Swollen Foot/Ankle

[Eve.]

I get hot swollen joints with inflammatory arthritis but I've got an irritated swollen red patch just in front of my ankle joint and further down. I got bitten by something (really itchy like insect bites) quite a bit a week or so ago but they had calmed down.

It's not the usual place of my arthritis swelling and it's only one foot and feels more sore and irritated and the skin feels a bit funny, quite rough.

Picture here if it helps: http://imageshack.us/...images/88/footve.jpg/

It reminds me of a similar thing I had a few years back when it ended up as a bad case of cellulitis (and I have a bad track record with skin infections). That time was after getting bitten on my foot by suspected mites or something from skanky pidgeons nesting in the wall behind where I sat at work (they fished dead ones out and all sort - smell was disgusting!).

If it is possible cellulitis I don't want to leave it so long this time but unlikely to now get a Drs appointment tomorrow. Can I head any possible infection off by using antiseptic gels and cream and such, at least until I can see someone if it stays or get worse? Don't want to end up at the walk in and waste their time if it's just the arthritis going weird.

[Anngel123]

I would try antihistamine first. I imagine you are already on some sort of steroid but, if not, you might get a cream with some in it. Mainly keep an eye out for any red lines coming away from the area, which may indicate an infection. It looks like a particularly bad mozzy bite to me! If it doesn't go down in a few days go to the doctors. If you have a pharmacist nearby many of them are allowed to give basic medical advise as well.

[Eve.]

No steriods and off arthritis meds at mo pending an ultrasound on inflammation in my hands and some test results. Have popped an antihistamine (good idea, thanks!) so will see if that helps. Ahh didn't think of mozzies! Not seen any though I suffered badly with bites when I was in Canada a few years ago - evil things! Came up in big red lumps.

I have some steriod cream somewhere, had it for a rash I got but would have been well over a year ago so not sure if I can still use it. Will hunt it out, see if I can find a use by date.

[Sqad]

That looks like cellulitis.

I wouldn't put any creams on it, but would take Ibuprofen 600mgms and monitor the situation until tomorrow morning.

[Eve.]

Thanks Sqad, I swear I'm a hive of bacteria or something!

Will see how it looks tomorrow and pop to the walk in after work if it's still bad/worse. It took 2 courses of co-amoxiclav to clear the last lot and ended up having to be off work with my leg above my head for 48 hours to get rid. The walk in dealt with that (and other skin infections and my infected surgical wound) so at least they have the records on that to help get shot.

Can they take a swab or something from it if it is cellulitis to see if it shows what bacteria might be causing stuff, given it's not weeping or anything so no fluid? I never got any feedback after I had an infected abscess removed in the hospital.

[Sqad]

Yes you can put a needle into it and culture the growth if any, from the needle. However this would only be as a last resort if it didn't respond to antibiotics.

[Eve.]

Makes sense. It's been red, irritating and painful all day and is now on the other foot too. Popped down the walk in after work. 2 and a half hours there and the nurse I saw said she wouldn't prescribe antibiotics at this stage for it as it wasn't an emergency (was walk in centre, not A&E) and to keep taking antihistamines and ibruprofen and keep my feet raised.

Will see how it goes over the weekend and hope it just settles itself down and see if I can speak to a GP at my surgery on Tuesday if needs be.

[Eve.]

Sqad, if you're about I wondered if I could ask for your opinion?

I still have the swelling (both feet and now under one of my knees) which feels squishy like fluid, they aren't so angry now (more like dark red marks) or irritating (though the one under my knee is painful) but they are still darkwith funny skin and I've come out in a load of little spider veins round the ones on my feet.

Could it be some kind of delayed reaction to the bites? All are near where I got bitten (assume so, normal red itchy bite like marks I can still see) - figured one of the cats had brought in fleas or some kind of mite if they got a bird or mouse or something with them on. I got bitten quite a bit over about a week but not since about 2 weeks ago.

I know it took a while for the cellulitis last time to get bad enough for me to get it looked at (figured it was arthritis related initially). If it could be bite related am I best just carrying on with antihistamines if that would help and keeping an eye in case it is cellulitis?

[Eve.]

Just an update, still not much improvement. Will see how it is tomorrow.

[Sqad]

I find it difficult to believe that this is a result of a bite....possible, but unlikely.

Carry on with the antihistamines as they will do no harm and keep resting them and I am surprised, given your medical history, that antibiotics were not prescribed.

[Eve.]

Thanks Sqad, will do. I guess the perils of a ridiculously busy walk in, seemed short staffed (no doctors there at all for a while after I got there, nurses trying to sort everyone) and 2 and a half hour wait so more of an in and out. I did explain a bit (wasn't in there long) but she said they wouldn't give antibiotics in that circumstance as it's an emergency facility.

Will see how it is over the next day or so. Thanks, as always, for the advice.

[shaneystar2]

Jenna ..the result of a bite can turn to cellulitis as I know to my cost .
It took a while for the two mossie bites on my leg to make themselves known into a huge elephants leg which ulcerated and caused me no end of problems . Keep your ankle moisturised .Try and get some Dermol and rub that in .Its an antibacterial cream which will fight infection .Take care .

[LoftyLottie]

Agree with Shaney. Definitely looks like a reaction from a bite. I got bitten about four years ago by some nasty critter and it looked dreadful and caused infection and did what you describe. Ended up on very strong antibiotics. Like Sqad, I think it very strange that you were not given antibiotics.

[Eve.]

I'll look out for that tomorrow, thanks Shaney.

I was surprised too Lottie but think they were just trying to rush people through as there were so many waiting for such a long time and they seemed very shortstaffed. I was so tired and really hungry after having sat there so long I just didn't have to energy to make any kind of fuss (not that I'm a making a fuss kind of person anyway - often to my detriment mind, I'm too soft).

I'm keeping a close eye and trying to keep it raised and such. My GP isn't in until Thursday so if it hasn't started to clear up or is any worse I'll give her a ring as at least she knows my history.

[Eve.]

Latest update, called GP yesterday and they called me in for an appointment today. Dr said she doesn't think it is cellulitis as it's not demarcated enough or hot to the touch (my feet feel hot and irritated but the rash bits aren't really hot to touch). She said she wasn't sure what it is but to show it to my rhumatologist

I see rhumo tomorrow (test results back for lupus and immune stuff so feeling a bit funny tonight) so will see what they say but any other ideas welcome.

[Sqad]

Thanks for the feedback Jenna.