Foot Pain: Is It Cellulitis or Something Else?

Abnormal inflammation of the toes at the front of the left foot?

Hello, last week a cold front hit, and I developed small cracks between my toes.
I didn't pay much attention to it, but around Tuesday or Wednesday at work, I suddenly felt sharp pain in the front of my left foot (I was barefoot at work but wearing thin socks).
I endured it until the end of the workday (by then, it was already difficult to walk).
After I got home and checked, I found that the front of my foot was red, swollen, and warm.
An elder thought I might have been bitten by an insect, so they gave me anti-inflammatory pills, which helped reduce the swelling and pain.
However, the next evening, after taking a warm shower, the pain recurred.
I took more anti-inflammatory pills, and the elder even had a pharmacy staff member give me an anti-inflammatory injection.
Feeling uneasy this time, I went to a nearby clinic after work.
The doctor there, after listening to my description, believed I had cellulitis and refunded my consultation fee so I could go to a major hospital's emergency department.
I went there and had blood tests done, but the attending physician at the hospital looked at the blood test results and said everything was normal and that I did not have cellulitis.
However, they still prescribed me antibiotics in injection and pill form.
The last time I took medication was yesterday afternoon.
Today, I walked for a longer period, and when I got home, my left foot felt slightly uncomfortable, and it was a bit swollen in the evening (but not as painful as it was at the beginning).
Does normal blood work mean there is no risk of cellulitis? Should I go for another examination just to be safe?

Tusi, 20~29 year old female. Ask Date: 2018/02/15

Dr. Li Zhonghuai reply Surgery

Hello! It is recommended to consult a general surgeon.
Please avoid exposing the wound to tap water for now.
Blood tests for localized cellulitis are mostly normal.
Take care! Changhua Hospital is concerned about you!

Reply Date: 2018/02/15

More Info

Based on your description, it seems that you are experiencing significant foot pain that has led to swelling and redness, particularly after a recent cold snap and the development of small cracks in the skin between your toes. The initial concern raised by your elder about a possible insect bite, followed by the diagnosis of cellulitis by a doctor, indicates that there is a concern about an infection in the soft tissues of your foot.

Cellulitis is a bacterial skin infection that can occur when bacteria enter through a break in the skin, such as a cut or crack. Symptoms typically include redness, swelling, warmth, and pain in the affected area. The fact that you experienced significant pain and swelling, along with the redness and warmth, initially suggested a possible case of cellulitis. However, the blood tests performed at the hospital showed normal results, which is a positive sign. Normal blood tests can indicate that there is no systemic infection or severe inflammatory response occurring in your body, which is often associated with cellulitis.

However, it is important to note that while normal blood tests can reduce the likelihood of a severe infection, they do not completely rule out the possibility of localized infections or other conditions. The fact that you experienced relief after taking anti-inflammatory medication and antibiotics suggests that there may have been some inflammatory process at play, whether due to an infection or another cause.

Given that you are still experiencing mild discomfort and slight swelling after walking, it would be prudent to monitor your symptoms closely. If the pain or swelling worsens, or if you develop new symptoms such as fever, chills, or increased redness, it would be advisable to seek further medical evaluation. A follow-up appointment with a healthcare provider can help determine if additional tests, such as imaging studies or a more detailed examination, are necessary to rule out other conditions, such as tendonitis, bursitis, or even a stress fracture, especially if you have been engaging in increased physical activity.

In the meantime, consider the following recommendations to help manage your symptoms:
1. Rest and Elevation: Avoid putting weight on the affected foot as much as possible. Elevating your foot can help reduce swelling.

2. Cold Compress: Applying a cold compress to the swollen area can help alleviate pain and reduce inflammation.

3. Footwear: Ensure that you are wearing comfortable shoes that provide adequate support. Avoid walking barefoot or in shoes that may exacerbate your discomfort.

4. Pain Management: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help manage pain and inflammation.

5. Follow-Up: If symptoms persist or worsen, return to your healthcare provider for a follow-up evaluation. They may consider further imaging or tests to assess the underlying cause of your symptoms.

In summary, while your normal blood test results are reassuring, it is essential to remain vigilant about your symptoms. If you have any concerns or if your condition changes, do not hesitate to seek medical advice. Your health and well-being are paramount, and timely intervention can prevent potential complications.

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