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Ask Dr. Natasha Your Own Question

Dr. Natasha
Dr. Natasha, Doctor
Category: Medical
Satisfied Customers: 12910
Experience:  American Board Certified in Emergency Medicine, Ivy League trained
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Hi, I am a gout sufferer with 2 x tophi on my left second toe.

Customer Question

Hi, I am a gout sufferer with 2 x tophi on my left second toe. I suffered a puncture wound 5 weeks ago and although the infection is almost gone and the toe swelling has subsided, I c annot get it to heal properly. It sacbs up then after a few days pus seems to leak from it, then it dires up again. I am currently on a 10 day course of Flucloxocilin 500mg 4 x times a day. Can you help, is the seeping anything to worry about? Do you think the wound is healing as the scab has stayed on for a week now but started oozing a little this morning? Should I keep the scab moist and covered or dry and exposed? Please help getting very frustrated. Andy
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. Natasha replied 3 years ago.

Dr. Cameron :

hello

Dr. Cameron :

welcome to the chat :-)

Dr. Cameron :

please type and hit reply

Dr. Cameron :

any history of diabetes?

JACUSTOMER-s28f7eva- :

No Diabetes, blood tests last week

Dr. Cameron :

are you still there, andy?

Dr. Cameron :

thanks

JACUSTOMER-s28f7eva- :

yes

Dr. Cameron :

Well, if there is pus leaking out, then it suggests that it is not responding completely to the antibiotics

Dr. Cameron :

I noted that you have been on two different types of synthetic penicillins

JACUSTOMER-s28f7eva- :

ok

JACUSTOMER-s28f7eva- :

yes

Dr. Cameron :

it may be resistant to penicillin

JACUSTOMER-s28f7eva- :

only 2 days into this course

Dr. Cameron :

well, usually antibiotics kick in the first 12-24 hours

JACUSTOMER-s28f7eva- :

what should I do?

Dr. Cameron :

You can give it another day, but if it is still oozing, you need to change medication

Dr. Cameron :

one question- were you wearing tennis shoes?

Dr. Cameron :

or a rubber soled shoe?

JACUSTOMER-s28f7eva- :

tennis shoes

Dr. Cameron :

thanks

Dr. Cameron :

one type of bacteria, pseudomonas, is known to cause infection

JACUSTOMER-s28f7eva- :

should I leave the scab alone or clean it off?

Dr. Cameron :

and it responds to a different medication called ciprofloxactin

JACUSTOMER-s28f7eva- :

The lab results came back with Staph

Dr. Cameron :

it may not grow out

Dr. Cameron :

either way, the staph may be resistant to the penicillin

Dr. Cameron :

in this case, you can add on bactrim or cipro to cover MRSA

JACUSTOMER-s28f7eva- :

should I go back to my doctor?

Dr. Cameron :

You should clean the scab with alcohol twice a day and apply antibacterial ointment

Dr. Cameron :

give the antibiotics another day, clean with alcohol and apply antibacterial ointment

Dr. Cameron :

if it does not get better by Monday morning (or gets worse), then go back to your doctor

JACUSTOMER-s28f7eva- :

ok

Dr. Cameron :

Anything else :)?

Dr. Cameron :

Did I provide you with excellent service?

Expert:  Dr. Natasha replied 3 years ago.
Hi Andy
It appears that our chat did not close properly.
Was there something else I can clarify for you or did I provide you with excellent service? :-)

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