Finger infection

Discussion in 'Resources' started by xcaret, Nov 18, 2010.

  1. xcaret

    xcaret Supporting Member

    What a day and must say thank you for the support.
    After a long day at the hospital I'm back; seems a horrible accident on Ocean Ave. kept ER very busy.
    I was given antibiotics and need to continue for seven days, pain has gone down. Rich was so right and thanks for the info on the bacteria, it saved doctors some time I guess. Must go back tomorrow for a hand surgeon? to look at my hand. Honestly I don't see why a surgeon would have to look into it but better safe than sorry and I should leave it to a pro.
    I remember Leslie Harris making that comment on wearing gloves...
     
  2. Tumbleweed

    Tumbleweed Guest

    Glad to hear that you are ok Mario.
     
  3. 99sf

    99sf Guest

    Really great to hear that the antiobiotics are working and the pain is lessening.
     
  4. Thales

    Thales Past President

    Yay!

    If you have it in you, it would be really helpful if you could post any info about what happened to you. What AB's did they give you? Are they doing cultures? Stuff like that.

    So glad you got looked at.
     
  5. sfsuphysics

    sfsuphysics Supporting Member

    Glad you're doing ok Mario.

    when my issue happened is when that antibiotic resistant strain of staph was going around so they didn't screw around and gave me a couple ABs one was a broad spectrum one, and another I can't recall. I do recall BOTH times I hurt myself, they took a sample to culture and neither time did they manage to get a successful culture, not sure if they thought it was terrestrial in nature and that makes a difference or what.
     
  6. Thales

    Thales Past President

    This is from Christine Williams:

    She'll might poke here head in here, but I figured I would post the above in case she didn't. :D
     
  7. tuberider

    tuberider Guest


    They may be looking at the potential for a granuloma to form and remove what ever offending goo may become encapsulated.
     
  8. patchin

    patchin Facilities / Event Coordinator

    Glad things are better, Mario. Very scary.
     
  9. xcaret

    xcaret Supporting Member

    Much better today, WAY better, barely pain but still burning sensation over where the infection took off; little swollen but able to bend fingers.
    Urgent Care Dr. did mention not wanting it to become a granuloma and sent me to ER...

    Off to the Hospital again...
     
  10. yardartist

    yardartist Guest

    Hope it continues to improve. Glad to hear the good updates.
     
  11. GDawson

    GDawson Guest

    Take care Mario. Glad to hear you're doing better.

    I'll bet I'm not the only one hear that is saying "There but for the grace of God go I...."

    -Gregory
     
  12. xcaret

    xcaret Supporting Member

    Thanks everyone !

    Seems a regime of two anti-biotics will take care of the infection; one last visit on Tuesday to the hospital just to make sure of no surprises.
     
  13. iani

    iani Guest

    Glad you are doing better. What antibiotics did they get you on?
     
  14. gimmito

    gimmito Supporting Member

    Glad to hear your doing better....it's a great reminder what can happen if we are not careful with open wounds in tanks. A friend in the aquarium maintenance business almost died from vibrio.
     
  15. anathema

    anathema Supporting Member

    Glad you are recovering well Mario.

    I just wanted to add a note to this as well. If you feel like an infection is taking hold and you are unable to seek treatment, soaking the affected body part in water with lots of Epsom salts in it can help. I fought off several cases of fish poisoning this way out at sea when I was unable to seek treatment. Longlining trips were especially bad for this as getting stabbed with hooks that had rotten bait on them was common.

    My dad swears by bag balm as well, and I have to admit it's effective but disgusting stuff.

    None of this is a replacement for a dr. visit by any means, but if you travel and dive it's something you want to think about in advance. Swelling, red streaks, pus, or just simply pain are all signs of something that should not be ignored.
     
  16. Gonzo

    Gonzo Guest

    Glad you're well Mario!!
     
  17. Thales

    Thales Past President


    Yikes! The first two paragraphs sound like post hoc, ergo propter hoc - Latin for "It happened after, so it was caused by". It's a common fallicy that leads to people not taking appropriate action and instead using anecdotal remedies. For more on fallacies check out http://www.reefsmagazine.com/showthread.php?t=77954 . I have emailed Christine about this, hopefully she will post and add some real information to the mix.

    The last paragraph sounds good, except I would suggest if you travel and dive that you bring antibiotics with you instead brining or hoping that where you are has anecdotal 'cures' - almost any doctor will give you a prescription if you are traveling, and if they won't there are doctors that specialize in travel medicine.

