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Have fever, swollen leg and fast heart rate. On linezolid. Any suggestion?

Dec 2012
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Answered by

General & Family Physician
Practicing since : 2012
Answered : 1694 Questions
My mother is having fever and her heart rate shows as 120. Her legs are swollen and right leg was operated a year back. both the legs are hot and red in colour.Attached the discharge summary. As of now, as it is night i have given linezolid 600 mg. Please reveiw as early as possible.
Posted Wed, 27 Mar 2013 in General Health
Answered by Dr. Nsah Bernard 27 minutes later

Thank you for posting on XXXXXXX

Your mother is obviously presenting with an infection (with systemic inflammatory response syndrome-SIRS) and given her past medical history of cellulitis, lymphangitis and fasciotomy, it is very possible that she is going through a repeated episode of the cellulitis and very rarely it could be bilateral XXXXXXX venous thrombosis (very rare because DVT hardly occurs bilaterally).
Let me go straight on what you have to do now. First giving the antibiotics was well thought of (as it is an infection), but should not have been done by you, because of fear of resistance. linezolid 600 mg is an antibiotics mostly used in case of antibiotics resistance and so if antibiotics get to be limited for your mother, she will be in trouble.
Since you have started, allow the next dose for doctors to decide.
The next thing to do right now at home is get some cool towels or wet cloths and place on her leg (change as needed), give her pain killers (specifically antiinflammatory such as diclofenac or ibuprofen or aceclofenac or piroxicam etc i.e any NSAID you can get at your disposal right now will be useful, ice packs will be good etc.
Then get her to the nearest ER or hospitals for emergency management.
Sudden onset red hot swollen painful leg is an emergency and if night is your worry, you better get her moving towards the nearest hospital (complications are far worst to treat than her present situation).

Hope this helps and please feel free to right back.
P.S I have gone through some of the few attachments and decided to message you fast so you can do something quickly, I will go through the rest of the attachments in case you come back for further assistance.

Thank you
Dr Nsah
Above answer was peer-reviewed by
Follow-up: Have fever, swollen leg and fast heart rate. On linezolid. Any suggestion? 15 minutes later
Thanks doctor for your earliest reply. I was awaiting for the response. I have given fever tablet "NIMUCET" for reducing the fever. Now it is 101 degree.Near the operated area , she is getting a water kind of liquid discharging. Will take her to hospital but only first aid would be available as emergency patient. Need to wait for her doctor till noon.

Please let me know how to reduce her heart beat rate below 100. it is now 115-119 fluctuating. SPO2 levels shows as 82. BP is 149/81 and sugar is 129.

I would wait for your reply , till then will be putting pad to her leg.

Also please explain me what it means "bilateral XXXXXXX venous thrombosis (very rare because DVT hardly occurs bilaterally). "
Answered by Dr. Nsah Bernard 26 minutes later

Do not worry about the increased heart rate, it is simply reactional due to the fever. It is an automatic response of the heart when there is an increased temperature. They are hemodynamic parameters that always move together as a compensatory mechanism. So control the fever and the heart rate or pulse will gradually stabilize.
To answer your question, Bilateral DVT is when one of the veins of the lower limbs is blocked or obstructed by a thrombus or blood clot or foreign body and causes swelling and pain of the affected leg. So my statement was that I do not think it is DVT as it can hardly occur in two legs at ones (bilateral).
There is a need for her to see a doctor soon. If you can get her to the ER that will also be helpful.

Hope this helps
Dr Nsah
Above answer was peer-reviewed by
Follow-up: Have fever, swollen leg and fast heart rate. On linezolid. Any suggestion? 28 hours later
Hello Doctor

After your suggestion, we have admitted her to hospital and the TLC count is found to 0000 with fever of 101. So doctor is giving the antibiotic ceftum and metrogyl. But he insists to go for decompression surgery. I would like to know , without the surgery cant they bring down the infection ?

Is surgery a must and should. Doctor is not giving clear picture and havent met the attendent nor the patient. But willing to go for surgery. Please advise , cant it be controlled with medicine?
Answered by Dr. Nsah Bernard 6 hours later

Thanks for updating,

If she is effectively suffering from cellulitis then surgery could be done as a second option. Her infection could be controlled with antibiotics and analgesic + antiinflammatory. A good dose of antibiotics already in place can treat the infection without the need of a surgery. My suggestion is that you ask for the surgeon's opinion about the matter and let him allow you to choose the best option available for treating your mother. I believe as a patient and you as a carer for your mother, you have the right to choose amongst the various treatment options.

Wish you the best and let me know if you have any more questions.
Dr Nsah
Above answer was peer-reviewed by
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