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Treatment for 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 : 2009
Answered : 675 Questions
User :   Hi
User :   Hello, there...
User :   Yesterday, I also went online and a different doctor responded to me.
User :   Are you also a general practitioner?
User :   Yes I am a General Practitioner
User :   Please go ahead with your query
User :   Yesterday, I talked with in this chat and he diagnosed my dad with Cellulitis. I took pictures of his foot yesterday and today. I would like to know if it looks better than yesterday.
User :   He's had complaints of itchiness on his right foot
User :   actually it has been swelling as of late
User :   but two days ago, it was really swollen and my dad had to go to have a doctor see it
User :   Ok
User :   He was given antibiotics and ointments
User :   but last night it looked bad
User :   Ok
User :   I was advised that if his foot does not get better, he should go to the hospitalized and have medications introduced intravenously.
User :   I have just gone through both the images
User :   have you received them?
User :   does the swelling look better today?
User :   yes
User :   So it looks better today
User :   But still I feel that IV antibiotics are the best way to treat at this time
User :   He certainly needs them
User :   You think he really needs IV antibiotics in contrast to the ones taken orally?
User :   It just needs a week of injections
User :   Yes
User :   We're in the Philippines right now.
User :   I would treat in that way and make the person more comfortable before complications set in
User :   And the dermatologists are on some convention today
User :   There are ooze points which is more prone for infections
User :   I suggest a General Surgeon handle it than a Dermatologist
User :   So you suggest that a General Surgeon introduce the IV medications and the draining?
User :   yes
User :   Tomorrow he has a business trip at the beach
User :   Could this wait at least 4 more days?
User :   A suggestion from the local Infectious disease specialist about the antibiotics can help too
User :   That would be his next appointment to the doctor
User :   I suggest an early treatment for better recovery
User :   Well, he's leaving for a business trip which is about 155 miles away from where we live.
User :   And there's not much medical facilities there.
User :   Ok it is his choice
User :   Till then he can continue on the oral antibiotics
User :   and then come back
User :   What are the possibilities if he continues with the oral meds with the IV treatment for the next four days.
User :   The morbidity is reduced by 60% if he hospitalizes and gets IV antibiotics
User :   Because he tells me that he could not get a doctor for the next two days
User :   The recovery can be within 10 days
User :   Is cellulitis a common ailment?
User :   No actually it results as a complication
User :   What are the causes of cellulitis? I was told the causative agent of cellulitis is Staph
User :   to some minor injury
User :   Well it all began we kept on scratching his leg
User :   I mean, he kept on scratching his leg
User :   Yes
User :   That can lead to bacterial infection
User :   and it spreads to the skin and sub cutaneous area
User :   But what caused the scratching was an insect bite.
User :   Insect bite can cause a break in the continuity of the protective skin
User :   and bacteria can go inside and cause damage
User :   Here's a list of his meds
User :   Yes
User :   Co-amoxiclav, clatidyne and clobetasol ointment
User :   He was given 1 gm of Augmentin (Co-amoxiclav) for twice daily and once daily for clatidyne
User :   Ok
User :   Same Augmentin if given IV
User :   So, to confirm, nothing adverse would happen for the next three-four days for as long as he takes his oral medications until he
User :   medications
User :   ge
User :   through IV
User :   It is better than taking nothing at all
User :   He should make sure that he does not get injured on the same leg
User :   Make sure he takes the medicines at the same time
User :   Proper diet
User :   what should he avoid eating?
User :   Nothing
User :   He is also asking if he's allergic to clobetasol ointment 10 grams
User :   If so he should stop using it
User :   and take a replacement of it
User :   Because yesterday just like the image on the right, it looks as if it's swollen. BUt today since he did not apply that, it looked better he says.
User :   What is your suggestion?
User :   Ok
User :   What should he apply instead?
User :   I suggest to discontinue it
User :   and see for a day
User :   or two
User :   What should be an appropriate replacement for clobetasol?
User :   I think he should ask his doctor itself
User :   Since he is not available
User :   He should just stop and continue on the oral antibiotics
User :   My best suggestion for him is
User :   Oh I see
User :   1) IV antibiotics
User :   2) Local cleaning with antiseptics
User :   3) Septic environment
User :   Would Agua oxigenada be okay as an antiseptic?
User :   I guess it is hydrogen peroxide
User :   Oh that's it!
User :   Should we leave the wounds open? Or should we keep it closed?
User :   Yes it is good antiseptic
User :   There are different opinions on this by different surgeons
User :   So we could do the cleaning at home?
User :   I prefer to open it and clean it daily
User :   Make his room a septic room
User :   with vaccum cleaning
User :   No one enters
User :   what if the scar tissue peels?
User :   Make sure whoever enters washes hands and legs with DETTOL
User :   Are the wounds infectious?
User :   Yes
User :   You mean it's contagious?
User :   My mom sleeps beside him
User :   I suggest not to do it
User :   Oh by the way, he used to suffer from boils. He had a cluster of them
User :   Can she use the same toilet with him?
User :   yes
User :   They use the same shower. BUt my mom has her own towels though
User :   Change his clothes once a day
User :   Would the boils have a connection with his cellulitis now?
User :   yes
User :   He changes his clothes once a day
User :   Good
User :   He likes using slippers all the time, my mom asks if the infection has something to do with that
User :   No problem
User :   He can continue the slippers
User :   Is there anything else I can help you?
User :   Hold mom has queries
User :   She's asking if the handwashing applies to the immediate members of the family when coming into his office and room
User :   yes
User :   everyone
User :   My mom is asking an explanation why we should do the handwashing.
User :   Hand washing prevents lot of germs contacting and increasing the infection
User :   So the next time he gets an insect bite, what do you suggest should he apply to the bite?
User :   Aspirin
User :   on the bite
User :   aspirin, as in the pill?
User :   Yes
User :   Make it into paste
User :   and rub over the bite
User :   So, should we pulverize the pill and apply water on it?
User :   Would the application of Listerine be okay?
User :   Yes
User :   What about Listerine?
User :   It is also fine
User :   It is alcohol based hence should act as antiseptic killing the bacteria and germs
User :   AAAAAAA are you there?
User :   Would it also be okay if we apply it on an itchy scalp
User :   Aspirin?
User :   Yes I am here
User :   or Listerine?
User :   THe Listerine, would it be okay for the itchy scalp?
User :   No
User :   Antihistamine
User :   is good
User :   ohhh
User :   the oral antihistamine?
User :   should we pulverize it too?
User :   yes
User :   take it oral
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