Cellulitis and Sepsis

[Owen]

There is growing concern that with current issues with antibiotics, that there is a trend for an increase of infections leading to cellulitis and possible sepsis.
Diabetics are classified as being at a higher risk due to the effects of slow healing and the general effect the condition has on the circulatory system.

Good infection control is a way to combat this. Anti-bacterial agents are not affected in the same way as the growing resistance to antibiotics. Therefore washing hands before testing and injecting, using and disposing of needles as recommended (that's why they are called disposable). Washing any minor wounds and using antiseptic agents are the preventative measures to reduce the risk of serious illness.

Both of these are not pleasant, I have had cellulitis which ended with a week in hospital.

There are no cost savings to the NHS when an ambulance relates to £250 then all the added costs at A&E, then using a ward bed for a week or more.

Trying not to preach, but what looks like a saving could cost a lot more.

 

[Bubbsie]

There is growing concern that with current issues with antibiotics, that there is a trend for an increase of infections leading to cellulitis and possible sepsis.
Diabetics are classified as being at a higher risk due to the effects of slow healing and the general effect the condition has on the circulatory system.

Good infection control is a way to combat this. Anti-bacterial agents are not affected in the same way as the growing resistance to antibiotics. Therefore washing hands before testing and injecting, using and disposing of needles as recommended (that's why they are called disposable). Washing any minor wounds and using antiseptic agents are the preventative measures to reduce the risk of serious illness.

Both of these are not pleasant, I have had cellulitis which ended with a week in hospital.

There are no cost savings to the NHS when an ambulance relates to £250 then all the added costs at A&E, then using a ward bed for a week or more.

Trying not to preach, but what looks like a saving could cost a lot more.

Had cellulitis prior to DX...awful...echo every word you say Owen...infection marker up to 325...by the time got to hospital...14 days of intravenous antibiotics...started by cutting toe nail to short...no referral to chiropodist yet...will be asking for one soon.

 

[Owen]

There is a consultation for improved pre hospital care and awareness of the symptoms, I had no idea how ill I was until I arrived at A&E. Once you have either then you are more likely to get repeat episodes.

 

[Amigo]

A good warning Owen. I've been unlucky enough to have sepsis twice and rapid access to antibiotic therapy is essential. What shocked me was the lack of awareness amongst medics about how critical timing is. I appreciate my situation is slightly different with having cancer of the immune system but everything I've subsequently read about sepsis implicates diabetes as an exacerbating factor. I found this link very useful;

http://www.mayoclinic.org/diseases-conditions/sepsis/symptoms-causes/dxc-20169787

 

[Lindarose]

At the Norfolk and Norwich hospital sepsis education is a big thing at the moment. Our computer screen savers have a default to sepsis alert. It was a double strength insulin warning previously!

 

[Owen]

A good warning Owen. I've been unlucky enough to have sepsis twice and rapid access to antibiotic therapy is essential. What shocked me was the lack of awareness amongst medics about how critical timing is. I appreciate my situation is slightly different with having cancer of the immune system but everything I've subsequently read about sepsis implicates diabetes as an exacerbating factor. I found this link very useful;

http://www.mayoclinic.org/diseases-conditions/sepsis/symptoms-causes/dxc-20169787

The consultation is to start iv antibiotics immediately, which makes sense with ambulance queuing. We have three training sessions scheduled to identify patients in need of urgent antibiotics. Cellulitis on its own is dangerous, let alone the risk of this entering the bloodstream and resulting in sepsis or septic shock. I think it is a good move as the symptoms can be overlooked or misdiagnosed.

 

[Amigo]

The consultation is to start iv antibiotics immediately, which makes sense with ambulance queuing. We have three training sessions scheduled to identify patients in need of urgent antibiotics. Cellulitis on its own is dangerous, let alone the risk of this entering the bloodstream and resulting in sepsis or septic shock. I think it is a good move as the symptoms can be overlooked or misdiagnosed.

You do your upmost to make sure this is identified and treated early Owen. Infection getting into the bloodstream (septicaemia) from a skin injury killed my dad at 60 after he developed septic shock. We will never know if early intervention could have prevented this and at that time, the dangers of sepsis were not on the radar in the same way. Incidentally he wasn't diabetic.
This post has opened up a lot of emotions for me this morning. Seeing someone in septic shock is harrowing.

 

[Hazel]

I have had cellulis on 3 occasions, huge doseages of oral antibiotics

It has left me with terribly scarred legs

 

[Bubbsie]

I have had cellulis on 3 occasions, huge doseages of oral antibiotics

It has left me with terribly scarred legs

Hazel...how awful...three times!!!...and painful...poor thing.

 

[Hazel]

Hazel...how awful...three times!!!...and painful...poor thing.

