Cellulitis or not!!!!

Woke up this morning and my arm was painful and swollen. Put my sleeve on and tried to carry on as normal. By lunch time it was really painful so took sleeve off and realised it was now very red!!! I rang the breast care nurse and she sent me straight to my Doc who has prescribed Antibiotics. She said it could be cellulitis. Never had it before,no rhyme or reason for it to have struck today. Any advice about what to look out for. I have marked my arm so I can see if redness spreads.

21 Replies

  • Hi Taffia - plenty of rest and fluids, take paracetamol to keep temperature down and discomfort at bay - don't try and wear your compression garment for a few days and skip the MLD or SLD until the infection is under control. - check out the lsn website 'management of cellulitis in lymphoedema consensus document' for advice for your doctor on the best antibiotics and for how long - most people need 14 days not the usual 7.

  • Thank you,- will go back to Doc on Monday as she only gave me 7 days.

  • I had/have cellulitis in my breast and have taken antibiotics for 14 days, but when I saw the oncologist nurse she wanted me to continue to take antibiotics. I declined because the oncologist told me a month before the nurse saw me that the reddish band on my breast is due to me being among the 20% of women reacting this way to radiotherapy. If I understand how cellulitis manifest itself is by the area affected getting red and hot, and also becoming painful. I hope that you'll feel back to normal after the two weeks that you will be taking the antibiotics. Which antibiotics were you given and what strengh? I was also told that the arm or the breast can get infected very easily; maybe one can get protection by moisturising these two areas all the time.

  • thanks for reply. I do moisturise every night,- it was fine last night. I have been put on Erythroped as I'm allergic to Penicillin. 500mg to be taken 4 times a day. So quite a hefty dose. I have had a small cut on my cuticle this week and wondered if that's the cause!!!!!!

  • That's exactly the strength I was given too. For sure the infection made its way from the cut in the cuticle. I have read that we should always desinfect each cut we notice on the affected arm. Hope you see immediate improvements. Good luck.

  • Hi Taffia - the cut cuticle will probably be the original site of infection. The little bug is on our skin - and in people with a compromised lymphatic system, I swear the little 'b*****rs' are issued with a knife, fork and and spoon, and just wait for the slightest dent in the skin surface to march in, have a feast and cause mayhem!

    Sometimes there doesn't have to be any cuts/grazes/bruises for cellulitis to occur. Some of my ladies who have had cancer treatment, can be hale and hearty, and then, for no known reason, but generally around tea time on a Friday (when the GP surgery has closed!) they notice the red patch, feel the heat and start taking the anti-biotics that they have stashed in the cupboard!

  • My cellulitis seems to co inside with bank holiday weekends. 111 has to be used to be believed. My last bout started with waking up shaking uncontrollably, apparently cause by a sudden rise in temperature. Terrifying. In all I have had it 3 times. Each time I cannot explain why nor can anyone else.

  • Thank you,- I've certainly learned my lesson and will have antibiotics in the cupboard from now on. Any problems I've had on the BC journey have all occurred on a Friday afternoon,- Sod's law eh. I wish I'd found this site two years ago. It's very comforting!!!

  • I am just adding this for info really. I totally agree with all the advice so far given and generally its exactly what I have done, because I have had one admission for Cellulitis and don't want to be in hospital!

    So, up until recently, I start on antibios at the first sign of a real redness or red spots. However, 3times this year I have photographed on my ipad, the spots and later shown my gp or Lymphoedema nurse. As often by the time you see them the evidence has gone.

    The time before last, I showed m arm to the nurse and she was mystified....small nipple like spots sporadically placed on my arm. She suggested I hold fire on the antibios next time, which I did...and they went away. Twice now thats happened. i now see a new mld therapist, who thinks they might be due to sweating under the sleeve, affecting the hair follicles.

    The other thing I would add is, when I did get cellulitis, it was last August and I had not been moisturising well enough , nor drinking adequately. A real learning curve( and im a nurse!)

  • Lots of good advice here. A couple of other points, please make sure you complete the course of antibiotics. If you stop before the end of the course there is a danger you'll select the more antibiotic resistant bacteria. Secondly many of the folks with primary lymphodema, like me, find we get recurrent infections after the first bout. Everything seems fine for a few weeks, months then bang, another infection. One treatment that seems to work is to continue taking a lower dose of antibiotics for several months after the inital infection clears up.

    Hope yours clears up quickly.

  • I agree with all the advice given. I always start taking antibiotics immediately I see the tell-tale blotches on my arm. I don't want to be in hospital again with cellulitis. In fact, because i had 3 bouts in 6 months, i am now on continuous low-dose antibiotics for a period of time and then they will try and wean me off them to see how I get on. So far so good - no infection for 3 months. I have secondary lymphoedema after breast cancer surgery and treatment.

    Hopefully, Taffia, things will start calming down very soon if they haven't already

  • Yes it's calming down tonight. Still very hot but not so red. I still feel lethargic and have been very quiet all day. Certainly on the mend. Thanks for all the advice,- I've taken it all on board!!!

  • One last question. How long does it usually last. Had a rough night and feel lousy again today. Arm still red ( but not so angry looking) Was hoping to be feeling more my usual self today!!!!

