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Cut in toe and on AVELOX. Is it infected?

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Is my cut infected? I cut my toe with a powerwasher on Monday at 8pm and was given antiobiotic creme to put on it and a 3 day course of avelox 400mg. It it sensitive to touch, but not warm.

I've posted a picture from Monday after it happened, and what it looks like now.

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
 18 Doctors Online

Hello.
Thank you for your query at DoctorSpring.com.

I have gone through both the pictures. Your toes does not seem to be infected at present. If it was infected, there would be pus/discharge or debris in the wound with swelling and warmth of the surrounding area. Your wound is clean. It is showing signs of healing (presence of healthy pink granulation tissue within the cut) and closing up (the cut margins have approximated).

I assume the cut must have been a few millimeters deep which would explain the time being taken for healing and presence of tenderness even now.
Continue using the topical antibiotic cream. Keep the foot clean and dry and it should heal completely in a week's time.

I hope this was helpful. Feel free to ask queries.

Regards.


Patient replied :

Thank you so much, This is my toe today (5 and a half days post injury)
Does it still look like it is on the right track? I posted my previous photo on medhelp and someone responded that i have a "serious problem." What do you think? It is not warm to the touch, no discharge, just some senstiitivity on the wound itself.



This was the response that had me scared, it was from a poster on medhelp.
"You have a serious problem and skin cream antibiotics are inappropriate. They only create a situation for a mutated bacteria resistant to antibiotics. MSRA is going around.You need to back to the doctor. Minor toe infections can grow inward and develop osteomyelitis with a few days resulting in toe amputation. These infections are common with diabetics but can occur with anyone. Oral antibiotics do not diffuse readily in the toes. That is a big problem, because the oral dose to maintain therapeutic concentrations in the toe become toxic. In 1975 the Veterans Administration did tests with silvered silk soaked in saline attached to the positive side of a 1 1/2 volt battery to treat these infections. See the book "The Body Electric" for the study. The silver ioones went 1/4 inch into the skin and destroyed the infection. The jan 2011 Journal of Infectious diseases suggests an oral fluoroquinalone (Cipro) is as effective as intravenous medications (generally Vancomyacin) for osteomyletitis of the toe. You need to see a physician. "


Hello.
Thank you for the follow up.
I will sincerely advise you to avoid that response from Medhelp.
The picture after 5 and half days, shows extremely good signs with healing almost complete. There is granulation tissue, it does not appear to be swollen, there is no sign of any pus, or any other discharge and you're absolutely on the right track.
Keep applying the local antibiotic creme that you're applying and it will heal in another couple of days time completely.
Regards.


Patient replied :

Thank you again, I've attached my 7 day photo. Does it still look like i'm on the right track? None of my toes hurt when touched directly (or are warm to the touch), but when i put on my shoes i now seem to have mild pain in some of the toes.
I wasn't sure if this is from me babying that foot and walking weird while it's been healing, but today is the first day i've put a shoe back on. Is there anything for me to worry about?

Thank you again,
Cole Smart


Hello.
Thank you for the follow up.
Yes i saw the image that you sent, you're definitely on the right track. The healing is taking some time, but then it's on the toe and it is expected that it will heal slightly slower compared to wounds in other places. The cut edges have approximated. I will advise you to apply Soframycin ointment till it heals completely. The pain can be due to a difference in the way of walking. That is nothing to be concerned about. But yeah soframycin will help in faster healing. Actually healing has happened, it will hasten or spped up the disappearance of the wound completely.
If shoes are creating discomfort try to avoid it for the next few days. And please use socks if wearing shoe is mandatory. It should not be compressed in any way.
Regards.


Patient replied :

Thank you, I tried looking for the Soframycin at my local pharmacy and they don't have any. Do you have any other suggestions?
Also, one more question. The wound continues to heal and look better ( i attached 10 days post), but i feel like i'm having nerve type pain over the cut. Last night after playing Tennis, i had a constant sensation as if someone was tapping the top of my foot over and over. Not painful, just odd. The sensation was gone in the morning, but it is still just tender. Thank you, Cole Smart



Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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