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Dr. Andrew Rynne

Family Physician

Exp 50 years

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On behalf of my mother who is 56 and morbid

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Dr. Hari Charan Perigela

General Surgeon

Practicing since :1995

Answered : 2307 Questions

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Posted on Sat, 26 Jan 2019 in Lump
Question: On behalf of my mother who is 56 and morbid obese. She has for the last few months had swelling in one foot and shortness of breath. I encouraged her to see a cardiologist as numerous water pills and antibiotics were not improving the shortness of breath. I was concerned it was possibly the beginning of congestive heart failure. After an echo and bloodwork the cardiologist said her heart is fine but she does have lymphedema.

Fast forward a month and she continues to have swelling in one foot. On top of that she is using dozens of bandages a day trying to contain leaky fluids. She says her skin is either in pain (stinging) or itches uncontrollably. The fluid is clear and she continues to receive antibiotics and multiple water pills from the family doctor. The shortness of breath continues and the leg has not progressed very far.

I am attaching a picture of its current status. What direction should I be pushing her in order to see a specialist. Is this a skin issue? A lymphatic issue? Obesity issue? How does lymphedema just spontaneously occur in someone who has not had it prior. Anyway - just trying to figure out next steps. At what point does this become something where you go to the hospital when you have shortness of breath, etc.

Thank you.
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Answered by Dr. Hari Charan Perigela 26 minutes later
Brief Answer:
It looks like Cellulitis of the Leg

Detailed Answer:
Hi
I saw the picture.
It looks like Cellulitis,i.e.infection of skin and subcutaneous tissue.In pure lymphedema,there will be simple swelling of a leg.The leg will not become red.Redness is due to Infection and Inflammation.
Colour Doppler of the Lowerlimb will give the correct diagnosis and Deep vein thrombosis should also be excluded.
Appropriate Antibiotic should be used.I prescribe Antibiotic like Linezolid 600mg twice daily to my patients with similar complaints.If there is no response,I use Vancomycin injection.
If your mother develops Fever, breathlessness etc she should be taken to hospital immediately.
Even now,please take her to a General Surgeon and get appropriate prescription.
Hope I answered your query.If you have any questions,I will clarify further.
Wish her speedy recovery.
Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj
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