  • How long does it last? It depends but in my experience a short episode might by something like 48 hours to reach peak redness, 48-72 stablizing then the reddens starts to disappear and finally the swelling starts to go down.

  • hi taffia

    it is a big learning curve, isn't it?

    just when we're feeling all floppy & poorly

    i bit a hangnail once (i know, i know, how stupid is that??) & watched the infection spread down my finger & into my hand

    i also find that, with my balance not being great, bouncing off walls is too much pressure on the lymphy skin & can lead to infection

    & i've learned that, if i'm tempted to draw round a rash, i should be getting out the stand-by antibi's

    cellulitis is harder to get rid of than other infections - 2 weeks minimum antibi's, often longer, when you feel completely better you should carry on taking them for a few days to knock the last of the bugs on the head so they don't have a chance to multiply again

    but, like bestbrush says, it's not always cellulitis - for me, if i get hot my skin goes blotchy (mmmm, how attractive!) where i've had cellulitis rashes before - but i don't feel unwell or produce spectacular temperatures so i know that, for me, that's not cellulitis but everyone's different & produces symptoms in different orders

    you'll get to know what cellulitis feels like for you (altho hopefully you won't get it too often!), & drawing round the rash so you can see what's going on, & texting a photo to your lymphoedema team's are good ideas too - i do that, but don't wait for a reply before i start munching antibi's

    if it's not treated quite aggressively it can turn into septicaemia, which is much more serious & can be why people end up in hospital on iv antibi's - which is one of the reasons why we have to take cellulitis seriously but also try nt to panic about it

    & i take prophylactic antibi's, too - since i've been on them, bouts of cellulitis are less long & go quicker which is good news

    good idea to print off the guldelines the lsn referred to above & give them to your gp, get antibi's put on your repeats list so you can get them when you need them without having to get a gp appt, & discuss prophylaxis if you meet the criteria

    & i have a little 'emergency kit' when i go out - antibacterial wipes, savlon or tea tree cream, plasters, hand sanitiser, latex gloves to put over my compression gloves, then add a few strips of antibi's for stand-by if i'm away from home

    sounds like a faff, but if you just keep all that in a small bag in your bag / coat pocket / car it means you can just deal with a cut or graze when you're out & about without needing to panic

    hope that doesn't make it sound more complicated - you'll develop your routines, it's not that bad, honest!

  • my wife has just spent 5 days in intensive care and is now in the medical ward in pinderfields hospital,west yorkshire with what looks like cellulitis and a streptococcus infection,it started in the arn which has secondary lymphoedema due to having her lymph nodes removed when she had breast cancer in 2010, she`s still on iv antibiotics and is getting better slowly, i`ll show her this website when she comes home it`s a great resource

  • Sorry to hear that. Glad she's on the mend. I'm also on the mend and feeling a lot better. Yes this website is great. I've learned so much about cellulitis over the past weekend and yesterday got a home visit from the Lymphoedema nurse. ( I didn't know she existed til yesterday) Its certainly a learning curve.

  • Hi All

    I think everyone at some stage or another has experienced cellulitis or will do. I would hasten to add that i have had it several times but have not had the same in terms of temperature or flu like symptoms experienced by everyone.

    I do however have an emergency supply of antibiotics as well as an additional prescription just in case.

    The key thing i think is to understand your body, i have sufferred from skin infections for years and now know when i do and when i don't need antibiotics.

    The rule of thumb i work to though is if doesn't feel right get it checked.

  • Hi Taffia - you totally did the right thing by calling your nurse the next day. I'm new to all this....I ended up spending half of half-term on a medical ward getting IV flucloxacillin and IV paracetamol for a particularly nasty case of cellulitis all over my left hip/top of thigh/ groin and stomach area. It came on in less than 12 hours and knocked me for six. I'd never heard of cellulitis and had no idea how I got it as no noticeable lymphoedema at that point. (I'm still unsure about it all as no-one's really explained anything!). I realised after that I'd had a pedicure the week before and one of my toes got "nicked" which is, I assume, how it happened. I have been left with awful dry skin patches so do make sure you moisturise (E45 is good), aching/arthritic-feeling joints and areas that look like bluish bruising. Oh, and I've also been left with awful lymphoedema now-left leg/groin/stomach area, so waiting to see a nurse to deal with that. Just keep on your antibiotics and be guided by how you feel. Take care :-)

  • Thanks for all the good advice. I've not been able to log on since last Friday. Have nearly finished second week of antibiotics and arm seems back to size it was before the attack. I've now got to start wearing my sleeve again.

  • I have had ongoing acute right lower leg cellulitis for 6 mos now when first diagnosed I was in the hospital for 20 days given antibiotics in iv and pain meds for the horrible pain it causes along with wound care for the blisters. What helps me a great deal with the pain and burning is to use silvadene cream 2 times a day on the affected are then wrap area with kerlix gauze and then place a tubigrip stocking over the leg. This treatment has helped me a lot along with ongoing pain meds and doxycyline. As I was almost done with this it starting back up again and now am on antibiotics once again. My infection was caused by an open cut on the bottom of my foot. This has been the most aggravating and painful illness for me and makes things difficult as I am a mom of 3 small children. For all of u suffering with this as well I wish u the best of luck and May the good Lord bless u and heal u quickly.

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