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Dr. Thomas, MD
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 63757
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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A friend has a knee that became very swollen, red and HOT.

Customer Question

A friend has a knee that became very swollen, red and HOT. These symptoms include the entire knee, entending down the leg with 2+ pitting edema at the ankle. There is what looks like an abcess on the front of the knee just proximal to the patella. But
when it was lanced nothing came out. She does have fever and chills. I suggested the E.R. but with no insurance, she refuses to go. I'm a podiatrist and this is something I need help with. Will oral antibiotics help and if so which one is the best option.
Since I can't get a culture I'm guessing staph, and ordered a Z pack. However, she works construction so is exposed to dirt, wood, metal shaving etc etc.
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Thomas, MD replied 1 year ago.
Hello
As far as I am concerned, if she goes to the ER they will have to tap the knee.
This could be gonorrhea for all you know.
Prescribing blindly is not standard of care, and will open any doctor doing so up to a law suit, as the destruction of the knee can occur rapidly, then there is a joint problem.
A z pak would certainly not be an indicated coverage without culture.
OK, so that is an initial answer….
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Customer: replied 1 year ago.
Well, that is great advise but it does not help since she WILL NOT go the the E.R. What now?
Expert:  Dr. Thomas, MD replied 1 year ago.
I would never treat blindly, nor would I advise anyone to do so.
Let's say it is staph. Oral antibiotics are almost never indicated int his situation...it starts with IV therapy.
MRSA is possible.
Gonococcus, which can be treated orally....but you don't know.
Empirical treatment must be started only after a culture is done.
I would call a squad to come see her, they can talk with her.
Starting antibiotics on a guess would be malpractice and might do irreparable harm.
OK, so that is an initial answer….
Please use reply to expert if you have further questions. When you are ready, please click a positive rating [hopefully excellent]. If you forgot something, come back. I am here daily.