Bless you - yes, certainly not good. The first time GP wanted to hospitalise me, but I was a full time carer to my late father, so I refused.
The district nurse came in twice a day to dress my legs. Took about 8 weeks to heal.
During that time my BG shot up through the roof no matter how much insulin I took.

Subsequent times not nearly so bad. I now have antibiotics on standby in the event of a hint that it is back - God forbid.

Since Dad's death not nearly as much stress, so that helps

 

[Bubbsie]

Bless you - yes, certainly not good. The first time GP wanted to hospitalise me, but I was a full time carer to my late father, so I refused.
The district nurse came in twice a day to dress my legs. Took about 8 weeks to heal.
During that time my BG shot up through the roof no matter how much insulin I took.

Subsequent times not nearly so bad. I now have antibiotics on standby in the event of a hint that it is back - God forbid.

Since Dad's death not nearly as much stress, so that helps

Difficult times Hazel...stress stress stress...then coping with a bereavement doubly difficult...diabetes and cellulitis too!!...however did you manage...had it once...it was a nightmare...couldn't avoid the hospital...14 days in total...I know how awful it is...hope never to have it again...hope you never do either...have a good weekend.

 

[Hazel]

Difficult times Hazel...stress stress stress...then coping with a bereavement doubly difficult...diabetes and cellulitis too!!...however did you manage...had it once...it was a nightmare...couldn't avoid the hospital...14 days in total...I know how awful it is...hope never to have it again...hope you never do either...have a good weekend.

You too sweetheart xx

 

[Amigo]

Bless you - yes, certainly not good. The first time GP wanted to hospitalise me, but I was a full time carer to my late father, so I refused.
The district nurse came in twice a day to dress my legs. Took about 8 weeks to heal.
During that time my BG shot up through the roof no matter how much insulin I took.

Subsequent times not nearly so bad. I now have antibiotics on standby in the event of a hint that it is back - God forbid.

Since Dad's death not nearly as much stress, so that helps

It's tough being a carer Hazel. Often we have to sacrifice our own needs and sounds like you did for your dad.

 

[Lilian]

I have it right now On strong antibiotics which finish on Sunday but not sure whether legs are better yet as they still tingle. Could not get an appointment with doctor for three weeks, so if it is not better, I will either have to see the emergency doctor or wait. It started in August. I had two weeks of anti biotics and went on holiday. Came back and it started up again.

 

[Amigo]

I have it right now On strong antibiotics which finish on Sunday but not sure whether legs are better yet as they still tingle. Could not get an appointment with doctor for three weeks, so if it is not better, I will either have to see the emergency doctor or wait. It started in August. I had two weeks of anti biotics and went on holiday. Came back and it started up again.

Sorry to hear that Lilian, it's a miserable condition! doesnt seem right having to wait that long for a medical appointment 🙄

 

[Bubbsie]

I have it right now On strong antibiotics which finish on Sunday but not sure whether legs are better yet as they still tingle. Could not get an appointment with doctor for three weeks, so if it is not better, I will either have to see the emergency doctor or wait. It started in August. I had two weeks of anti biotics and went on holiday. Came back and it started up again.

Lillian...three weeks is unacceptable...you need to get seen...cellulitis is so dangerous...I got to the point where they said sepsis would set in...tachycardia...organs would be next...please go and see the doctor...even if emergency one...and of course as we both know it is so painful...get it checked.

 

[Owen]

I have it right now On strong antibiotics which finish on Sunday but not sure whether legs are better yet as they still tingle. Could not get an appointment with doctor for three weeks, so if it is not better, I will either have to see the emergency doctor or wait. It started in August. I had two weeks of anti biotics and went on holiday. Came back and it started up again.

From a clinical point of view, keep an eye on your temperature, if it rises above 38, then off to hospital. Also if you start breathing more rapidly ecetera

 

[mikeyB]

Agree with Owen. Though sometimes that tingling is a sign of healing as the little nerves in the skin heals up. Vigilance is the word.

 

[Amigo]

From a clinical point of view, keep an eye on your temperature, if it rises above 38, then off to hospital. Also if you start breathing more rapidly ecetera

Also if your temperature consistently drops below 36, it's not always characterised by high temps.

When I had sepsis (through an unidentified infection and pneumonia the second time), the main presenting symptom was tachycardia and dropping b/p. As soon as my pulse rises, I do regular home obs.

 

[Owen]

Also if your temperature consistently drops below 36, it's not always characterised by high temps.

When I had sepsis (through an unidentified infection and pneumonia the second time), the main presenting symptom was tachycardia and dropping b/p. As soon as my pulse rises, I do regular home obs.

Another good point, the major one if you can check your own blood pressure, is a drop in pressure is an early indicator for sepsis.