was told that I had great circulation and my blood sugars are also great…started to wonder when my Vit D levels came back really low. Have added supplements and taking good care of the area…so, not certain what my risk factors really are?? Anyone experience this…what did your doctor do. Mine just keeps waiting for me to say the area “feels funny” and then starts me on antibiotics for 8-11days. Gets better, but never feels really gone and then I go about 1-2 months and require the same thing again!! Any insights would be helpful.
Has your doctor cultured the infection? Can be hit & miss with antibiotics to find the right one if your doc doesn’t know exactly what it is.
Interesting, thanks. Do you know how long someone would have to be off antibiotics for a culture?
Thanks, Dave. I think you are right. I read a protocol that said different meds for initial treatment and others as 2 and 3rd line drugs. They recommend long term (up to a year) of low dose penicillin for those who have had more than 2 re-occurrences. The longest I was on meds was 2 weeks and then we just wait for it to start that tell tale stinging feeling. Mind you, it is not red or inflamed like the first infection…but, I am scared to death that something is there…right above my tibia!
Yes…they did, but it was 5 days into IV antibiotics so it grew out nothing…was sterile by that point. So…no idea what the original organism was. Good news was that it responded to drugs that suggested it was not a resistant bug…an Amoxicillin + = Augmentin seems to knock it back…just doesn’t work very fast and doesn’t seem to get it all…meaning, stinging comes back in about 1 week and noticeable enough to get me to call the doc shortly after that.
I also think it is real hard to get positive cultures…punch biopsy is about the most accurate and that would open you up to more infection. Antibiotics on board definitely decrease the chance of an accurate diagnosis. The sample they sent to the lab on me from the wound while I was in the hospital…grew nothing…was sterile already. I am thinking it was one of the likely bugs like Staph or Strep. The original wound was due to falling/scraping my shin on an old cellar step! yes, worst situation…bugs on that step were in a dark, wet environment. They chose to give me some antibiotic tonic IV that should have taken out just about anything…I just think I did not get the right oral f/u meds and for long enough.
Good question…do not know. I suspect they would never hold antibiotics if you still had an active wound…they just keep trying different meds. Good thing I have never required antibiotics before…should not have resistant bugs on my body. Although…makes one wonder about the use of antibiotics in our food and antibiotic washes, etc. Maybe I do have resistant bugs living on my shins! I remember a story about a pig farmer who fed antibiotic laden food to his hogs and then got bit by one…terrible course given the bugs living in the pig’s mouths were antibiotic resistant! He almost lost his life…and I think he did lose his leg…and he was middle aged and non-diabetic. Our population would just be that more at risk in the same situations. We try to eat all organic, from our farm…but, still by some vegetables, dairy and meat. The other major risk factor for reoccurant cellulitis in the legs is lympodema and edema…both of which I do not have. It has made me much more aware of the importance of exercise…walking and keeping the weight down.
Maybe you need to culture that step:)
Hope you find the right med!
Ask the doc about an IV antibiotic, it may require going in to the hospital for a few days, but if the infection is reoccurring, it is often the only way to get it. In many way bring out the big guns, is not a bad idea, so it can be gotten before it mutates into somehting nothing can get rid of.
Thanks Judith for your thoughts. I will have to look at topicals. I did make the decision after the first course to start taking immune enhancing supplements…thinking something must be up that I could not fight the infection reoccurring. I think the first time it came back was at about 6-8months. That was when we checked my blood values and saw the low Vit D levels…my endo recommended supplementation daily (articles say w/ diabetes…about 5g/d). The plastics doc who opened the wound in the hospital, and has done f/u on the other infections…recommended I even use HibaClens wash on my legs…same idea, decrease bacteria on my skin. I was a little reluctant to kill off all the bacteria on my skin…so, I have not taken that suggestion…maybe Tea Tree or one of the others may be less broad spectrum in nature. Docs logic was I must be colonized w/ something and it was gaining access through minor cracks in my skin…w/ dry skin. I already use almond oil daily on my legs and feet. I will check what I can find about some of these other natural antibacterials. Hope you are doing well…my friend:)
yes…I may need to do this. Thanks for your thoughts Rick. I am going to talk w/ my docs office tomorrow and see what they think…maybe a different antibiotic…longer course of treatment…and definitely check an x-ray to be sure it is not in my bone given where it is. Maybe they need to do more definitive tests to be sure I have good perfusion to that leg?? Something is wrong…need to get this resolved. Evidently, the more times it gets reinfected…the more tissue damage is done that makes it more likely you will have a problem later.
