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Bug culture and sensitivity,cellulitis - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Bones, Muscles and Joints
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3632 Questions
User :   Hi Doctor - I am currently in hospital and very worried - I will type out everything for you to read.
38yr old XXX XXX Male 103kg 190cms tall
I have had some unsolved health issues over the last 4 years however these most recent events have me very worried.
6 days ago Iwent to get some fluid drained from a Bursa on my elbow (it had been there for 12 months - but wasnt worrying me)
They did a needle aspiration guided by ultrasound - by that evening the bursa was larger than before the procedure
the next day it swelled like an agg on the end of my elbow - i saw my GP and he said it was just a reaction - no infection
The fluid they originally extracted showed no signs of infection.
4 days ago it started to go very red and swell more and a red colour forward from the elbow and up towards the armpit
it was pretty obvious it was an infection - I went to a public hospital 3 days ago and they were so terrible that I left after they took the blood tests
and went to a Private hospital were i was admitted and currently am - I was treated with one type of antibioticc then switched to Keflex -
or something like that becasue I had gotten diahorea - after 2 days it started to show signs of going from red to light pink but hadnt reduced much.
My forearm lost ALL swelling excet the bursa itself - I can push my fingers into the forearm and my flesh feels like it does not spring back.
A bit like it would be if you put your fingers in flour dough, indentations stay for a while.
TODAY i got a call from the public hospital that took my original bloods - they said that the culture had shown a nasty bug
and that i should get to emergency department immediately - however the name of the bug was not known as it was not fully cultured yet
I informed them that I am already in hospital - they said they wont know the bug name for a few days but they know
User :   the type and I gave them my
doctors number to call - my doctor is ver busy and could not remember the call and I am afraid my results will be sent to accident and emergency section
at the first public hospital - where I no longer am.
my concern is that my armpit lymph nodes are hurting and swollen and my arm is still light pink but my doctor wants to send me home tomorrow
When I asked the public hospital what the bug was they said they can only tell the doctor but if it was affecting me I would already be in intensive care
I am very afraid I will get taken off the current antibiotic drip that I have been on (every 6 hours) and sent home and I live by myself so I am worried
the doctor tried to drain the bursa today but I am pretty sure he missed it as I can still feel the fluid bubble and not muc came out in his needle.
I am concerned that a serious bug was introduced when they did the aspiration and it is deep in the bursa - I am also concerened that the final culture
information wont get to my doctor I am concerned that if I go off the antibiotics this serious bug might kick in and I worry if my arm has pitting
adema or has some affected flesh underneath?
Doctor :   Hi
Doctor :   I am Dr.XXX
Doctor :   Let me read the query
User :   Hello - sorry for all the detail
Doctor :   Please give me some time to read it
User :   no problem
User :   still reading?
Doctor :   YEs
User :   k
Doctor :   I read it
Doctor :   As per your description I feel that you might hve something like arm cellulitis
Doctor :   with enlarged lymph nodes
Doctor :   at the arm pit
Doctor :   Did your doctor say you about the diagnosis?
User :   celulitis - but ZI worry about what the culture found in the blood
Doctor :   Ok let me explain you
User :   I went to two hospitals, first one did blood culture and only called me now to say serious bug
Doctor :   why you should not worry
User :   ok
User :   explain
User :   to em
Doctor :   Any region has protocol measures to treat the most common bugs ( same would be in XXX as its health system is far better)
Doctor :   So now your doctor at private or any doctor at Govt hospital would follow the same protocol to treat the infection
Doctor :   Whether it is serious or benign bug
Doctor :   This is called empirical therapy
Doctor :   which goes for sometime till they culture and find the sensitivity of the bud
Doctor :   bug
Doctor :   Did you understand
User :   I understand that my concern is - my private doctor wants to stop treatment tomorrow - now the reason I am concerned is the bug type is only partly sensitive to my current antibiotics and i am concerned he cellutlitis is not the same bug -
Doctor :   I shall tell you how can you approach this situation
Doctor :   First of all your doctor cannot leave you without any medicine
User :   the private doctor told me it was impossible to have this serious bug tpe because the antibiotics i am on are mostly resistat and i would be getting sicker not better
Doctor :   Since there is an improvement on Injectible antibiotics
Doctor :   clinically
Doctor :   Leave about the serious bug
Doctor :   he feels that his treatment improved
Doctor :   you also know that
User :   yes
Doctor :   The culture and sensitivity has less importance than the clinical symptoms
Doctor :   You understand that?
User :   but what about the serious bug they found in my blood
User :   yes I understand the current antibiotics are working slowly
Doctor :   The doctor now can discharge you and put you on oral medicines rather than injectibles because you cannot get injectibles at home
Doctor :   as you are alone
User :   yes I understand this...
Doctor :   Now you can do one more thing here
Doctor :   You can request your treating doctor to extend your stay by one day
Doctor :   He should be able to do it on request
User :   my concern is - the bug I got phoned about - could be being stalled becasue of current antibiotics, but if it is resistant to these antibiotics as he says -- then I am afraid the serious bug will kick in after the cellulitis is gone
User :   good idea, I will ask too know what the finall culture is and ask if I can stay until that time to make sure i am on the right antibiotics
Doctor :   yes
Doctor :   One more thing here
User :   one last thing though...when they aspirated the bursa - they hit something
User :   oh sorry i wait for you for last question
Doctor :   Your doctor can discharge you because he has to weigh the benefits of hospital stay and discharge and decide on
Doctor :   Because hospitalization can also cause nosocomial infections
Doctor :   which will delay the healing sometimes
User :   ok that makes sense
Doctor :   The other way to think about is, you retain the cannula and come every day for your antibiotics
Doctor :   injections
Doctor :   By this way your doctor is also in touch with you
User :   one last qtn - the first aspiration, needle hit something, it was so very painful - i had another aspiration tonight but it was nothig like that - is it possible that what they hit in my bursa could be bleeding rather than an actual infection? Doctors here only come in once a day to see you at hospital, antibiotics would be given by a nurse - even if IV
User :   can bleeding cause your arm to go red - or would it more like bruise en from that deep
User :   and how long is it normal not to poo for, I havent moved my bowels for 2 days since the diahorea
Doctor :   3 days is the answer for your last one
User :   ok cool - thanks doc -- is there any way I can make sure that the final culture results get not sent to the wrong place
Doctor :   The swelling if it is cellulitis is because of infection
Doctor :   The bleeding may not cause redness to the entire hand
Doctor :   or forearm
Doctor :   Now I am not sure about the processes followed in your country.
Doctor :   But you can leave your address at the admin of the govt hospital to send the results
Doctor :   and also leave a copy at the help desk of your private hospital
Doctor :   or secretary of your treating doctor
User :   ok thanks for everything....
Doctor :   So take the number or contact of the secretary
Doctor :   of your doctor and leave it at the Govt hospital help desk
Doctor :   Is there anything else I can help you with?
User :   nope...I wold be interested to know though....can a bug lay dorment - and can a bug cause chest pain when breathing in and difficulty breathing when at rest
Doctor :   If the bug is actively proliferating it can cause muscle soreness of the entire body
Doctor :   and during the respiration this can manifest as chest pain
Doctor :   That ends our chat
Doctor :   Thanks you
User :   thanks bye
Doctor :   Bye for now
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