    :D
     
  18. xcaret

    xcaret Supporting Member


    There was no sample for culture taken off of the infected finger; X-rays were taken and will be forwarded to the hand surgeon so Tuesday I'll know a bit more or that will be the end of the scare.
    Anti-biotics are Clarithromycin and Sulfamethoxazole-Trimethoprim
    The most important thing is acknowledge when something is wrong and get prompt attention; a very important little thing, and a BIG thanks Rich is a name; Micobacterium Marinum. I mentioned what you posted to the doctor, explained what happened as much detail as I could and also expressed my concern for an infection to cause amputation due to lack of treatment, think the Dr. knew instantly what the infection could do and they did not want for it to leave/have/grow/develop? a granuloma (I still don't know what that is but I associate it with melanoma by the means of not good)
    Initially the superficial cut I had did not bleed, just felt like any scratch that you dip into water or saltwater in this instance.
    The following day around the cut was red, by Wednesday it was a bit sore, burn like feeling and looked like a blister, only red.
    I tried squeezing it to check if there was pus but only a bit of clear blood-red liquid came out. I rubbed some Neosporin on it but was thinking it was just due to the cut; by Wednesday evening it was bad, a red streak over my skin from the finger to my wrist; swollen hand and the pain was bad and extended to my elbow, can't say it was killing me but knew a bad night sleep was ahead; no fevers at all which was OK. It was when I realized an infection was taking place.
    I've been to an infection before as a teen, my foot had an ingrown nail that I neglected then boom, a red streak from my toe to my knee and lots of pain took me to ER and an open toe to clean the pus, then antibiotics...
    So I'm going to take better care when dealing with the tanks and a bit more when it has to do with fragging something.
     
  19. Spracklcat

    Spracklcat Guest

    Hey guys, sorry it took me a while to chime in here--I needed to get a UserID. For those of you who don't know me, my name is Chris Williams, I'm a hobbyist-microbiologist-lecturer and my area of expertise is when things go terribly wrong :)

    So I've read through this entire thread, and there are a bunch of things I'd like to address. In general there is a lot of god information here. All in all, Mario, you did exactly the right thing here, which is not not mess around. If there is ANY feeling of "this doesn't seem right" then GO TO THE HOSPITAL. In some cases there may be no problem at all, or something small that can be easily treated. However, sometimes these symptoms mean there is something very bad happening very quickly, and is is just stupid to take a chance and bet that it's nothing.

    1. Speed of infection: generally, Mycobacterium infections are slow--slow to start, slow to progress. In this case I'd bet against it as a primary pathogen simply because Mario's hand started hurting really quickly. That of course doesn't mean there isn't ALSO mycobacteria going on there, it just isn't likely to be the big player at this time. Much more likely are some of the more virulent strains of Vibrio, or Streptococcus iniae, or perhaps something else. Vibrio and S. iniae move wicked fast, so it is critical to get to an ER if your hand starts hurting worse within 24 hours and isn't getting better, or if you see red streaks.

    2. Red streaks are caused by the infection traveling thgourh the lymphatic system (your lymph is a fluid wich travels through lymph vessels, kind of like blood but without any pump). This is a "get ye to the hospital immediately" sign.

    3. Urgent Care vs Emergency Room: Urgent care is a decent enough idea if your local ER is a disaster and you won't be seen. The reason I don't recommend it though, is that local urgent care places tend to see things like colds, flu, simple lacerations, easy stuff. They aren't going to be thinking about crazy weird infections unless you tell them to, and they won't be as experienced. Also, you may need to be evaluated with tools and expertise they don't have--infectious disease specialists, hand surgeons, special culturing techniques, so you'll end up going to the hospital anyway as Mario did. If you suspect an infection from your tank, always ask to be seen by an Infectious Disease Specialist. These are doctors trained in weird tropical diseases and are more likely to recognize your infection for what it is than your typical doc. Remember, the things in your tanks are NOT normal. :) (This is by no means a put-down of ER or general practitioners)

    4. Culturing bacteria: they may or may not get a positive culture from your wound. This isn't uncommon. If it is Mycobacterium, that takes weeks to grow, in special conditions, so you won't get that result for a long time. Even if it is a vibrio they may not catch it, and here's why: Vibrio likes hands and aquariums because they are cooler than your normal body temperature--(I'm making big generalizations here but bear with me). When docs send off a culture, they incubate it at your normal body temperature, not the tanks'. It may not grow that way. When I run cultures I always do some at human temperature and some at tank temperature--your hospital most likely won't. Also, there's no guarantee that the open wound part of the hand may have the bacteria still. These bacteria like to dissolve tissue and dig down deep into the flesh (hence the pain), so there may not be any more on the surface. This is also why you may not see pus and goo--this infection doesn't necessarily work like a typical one. Myco will form granulomas, Vibrio and Strep probably won't.

    5. The reason you were asked to see a hand specialist is that some bacteria like to infect the linings of the bones in the hand. The X-ray and hand person would be able to see if this were in fact happening before it could cause major damage, and they could adjust your antibiotics to make sure you're getting them where they need to be.

    6. I'd be hesistant to recommend any sort of Epsom salt treatment for an aquarium-related problem, because even if it is decreasing the swelling (which it might) you'd just be masking a symptom that is telling you you need to get to the doctor. Epsoms salts are great for aches and pains and sprains and the like, but they are NOT antibiotics. They are not going to cure anything, they will just make it feel less ouchy. Same thing with bag balm--there is a little bit of antiseptic in there, but not enough to do anything at all about an infection. You need to be paying attention to the progression of symptoms here when you don't know the cause of them.

    If you have any access at all to medical treatment, use it.
    If you are going out to sea where you may be exposed to nasties you can't treat, get a friendly doc to write you scripts for antibiotics and bring them (the antibiotics, not the Rx's :).


    --Christine
     
  20. patchin

    patchin Facilities / Event Coordinator

    Great info. Thanks Chris.
     

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