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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For An Ulcer In Big Toe.

I am a type II diabetic. I have a small ulcer in my left big toe. I have dealt with an infection in it since before December 2013. I have been seeing a pediatrist and PCP. I have been treated multiple times for the infection. It gets better and seems to be gone and within a few days of not taking anti biotics it is back. They continue to prescribe me strong bactrim and kephlex. it moved into the top of my foot and just above my ankle as celluitis in mid January. Again 20 day round of strong anti biotics. Seemed to be doing well for awhile. In March it came back with a vengence! My fever spiked to 103.7. I went to the ER; however, at the time I was in the ER there was no physical sign of infection. We did not know the celluitis was back. they completed blood work and stated I had an infection and sent me home with two seperate anitbiotics. This was on a Friday; Monday afternoon my leg appeared worst and my fever returned. I went to my pcp and they told me to continue my prescriptions and gave me another 10 days of bactrim. Seven days into that prescription my leg flared again and again fever. I have seen my pediatrist since and have been taking yet another round of kephlex. I finished it last night and I am still experiencing tenderness in the affected area but not red and swollen like it was. Now it seems as though there is a hard flat lump in my shin in the area of the infected area. My skin is tender to the touch but the lump itself does not seem to be. I am very frustrated with the entire process. Any suggestions?
Sat, 26 Apr 2014
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Diabetologist 's  Response
Dear sir

As per the query you are suffering from infected diabetic foot ulcer.

There are three fundamental aspects in treating foot ulcers . Site and position . Infection and grading of ulcer.

According to these criteria there are so many treatment protocols
1. Treated the infection with appropriate antibiotics and if associated with edema then it should be treated with tryin and chymotrypsin.
2. Mechanical offloading using footwear
3. If not getting healed with the treatment then total contact pop cast should be applied

Thanks
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Suggest Treatment For An Ulcer In Big Toe.

Dear sir As per the query you are suffering from infected diabetic foot ulcer. There are three fundamental aspects in treating foot ulcers . Site and position . Infection and grading of ulcer. According to these criteria there are so many treatment protocols 1. Treated the infection with appropriate antibiotics and if associated with edema then it should be treated with tryin and chymotrypsin. 2. Mechanical offloading using footwear 3. If not getting healed with the treatment then total contact pop cast should be applied Thanks