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Suggest Treatment For A Lesion On The Lower Part Of The Leg

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Posted on Tue, 12 Jul 2016
Question: My son had a intense skin reaction to potentially scabies or fire coral...not positive, but he developed a skin infection. He received bolus IV antibiotics in the ER and was released. after the lactacte test that was WNL. The ER physician said that he thinks the infection is just on the skin and not "septic" however, he has painful and stiff Iliopsoas bursitis and pain in his joints. Would this Would this be considered it has gone beyond the skin/cellulitis.
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Answered by Dr. Panagiotis Zografakis (1 hour later)
Brief Answer:
there are ways to test it

Detailed Answer:
Hello,

I suppose you're talking about a lesion on the lower part of the leg (somewhere on the shin)? There are ways to distinguish between infection and non-infectious causes.
Fever is a prominent sign of infectious cellulitis (or erysipelas).
The skin is also tight and shiny and you usually can distinguish clearly the margins between healthy and infected tissue.
The patient is feeling ill.
The white blood cells count is high and there are a lot of polymorphonuclear cells.
The C-reactive protein is high and keeps rising if the infection is left untreated.

A low C-reactive protein and low white blood cells count with the absence of fever almost completely exclude the possibility of infectious origin. Please note the word "almost".

Keflex sounds like a good choice for a mild case of cellulitis, so the doctor got that covered as well. Benadryl is an antihistamine to help with allergies (if this is an allergic reaction).

The symptoms you've mentioned are not specific enough to evaluate. Joints pain usually accompanies systemic reactions, so this is a bit worrisome but the findings I've mentioned in the first part of my answer are more important.

I hope it helps!
Kind Regards!
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3809 Questions

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Suggest Treatment For A Lesion On The Lower Part Of The Leg

Brief Answer: there are ways to test it Detailed Answer: Hello, I suppose you're talking about a lesion on the lower part of the leg (somewhere on the shin)? There are ways to distinguish between infection and non-infectious causes. Fever is a prominent sign of infectious cellulitis (or erysipelas). The skin is also tight and shiny and you usually can distinguish clearly the margins between healthy and infected tissue. The patient is feeling ill. The white blood cells count is high and there are a lot of polymorphonuclear cells. The C-reactive protein is high and keeps rising if the infection is left untreated. A low C-reactive protein and low white blood cells count with the absence of fever almost completely exclude the possibility of infectious origin. Please note the word "almost". Keflex sounds like a good choice for a mild case of cellulitis, so the doctor got that covered as well. Benadryl is an antihistamine to help with allergies (if this is an allergic reaction). The symptoms you've mentioned are not specific enough to evaluate. Joints pain usually accompanies systemic reactions, so this is a bit worrisome but the findings I've mentioned in the first part of my answer are more important. I hope it helps! Kind Regards!