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Suggest Treatment For Swollen Foot After A Bug Bite

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Posted on Thu, 3 Apr 2014
Question: Hi Doctor, I am in Costa Rica right now and last Friday, it appears that some bug bit me on the foot. The foot went twice in size and I had a fewer threw up a couple of time and the foot was very painful and hot. Initially I thought it was dengue as it looked almost exactly as it was 3 years ago when I had dengue. Next morning the fewer was gone, but the foot was the same. On Monday I went to see a local doctor and she prescribed me some antihistamine, antibiotics and some powder for compresses. I have been taking medication for the last 4 days, but it appears that there is no change in the condition. I am 55 yo male. Had an aortic valve replacement operation in 1999 and take 8 mg of warfarin, 20 mg of Bisoprolol, and 40 mg of atorvastatin daily. We flew from London, UK to Costa Rica on March 2, 2014.
doctor
Answered by Dr. Dr. Kakkar (1 hour later)
Brief Answer: Cellulitis of the foot Detailed Answer: Hello and welcome to healthcaremagic. I am Dr. kakkar. I have gone through your query and I have understood it. From your description it appears to me as a case of Cellulitis which is bacterial infection of the skin as well as the subcutaneous tissue, that is under the skin. Fever accompanied by pain and swelling of only one foot also suggest that it is cellulitis. Infection might have got introduced through a cut or unnoticed trauma/break in the skin. If I was your treating doctor I would have started you on empirical antibiotics covering most likely bacterial i.e staphylococcus, streptococcus as well as anaerobic bacteria. You should get a lab bllod test for cbc , wbc and ESR. -I would like to know from you the antibiotics that you are currently on? My Ideal choice of empirical oral antibiotics would have been Cefixime in combination with cloxacillin(Gram +ve and Gram -ve bacteria). I would have also started you on oral metronidazole to cover anaerobes. Once on antibiotics the cellulitis should improve in 3-5 days. Getting admitted at a hospital would allow your doctor to administer IV antibiotics, which would be obviously rapidly effective than oral antibiotics. I would have also started you on oral antiinflammatory/pain killers like either diclofenac or ibuprofen along with serratiopeptidase to decrease the pain and swelling. regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Dr. Kakkar (16 hours later)
Hi Doctor, The meds prescribed by the local doctor are as follows:- Avelox 400 mg daily Enantyum 25mg every 12 hrs Allegra 120 mg daily. It's the 5th day I am on antibiotics and though general condition somewhat improved but no visual improvements on teh condition of the foot.
doctor
Answered by Dr. Dr. Kakkar (27 minutes later)
Brief Answer: Cellulitis Detailed Answer: Hi. You are on the right kind of treatment for cellulitis. Avelox is Moxifloxacin which is good choice of drug in case of skin and soft tissue infections(SSTIs). It has broad spectrum of activity against Gram +ve Aerobes, Gram-ve Aerobes and Anaerobic bacteria. I would advice that you continue with it for a total of 7-14 days at this dose (it can be taken for a total 5-14 days depending on the condition). Enantyum 25mg is a pain killer and Allegra 120mg is an antiallergic. regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Kakkar

Dermatologist

Practicing since :2002

Answered : 9612 Questions

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Suggest Treatment For Swollen Foot After A Bug Bite

Brief Answer: Cellulitis of the foot Detailed Answer: Hello and welcome to healthcaremagic. I am Dr. kakkar. I have gone through your query and I have understood it. From your description it appears to me as a case of Cellulitis which is bacterial infection of the skin as well as the subcutaneous tissue, that is under the skin. Fever accompanied by pain and swelling of only one foot also suggest that it is cellulitis. Infection might have got introduced through a cut or unnoticed trauma/break in the skin. If I was your treating doctor I would have started you on empirical antibiotics covering most likely bacterial i.e staphylococcus, streptococcus as well as anaerobic bacteria. You should get a lab bllod test for cbc , wbc and ESR. -I would like to know from you the antibiotics that you are currently on? My Ideal choice of empirical oral antibiotics would have been Cefixime in combination with cloxacillin(Gram +ve and Gram -ve bacteria). I would have also started you on oral metronidazole to cover anaerobes. Once on antibiotics the cellulitis should improve in 3-5 days. Getting admitted at a hospital would allow your doctor to administer IV antibiotics, which would be obviously rapidly effective than oral antibiotics. I would have also started you on oral antiinflammatory/pain killers like either diclofenac or ibuprofen along with serratiopeptidase to decrease the pain and swelling. regards