Cellulitis in the leg

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nootka

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Hi!

A few weeks ago I posted about my friend and associate, Bill, who came down with an infected leg from a small wound in his shin. It was complicated by cellulitis. He came home from the hospital after very nearly losing his leg (the infection was a streptococcus bacteria). He's been in bed almost exclusively although his wife and I have been encouraging him to get up and around a bit more. When he does, though, the lower leg turns very dusky purple again almost like when it was not responding to the antibiotics. He didn't have any surgery on it and it looks to me to be healing well (his doctor is also very pleased), but I wonder if any one else here might have experienced a similar situation and what your recovery time was, were you encouraged or discouraged from walking around by your physician and what you experienced as you recovered....he goes back May 1 to see his doctor and we're all getting together a list of questions for that next visit...

Thanks in advance!

Liz
 
I've had it and tried a lot of different things and complications led to a not so great (at the time) outcome. However, one of the issues was that by not using the leg the lymphatic system backs up. The normal walking keeps everything circulating. I remember there was a time that they were putting my leg in a "boot" that compressed the leg to try to get a more normal balance of fluids. The duskiness occured with me because I was unable to use the foot at all. I spent so much time with it elevated that it hurt like crazy and felt like it was filling beyond capacity each time I set it down. Compression stockings helped a lot.

I spent weeks on IV antibiotics. There were some pretty rough patches. Tell your friend that he is in my prayers, and that I wish him a quick and full recovery. Also tell him that he needs to IMMEDIATELY get to the doctor if he reinjures that leg once it is healed. No waiting, no thinking it is no big deal. Cellulitis seems to be one of those things that seems to just sit "in wait" once it has reared its ugly head.

Nancy
 
Thanks, Nancy, for your experience. I'll add it to the concerns he will likely want to address with his doctor.

His leg is no longer swollen except in a patch around the original injury that is about a 4.5" diameter circle.

He does complain of "tightness" when he walks on it much, or stands. I thought maybe he should try to get up for a few minutes every couple of hours to try to get the leg re-accustomed to walking and standing.

Hard to believe this has taken down a person who usually stands for 8 hours or more during a day although not at one stretch, he often does for a few hours at a time while working.

Did you have any other complicating conditions if you don't mind me asking? So far, Bill has none, and they said his lymph glands never swelled up even though he had so much trouble getting rid of the Strep that brought it all on.

I bet he will be much more careful about any injury he gets in the future.

thank you again and I hope you never go through this again, it is awful....
 
I had it in my arm. Nasty stuff, 3-4 month recovery, horrible scar left after surgery and my arm is hollow inside now. Not to mention how disturbing it was to go through at only 17. They thought I had flesh eating bacteria. I was in isolation for a week and a half before they finally figured out it was cellulitis.

So I feel for your friend. Hopefully he will have a speedy recovery.

Nancy....so does that mean that I could get it again in the same arm or anywhere on my body??? I was never warned of this. I guess because they never knew what caused it in the first place besides getting the injections.
 
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I've had it twice, once on my lower leg, once on my upper thigh. Each time the doctor started off treating it with just antibiotics and it would get worse, then they would put me on a steroid (I forget which though, its been about two or three years since I had it) combined with my antibiotic and that would help a lot. Initially it was painful to walk, but it helped in the long run. The first time I had it in my lower leg I found that it was MUCH more comfortable to wear a slipper on that foot when walking, since the leg was swollen, if I put a shoe on it seemed to swell much worse.
 
It did kinda concern me that they didnt do surgery and remove some of the dead skin but I cant see it so maybe there wasnt any.

When my daughter had it they had to go in and cut it all out and then we had to clean it and pack it several times per day. She was on antibiotics for a month as the infection had gone to her blood stream. She was encouraged to walk and move around. I dont think laying in bed is probably good at all because even in the hosptial she was encouraged to get up and move.

Once she came home from the hospital it never turned colors or swelled. That is a bit worrisome.

Sending good thoughts!

Kay
 
First and foremost he should call his doctor and ASK!

I do think that walking should help, these days the docs have people up and walking as soon as possible because full bed rest is so bad for you.

I had it in my leg after knee replacement surgery, but we caught it fast and was on antibiotics every six hours around the clock and got rid of it. Bed rest was not on the plan, I kept on with my physical therapy twice a day as normal.

I asked my Ortho doc about recurrences, and it depends on the person. Some people have it in their systems waiting for the right moment to hit again. That is my roommate. He has it almost every year. This last time was terrible, he was laid up for weeks and the entire leg was infected and oozing. Turned into a staph infection. Since he has no health insurance, he never went into a hospital, so was on oral antibiotics at home. At first it got worse, that is when they figured out he was allergic to the medicine he was taking.

Other people never get it again, so don't get too paranoid about it.
 
Takes awhile, up to 6-8 weeks to get it out of the system. Walking, if it is in the leg, hurts, but necessary for healing. Also the doctor might need to prescribe a tension sock to help keep fluids balanced.

Take care!
 
