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Dr. David
Dr. David, Board Certified MD
Category: Dermatology
Satisfied Customers: 42843
Experience:  Board Certified Physician
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There,Just under 2 weeks ago I was given 1 week's worth

Customer Question

Hi there,
Just under 2 weeks ago I was given 1 week’s worth of Clarithromycin (500mg twice a day) for a nail infection under the nail of my little finger.
It started as a small dark pink border at the base of the nail which eventually began to spread, lifting some of the nail away from the bed and eventually, it started leaking pus at the side; it was also painful if i pressed the base of the nail. I tried to treat it for about 4 weeks using warms soaks (Epsom salts, 3% hydrogen peroxide etc) but became concerned as it still continued to leak and the nail to lift, and so I saw the doctor.
He said it was bacterial and not fungal and so I finished antibiotics Tuesday night but this morning noticed that, once again, pus is building up beneath the nail at the base and leaking from the side that’s lifting up.
My question is therefore does this mean that it’s still infected and, if so, what is your recommendation in treating it? I’m planning on seeing the doc next week (if I can get an appt) but am very reluctant to take antibiotics if they’re not going to be effective or the right ones! In your opinion, if you think I do need further antibiotics, which one is the best for this type of infection?
I should mention that I’m severely run down after a year’s illness with 2 frozen shoulders and several steroid injections, and in fact, have developed mild folliculitis as a result (I treat this with fucidin cream and a dermo has given me dermol cream as a cleanser as the spots aren’t just in one area but intermittent and diffuse; perhaps a side effect of the meds I’m taking). Currently, I’m also suffering from an ear infection that the clarithromycin was meant to treat alongside ear drops.
Any advice you could give would be most helpful as being so run down, I’m very reluctant to just keep taking antibiotics haphazardly and would very much like the expert opinion of a dermatologist!
I have taken photos of the nail over the past few weeks so can supply pics if that’ll help?
Many thanks,
Sally
Submitted: 1 year ago.
Category: Dermatology
Expert:  Shantal-Mod replied 1 year ago.
Hello Sally,
I'm Shantal and I'm a moderator for this topic.
I've been working hard to find a Professional to assist you with your question, but sometimes finding the right Professional can take a little longer than expected.
I was checking to see if you had already found your answer or if you still need assistance from one of the Professionals.
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Shantal
Expert:  Dr. David replied 1 year ago.
This is Dr. David

I would be happy to look at pictures.

here are instructions to upload photos

type a word in the textbox and highlight it

then select the "chain" icon above the textbox or the paper clip icon to upload a jpg

this opens a window where you can click next to the text box to select the jpg or pdf file on your computer to upload into JustAnswer

http://ww2.justanswer.com/how-do-i-send-photo-or-file-expert

pus can still mean it is infected or something else is going on

I would recommend you see your dermatologist again

and ask for a wound culture of the nail bed and also a biopsy

a culture can see if there is an infection which is resistant to clarithromycin.

a biopsy can tell if there might be a skin cancer or something in the nail bed which is causing the nail to lift up and not heal properly.

skin cancer is rare in the nail bed, but can happen in rare cases

let me know if you have questions.

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