Yup! Recurrent infections is our bane. I have had cellulitis several times. Now I have an infection in the bone of my left foot. Could lead to amputation and/or …
Always take care of your infections because diabetics are more prone to them and they hit us harder. Loss of a limb and/or life are extreme consequences, but risky nonetheless. Your DR knows you and your body. I would listen to them both. If it isn’t an infection, then it can be taken care of easily. The infection in my foot now is packed with gentamycin pearls right now. It has to be replaced once a week. Good thing that I don’t have to go on pills or end up in the hospital (yet!).
Lois La Rose
Great suggestions from Judith about tea tree oil & grapefruit seed extract. I’ve used both for myself & my animals & they’re effective. Tea tree oil can cause some peeling of the skin, which in some cases is good. I use tea tree oil full strength, but I don’t have sensitive skin. Mixing it with almond oil would be good to know if it’s too strong for you.
Hello Lois:) good to know you are doing well. I hope you are on you way to recovery. How did your infection start? Mine was a fall…but, the spot was such a silly little scratch! I was more worried I broke my arm! It was only 3 or so days later and my leg started hurting and stinging. It got really red, hot…all the classic signs. Being paranoid and formerly working as in a hospital…I rushed to the ER. Seemed like it should have cleared up…but, it did not and required IV antibiotics in the hospital. I thought when I got out of the hospital it was over…but, it has continued to try to come back…not as bad as originally…but, simmering like. Seems about 30% of cellulitis cases reoccur and often multiple times. It is also driving me crazy w/ worry. I will be ok though:) My hope is that the docs look out for me and fully work up any and every option so that it does not get worse or enter the bone. Again, thanks for your insights and good wishes to you as you are on the mend as well:)
I used to be a nurse and it seems that they usually wait 48-72 hours off an Antibiotic to do a new culture. They should be doing blood cultures as well, since it seems critical to find the correct antibiotic for you. You definitely need a more educated doctor because symptoms like " the area feeling funny" are very vague and don’t tell you to watch for redness, swelling, pain, warmth, fever, etc.
Thanks for your response, Kathleen. They did mention all the other things to look for…and it has swollen a few times…but, may be due to lymphodema from original infection. My understanding is that tissue damage occurs when you have an infection and that can limit good circulation in the area of the original infection. Once it is inflammed (warm) is usually time to call the doc…I have never had a high fever w/ even the original infection that put me in the hospital. So…it is atypical…yet something is always going on and if I let it go…I have to start antibiotics. My goal is to prevent the frank infection and risk of worse infection. I am still thinking I qualify for a low dose, long term antibiotic and plan on discussing w/ my doc (endo) this coming week at my visit. At a minimum it should be x-rayed. Maybe what is happening is not an infection…but, need to know what it is. I will come back and let you guys know, if it is of interest, what transpires this coming week. Thanks again for everyone’s responses. Much appreciated. PS: Judith and Gerri, I did make a almond oil/Tea Tree oil to rub on my legs…pretty benign amounts of Tea Tree (looked up recipe in very helpful book: Earthly Bodies by Dina Falconi…recipe for kids so very gentle…4oz oil and 8 drops Tea Tree). I like that it is antibacteristatic and antifungal and not an antibiotic. Interesting side note, is that oils are absorbed into the skin…it may penetrate the tissue which is hard for oral antibiotics to do. Let’s hope:) Take care all.
It is a wonderful little book. I use the recipes for shampoo, deodorant, tooth powders, etc. She has recipes for body, bath, hair, kids, mouth care, etc…even first aid…should have looked here earlier:) I switched to all natural deodorant about a year ago. Using tea tree and witch hazel deodorant works great for me:) and no aluminum. Be well my friend, and have a great holiday w/ family and friends!
Just a quick update. My doc canceled my Dec appointment and I have to wait until January 24th:) In the interim I made up some tea tree/almond oil rub that I am using on both legs to minimize dry skin…and hopefully minimize risk for infections. I have no tingling feeling and leg looks good. Just to re-cap…no active infection, just odd feeling in leg…and that is gone. I am still going to discuss w/ doc and have them x-ray it.