Liz, the story of your friend's leg sounds much like what my step Dad went through several years ago. (within the last 10 years I am guessing) I am not sure it was Cellulitis, but sounds very similar to what he experienced. He (Jim) had bumped his leg at work ang got an injury, but nothing bad...I don't even think it bled or anything, just was an injury to the tissue in the leg. (bruising, pain etc. but not an open wound) Quite some time later it "broke open", and it spead from there. It was HORRIBLE! This went on for well over a year and it wouldn't heal. They tried dressings, elastic compression stockings, then some other sort of treatment finally worked. His leg was so terribly swollen he was on dieuretics for that, and also other meds for the leg. He had to have home care in every other day I think it was to change this thing. He was in pain, could hardly do anything as it hurt to walk and also could not wear shoes so was really tough in the winter!!

It would start healing, then it would start up again...he was hospitalized and we were really afraid of him losing his leg, and he was so depressed with it all, he had hoped they'd take it! The skin, even though had to be rubbed with special moisturizing lotions would thicken like leather then crack. It (the skin) could be peeled of in thick chunks!! It really was a LONG process, but he finally got it cleared up, but even still, has to be very careful to ensure he does not injure it so it all starts back up again! He's a had a few "close calls" since then!

[SIZE=14pt]I am posting photos below, but please be warned, they are GRAPHIC, and not for the weak of stomach, so if you cannot handle such things, DO NOT scroll down beyond here!!![/SIZE]

The forum or your computer may auto-shrink them, but I think you can click on it to see it full size.

jim_leg1.jpg


jim_leg1.jpg
 
Wow, Mona, that looks terrible! I do think it might have been cellulitis from the look of it and the look of other photos I've seen.

Bill's doctor said he thought surgery would have been wrong for him as it would have never healed right. It really does look tons better and they x-rayed the leg to see what was inside, said there was nothing there so I assume that is the part that would have been surgery-worthy if they had seen something inside?

Anyway, yes, he knows he needs to talk to his doctor, but somehow they seem reluctant to bother the doctor between visits. I have of course, not been to the doctor visits with he and his wife, so I have no idea, just thinking that since he is the patient he has the right to inquire on these things to set his mind at ease or to nip any possible complication in the bud as well as do the right thing for a swift and complete recovery. I am thinking Bill will never face this again, trying to think positively in that respect and I can't believe it is such a problem when it started out so small.

Witnessing something like this really makes one aware not to ignore these wounds and to clean and inspect them for improper healing!

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This should be a pic of it at its (almost) worst, after the blistering had opened up and just after he got home from the hospital. This is totally opposite from where the infection began, on the back of his leg.

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here is how it looked a few days ago, same area.

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This is the shin area with the circled original wounds (which look far worse now than they did when they happened on Apr. 3 or even the 7th when this all began).

Thanks again for the experiences you've all had. I believe each case is different, so he will be talking to his doctor about his experience and concerns.

Thanks also for your thoughts, well-wishes and prayers.

Liz
 
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OH MY! That looks sooo awful! It sure has healed nicely though! My Mom called awhile ago so I asked her what it was that Jim had and she said it is called (not sure of the spelling so am spelling it the way it sounds) Stasis Ulcers.
 
wow that shin looks exactly like my daughters before they operated. Im just so surprised they didnt open that up but I am for sure not a dr. I will say it took me taking her to two different ER rooms and 2 different doctors before she finally got the correct treatment. I knew something was not right and would not stop. She came within hours of losing her leg because she was misdiagnosed so many times. I will never forget the surgeon screaming at me about why I waited so long to have her treated and I screamed back how many hospitals and Drs we had seen during the last week and he apologized
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The back looks really good but the front does look like its still infected.

Sending more good thoughts

Kay
 
I'm glad you posted, Liz...I've been wondering how he's doing.

Let me second that he should check with his doctor; as you can see from the wide range of experiences listed here, everyone is different.

I had it two years in a row, once in each leg. By the second occurence, the first leg was still swollen and painful, but on its way to healing. It has taken over two years to have normal-looking legs and for the pain to entirely go away (no swelling or redness), but so far no recurrence.

They did no surgery on either leg; I sloughed off a good deal of dead tissue, but this was all on the surface, so that was perhaps the difference.

My leg was horribly swollen and fiery red, but I had no lesions -- just a couple of splits from the extreme swelling.

I was told to walk and get exercise, but to keep the leg elevated most of the time -- and it had to be elevated so that my ankle and lower leg were higher than my heart.

The pain and swelling were EXCRUCIATING. I've never experienced anything like it. I can totally relate to what Bill is experiencing, and he is doing the right thing by keeping it up, but from my experience and the advice of my doctors, exercise is necessary and will help -- but he needs to check with his own doctor.

I continue to elevate my leg at night in bed and whenever possible while I sit, especially when in the car. Whereas before I loved sandals and going barefoot, these days I wear shoes and socks even indoors. I won't even walk near blackberries or walk through underbrush. I wear gloves for almost any outdoor task. Yes, my name is susanne and I am a wimp...
 
I knew someone also who got this from a small wound on the leg.... it is awful. He finally ended up in the hospital also and had to have the wound cut open, much bigger than the original problem, and cleaned out. Was on heavy antibiotics and the bandage had to be cleaned a lot. The wound was packed with antibiotics and gauze to keep it open and draining if I remember correctly for a while until the Dr. said it was ok to let it start to heal. It is serious and nasty, I know that!!!

And those pictures....
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Oh WOW
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Those pictures are terrible! It looks so very painful! I will be praying for him
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