Medical Questions? Ask a Doctor Online!
You need to see your surgeon right away. If it is painful and draining, it probably needs to be redrained. There is something that is preventing the healing--do you have diabetes? Thank you.
Let me see if there is an ID specialist I can refer you to on JustAnswer. Good luck!
I referred you toCustomer who is an ID specialist. Please wait for his response. Thanks.
When the surgeon did the I and D- is it fair to assume that he left the screw and plate in?
Is the drainage you have now increasing from the time of your last surgery?
Do you know if additional blood work has been done- a white cell count? ESR or C-reactive protein?
Why did your surgeon decline your request for an ID consult when he did the second surgery? And have all the antibiotic choices so far been done just through his office ( and his NP)
He is a specialist. Thank you.
Yes, the drainage is increasing since the 2nd surgery-it is a dark yellow but is negligible in amount, but my toe and surrounding area is becoming edematous and erythematous.
I am a Registered Nurse with a wide range of experience. And I long to have this health problem resolved.
I apologize---but I did not "Release lock" which means that you may have to wait 2 hours for THEGERMDOCTOR to respond to you. He just explained this function of JustAnswer to me. Sorry, please wait for your response. Thanks!
The question has now been opened for me to answer ...
Since you already saw the ID doctor once- why don't you schedule a follow up appointment with him now? You should not need your surgeon's approval for that,
Did the ID doc think you did not need a longer course of therapy when he saw you? What specifically did he say?
Well , the honest truth is it sounds like you did not respond to oral therapy and likely do need iv therapy.
I probably would at least give you Vancomycin, but may add a second drug- Sometimes cultures may not be fully sensitive and may be falsely negative, especially with retained foreign bodies.
Without seeing you it is hard for me to say what I would do. But I would check an ESR and CRP, and repeat cultures from the drainage. And I'd likely start you on iv therapy.
But the other important thing is that not uncommonly the response to antibiotics is poor with a foreign body infection ( your plates/ screws). Infection does not respond sometimes unless it is removed, if the infection has extended down to the foreign body. Plus this requires a much longer course of iv therapy- longer than you received- like even up to 4-6 weeks.
Always ask if you need clarification/more information.
POSITIVE feedback & a BONUS are warmly appreciated. Please note that answers are for information only, do not take the place of an assessment by your doctor,and does not establish a patient-physician relationship.
If you get online again, please respond ASAP and then I will gratefully pay you. God richly bless you during this holiday season and if you are a believer in the Lord Jesus Christ-Please pray that the Lord God would heal my foot-I need a miracle. By having the 2nd surgery and if the infection was obvious on the outside of my foot -because according to the surgeon he over-reacted- that was his comment on the post-op appointment could the infection have spread internally inside my foot by doing the second surgery-I&D,C&S. I know my skin was prepped with betadine-but will betadine kill staph epi?
Sorry for the delay in responding again.
( I actually see patients in real life, and was busy in the hospital and office all day.)
As can be seen in my profile I am based in Chicago, but the JA policy is not to provide personal contact information offline. This is to protect everyone involved.
I am quite positive you should be able to find many very well qualified and excellent clinical infectious diseases physicians in most large hospitals- If you are not satisfied by the opinion you received from the one you already saw- you absolutely SHOULD seek another opinion from another ID doctor offline.
My concern, as noted is if there is indeed residual infection deep in your wound- I cannot be certain without more investigations and a proper assessment, but that would be the concern that needs to be addressed.
Betadine does lower bacterial counts before surgery and is commonly used- but having said that, Staph. epi remains the commonest bacteria that infects foreign bodies after surgery- So clearly effectiveness is far from 100%.
Good luck and let me know how it goes.