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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Headache, Nausea, Sore Calf, Diagnosed As Cellulitis, Given Antibiotics. What Do You Think It Could Be?

I am a 55 year old generally healthy woman. I do not take any medication except I started taking estrogen/ progesterone in January for hot flashes. One month ago I ended up in the emergency room on vacation. My right calf , became hot, itchy, and very painful. I was put on a 2 hour IVof anitbiotics & pain medicine. The doctor wanted to admit me but I chose to be discharged & took the 2 antibiotics that he prescribed. I was dianosed as having cellulitis . He did take an ultrasound & ruled out a blood clot. I had been injured the week prior by my bicicle falling on the particular area but the skin did not break. I finished the 10 days of medicine & seemed fine. Sunday, exactly 30 days later I woke up with a head ache & a sore right calf again. I later felt nausea . The pain in my calf (lower this time than last) was excrutiating. I went & saw someone yesterday. They could not get me into the dr so I saw the PNA. She wrote a prescription for antibiotics & ordered blood work to compare to the bloodwork from a month ago & I go back on Monday. What do you think it could be?? Today it does not seem to be as bad as the last 2 days--I did not start my antibiotics until 1 hour ago? Nancy YYYY@YYYY
Wed, 18 Jun 2014
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General & Family Physician,  's  Response
Thank you for your question. At this stage the most important diagnosis to rule out is a blood clot in the deep veins of the leg. In the absence of fever and redness of the lower leg, cellulitis would be less likely. The fact that an ultrasound was negative previously does not rule out this diagnosis. Also, the fact that you are being treated with estrogens increases your risk for clots. if you were my patient I would start by sending you to have an urgent repeat ultrasound by an expert sonographer.
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Headache, Nausea, Sore Calf, Diagnosed As Cellulitis, Given Antibiotics. What Do You Think It Could Be?

Thank you for your question. At this stage the most important diagnosis to rule out is a blood clot in the deep veins of the leg. In the absence of fever and redness of the lower leg, cellulitis would be less likely. The fact that an ultrasound was negative previously does not rule out this diagnosis. Also, the fact that you are being treated with estrogens increases your risk for clots. if you were my patient I would start by sending you to have an urgent repeat ultrasound by an expert sonographer.