Managing Cellulitis After Dog Bite and Rusty Cut: A Guide

I was cut by a rusty instrument while being bitten by a dog four days ago?

I would like to ask the doctor, four days ago I was cut on my left forearm by a rusty object.
Initially, there was no swelling, just a little bleeding.
Then I was bitten by my neighbor's dog.
That same evening, I went to the clinic and received a tetanus shot and an anti-inflammatory injection, and I applied medication.
After applying the medication, I went home for dinner and took the prescribed medication.
I noticed that one of the side effects could be skin allergies.
The next day was normal, but by the third day, my hand started to swell and turn red.
It hurts when I squeeze it, and there is a lot of serous fluid; it itches when I sleep, but I don't scratch it and apply ice instead.
I then went back to see the doctor.
The back of my hand is swollen, and there are two hard swollen lymph nodes.
I showed the doctor, and he said it was cellulitis.
I would like to ask the doctor how to treat cellulitis and the schedule for changing the dressings.
I have a lot of serous fluid, and the gauze is soaked.
In what situation can I buy medication, and what products can I use for temporary self-care? I am very worried that my wound is getting worse day by day.
How can I determine if my cellulitis has been treated successfully?

Rong, 20~29 year old female. Ask Date: 2020/10/12

Dr. Ke Fangxu reply Surgery

The treatment for cellulitis relies on oral antibiotics, and the wound needs to be disinfected and cleaned daily, using povidone-iodine.
Please consult a surgeon for examination and wound care; do not make judgments on your own.
Proper treatment is essential to prevent a small wound from becoming infected and worsening into sepsis or necrotizing fasciitis.

Reply Date: 2020/10/12

More Info

Cellulitis, particularly following a dog bite or a rusty cut, is a serious condition that requires careful management to prevent complications. Given your recent experiences, it’s important to understand the nature of cellulitis, its treatment, and when to seek further medical attention.

Understanding Cellulitis
Cellulitis is a bacterial skin infection that can occur when bacteria enter through a break in the skin, such as a cut or bite. In your case, the combination of a rusty cut and a dog bite increases the risk of infection. Symptoms typically include redness, swelling, warmth, and pain in the affected area, along with possible systemic symptoms like fever.

Initial Treatment
You mentioned receiving a tetanus shot and anti-inflammatory medication shortly after the injuries, which is a good first step. The application of topical antibiotics is also common. However, if you notice increasing redness, swelling, or pain, as you described, it indicates that the infection may be worsening.

Managing Symptoms and Treatment
1. Antibiotics: If cellulitis is diagnosed, oral antibiotics are usually prescribed. It’s crucial to complete the entire course, even if symptoms improve before finishing the medication. If you are experiencing significant swelling and pain, your doctor may consider switching to a different antibiotic or even intravenous antibiotics if the infection is severe.

2. Wound Care: Keep the wound clean and dry. Change the dressing regularly, especially if it becomes saturated with fluid. If the dressing is soaked with exudate, it’s a sign that the wound is still producing fluid, which is common in infections. Use sterile gauze and, if necessary, a non-stick dressing to avoid further irritation.

3. Pain Management: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage pain and reduce inflammation. However, consult your doctor before taking any new medications, especially if you are already on prescribed antibiotics.

4. Monitoring Symptoms: Keep an eye on the symptoms. If you notice increased redness, swelling, warmth, or if you develop a fever, it’s essential to seek medical attention immediately. These could be signs that the infection is spreading or not responding to treatment.

5. Signs of Improvement: You should start to see a reduction in redness and swelling within a few days of starting antibiotics. The pain should also decrease. If the area becomes less tender and the amount of fluid drainage decreases, these are good signs of healing.

When to Seek Further Medical Attention
- Persistent Symptoms: If symptoms do not improve within 48-72 hours of starting antibiotics, or if they worsen, return to your healthcare provider.

- Systemic Symptoms: If you develop a fever, chills, or feel generally unwell, these could indicate that the infection is spreading.

- Increased Swelling or Pain: If the swelling continues to increase or if the pain becomes severe, it may require further evaluation.

Conclusion
In summary, managing cellulitis after a dog bite and rusty cut involves a combination of proper wound care, adherence to antibiotic therapy, and vigilant monitoring of symptoms. If you have any concerns about your treatment or if your symptoms worsen, do not hesitate to contact your healthcare provider for further evaluation. Early intervention can prevent complications and ensure a smoother recovery.

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