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drsharmas
drsharmas, Doctor
Category: Health
Satisfied Customers: 99
Experience:  M.B.B.S. , DNB(P), - HAS 3 YEARS OF CLINICAL EXPERIENCE AT A LEADING HOSPITAL OF RAJASTHAN, JAIPUR
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weird gem in his upper arm. 2 days..diagnosed as cellulitis

Resolved Question:

My 55y/o son fell and apparently got a weird gem in his upper arm. 2 days later, he developed what was diagnosed as cellulitis. He became nauseous, and just dreadfully sick. 12 hrs. later, he began to sweat profusely, all over and especially from his swollen arm. B/P fell to 90/60,with hallucinations and was placed in ICU.Liver enzymes elevated and he was incoherent for 8 days. No temp. elevation. Was given massive doses of antibiotics. The Drs. thought maybe he had Hep. C, or experiencing D.T.s. He did recover, but we have no idea what he had. All blood,and cultures were negative. Any ideas?
Submitted: 6 years ago.
Category: Health
Expert:  drsharmas replied 6 years ago.

Dear friend,

Since the lever enzymes are elevated so he is more likely to have his liver compromised.

What are the other viral markers test he has done with like hep . HBsAg, anti hep E virus antibodies, hep. A if any?

Also i want to know what antibiotics he was given?

Customer: replied 6 years ago.
I only know he was given Vancomycin,I was not told the other one. After he got better, they said he did not have Hep. C nor liver enzyme elevation. That all the symptoms vere the results of the cellulitis Poisoning? But he dripped fluid from every pore of his body. Much more that what would be termed 'profuse sweating'Does thkat sound like D>T>s to you?
Expert:  drsharmas replied 6 years ago.

dear friend,

Cellulitis if widesspread is very dangerous. As the bacteria over the wound area will make a entry in the systemic circulation & will cause multiple organ failure & DIC that is disseminated intravascular coagulation.

Multiorgan failure will result in heart failure resulting in lowering down the blood pressure. kidney failure will result in decreasd urine output causing retention of fluid in the body & swelling of the different body parts & widespread edema.

Also in your case the same thing is happening & he recovered after giving the dose of broad spectrum antibiotics as u told.

Sweating can occur due to all these compromised end organs.

this seems more likely to be the result of uncontrlled cellultis in the early time & all the clinical picture seems to likely due to it.

If you have still any doubt left then u can ask me.

thank you!

Customer: replied 6 years ago.
Thank you. As a retired R.N. that makes sense. My only question-why do you suppose the cultures of the fluid and blood would not grow out anything?
Expert:  drsharmas replied 6 years ago.

Dear friend,

Blood cultures sometimes can be contaminated giving false positive results due to contamination showing bacteria which are actually not present in the patient.

It sometimes is the case with the culture also which can show negative due to the resistant strains of bacteria developing due to mutation.

Also when the blood culture is done in the laboratory some atypical bacteria are there which may not grow in the normal broth used to culture the routine bacteria.

The laboratory tests should be only taken as a helping hand, we should not rely completely on that.

Judgement has to be made on the basis of clinical response only.

Thank you

drsharmas, Doctor
Category: Health
Satisfied Customers: 99
Experience: M.B.B.S. , DNB(P), - HAS 3 YEARS OF CLINICAL EXPERIENCE AT A LEADING HOSPITAL OF RAJASTHAN, JAIPUR
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