Antibiotics are not doing the job - what next?

[sammyvan]

I need help and advice from all you lovely people out there who also have this dreadful Lymphoedema. Mine is in both legs, diagnosed a few years ago now. I have had several bouts of Cellulitis, despite rigorous cleaning and moisturizing every day [ sometimes twice daily ] and wearing wraps on both legs - feet included, every day except for ''wash day''. I take a basic dose of Clarithromycin 250mg daily, use Dermol and Dermol 500, with Elocon when a red patch develops.

Not sure if it has been the heat, combined with the bandages and wraps on top, but my skin started to develop raised, blister like [ no moisure though ] bumps all over the bottom half of both legs. I also have a type of ''bracelet'' around both ankles, where there is quite a deep indentation caused by the flesh, above and below, swelling. The skin in this part of the legs is very tender, and today I notice there is a slight reddish discharge! My legs have been reddish in patches for about three weeks now, and I have been on Clarithromycin 500mg x twice daily for the last two weeks.

I have not had the symptoms of previous Cellulitis bouts, no heat in the legs, no feeling hot/cold or shivering, no feeling nauseous and no temp.

I am still using the creams as before, but have today decided to also use Sudocreme barrier and antiseptic cream, around the areas that are rubbing together. I thought this may help.

Because I am allergic to penicillin, the antibiotics I can take are restricted. The Clarithromycin does not seem to be working as well as before. Last time I was given Clindomycin, but developed quite a severe reaction to it, so that is out! My doctor [ who has diagnosed and treated me over the phone!!!] says if there is no improvement by Tuesday, then it is into hospital and onto IV again. Dreading that, as I have to leave my 81 year old hubby, and he goes to pieces slightly!

Sorry this screed is so long, but needed to give you all the facts before asking for help/advice. Any other treatments? Any antibiotic recommended? Thanks for your patience. Sammy

[Lynora]

I think you need to be seen by a doctor. Something ain't right. Diagnosis by phone is not ideal. And no one here is qualified to diagnose or prescribe. If you need IV a/bs so beit - sorry.

When you say 'rigorous cleaning' are you being too keen and removing skin? Can you leave the bandages off for a day, and just use actifast (the skin protecting layer - looks like tubigrip) with the wraps to see if the reddening diminishes or the 'bracelet' calms down?

[sammyvan in reply to Lynora]

Thank you for the reply, Lynora. As far as the cleaning goes, any sign of redness or irritation and I then only use the Dermol 500 to clean my legs.

As for the wraps/bandaging, I have not worn them now for two weeks - from the time I noticed the 'blister like' skin, and the red, irritated patches. Not that it is painful, apart from the sections that seem to be red. Also noticed that it is now leaking! Very little, but there is that irritating little leak which requires a paper towel under my foot! Hate it.

I will have to ask the doctor to come and see me tomorrow - no more ''on the phone'' chats. I have extreme arthritis as well as this Lymphoedema, so getting about is a problem and I very seldom leave the house. I also have the district nurse coming tomorrow. Looks like I get to have a holiday in hospital! Just hate the IV, and having to have that ''line'' inserted into my arm. My veins disappear the moment a needle is in sight!

Thanks again - always depend on your answers! Sammy

[Magpuss]

I think it's shocking that you were given a diagnosis over the phone. I wouldn't be happy to be treated by any doctor who didn't want to see me and the severity of my condition before prescribing a treatment. Sorry I can't help re antibiotics, I do think you should insist on a visit from your doc' though, perhaps your district nurse could have a word with him on your behalf if necessary. Hope you manage to avoid another trip to hospital.

[sammyvan in reply to Magpuss]

Finally, after two weeks of asking, today had home visit from a Doctor. HOSPITAL AVOIDED! The district nurses added their weight to the request, as you suggested. I have infection [ started with blisters ] in both legs, but not Cellulitis yet......and wont ever be if I can avoid it.

Thanks for taking the time,,,

sammy

[lancsgirly45]

Hi, well im not a gp but from what im reading it doesnt sound like cellulitis. I found out 6 weeks ago from a private vascular surgeon and a dermatology specialist that i have been misdiagnosed for the past 7 yrs, yes 7 years with supposed cellulitis!!! for the past 2 years i have been taking 2 penicillin tablets a day..........I have actually got lymphoedema/ chronic venous insufficiency!! There is a big difference in symptoms for me...cellulitis always made me feel ill, sickly, temperature and redness , swelling etc, however for the past 3yrs i have got worse and worse, in fact so bad that i couldnt get up my stairs to the bathroom, pain off the scale...but NOT temperature or flu like feeling. I couldnt understand why i was still getting worse and worse, even though was taking antibiotics daily!! My mum was so worried she paid for a private appt with a dermatologist..........within 5 mins of seeing him, he said that i definitely havent got cellulitis, but venous insufficiency/lymphoedema!! he said that cellulitis comes in 1 leg...not both!! My own gp was arguing with me that it does come in both legs. am now left with long term damage, and really angry. 1 week ago i joined a lymphoedema support group........best thing iv ever done. i have 2 printouts now that states..." Cellulitis most commonly

affects one leg only whereas lipodermatosclerosis more commonly affects both legs.......so my gp talks nonsense!! if i was you ii would join the lymphoedema.org group. Iv found it so assuring, loads of people to talk to...professionals and sufferers. i really do hope you getsome answers and relief soon. i would listen to your body as well as docs. yoou know your body better than anyone. Best wishes

[SmallBlueThing in reply to lancsgirly45]

I was wondering if I had chronic venous insufficiency, as my leg was tender to touch. It changed colour but my temperature wasn't high, so was told to come back if there was any change. I seemed to fight it off for a while but then was prescribed flucloxacillin. There was no advice to report after three days (would've been at the weekend, anyway) and I felt worse as soon as I knew I was going on the antibiotic, as if my system had said it didn't need to fight so hard. So, I wasted a week on flucloxacillin, when I needed something for community-acquired MRSA.

[sammyvan in reply to lancsgirly45]

As you will see from my post above, I did finally see a doctor - and you were correct......not cellulitis, just infection. Hopefully under control, with antibiotics.

However, with regards having Cellulitis in both legs, it can happen. last year I spent just under a month in hospital, hooked up to IV antibiotics and vey heavy dose of Clindamycin. I had developed infections in both ankles, started from blisters, which after several weeks on antibiotics had developed into Cellulitis. I had two bright red, very swollen [when the skin gets very tight and shiny?] legs, weeping copious amounts of fluid. I had resorted to tying sanitary towels around my ankles, to soak up the fluid! When I started vomiting during the night I was admitted. That is why I am so fearful when I develop any infection in my legs now........I have visions of the last time. Have learnt to NEVER ignore the signs of Cellulitis, and have had one attack since then, treated in time.

So sorry you had to go through all those years of pain - not right. Hope all well now.

Thanks for your concern.

sammy