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Infection at Incision - How to Proceed

4 1/2 weeks post-op Posterior Laminectomy & Fusion C3-6 with bone graft.

From what I've seen online, blood tests and MRIs are usually recommended when infection is suspected. I was diagnosed with an an infection and prescribed an antibiotic over the phone based on my description and that of my visiting nurse without any tests. Should I be concerned that I might not be on the right antibiotic? How do they tell whether the infection is superficial or inside the wound? I'm assuming they think it's superficial, hence the prescription for Keflex. However, from the recommended dosages I've seen online for skin infections, the duration is 7-10 days minimum for Keflex, and often longer. I was only given 5. After 3 there is little improvement.

Based on comments read on past forum threads, I see many people recommending consulting an Infectious Disease Dr. for infections. At what point would I do this? Should I wait and see what transpires or call Monday to make an appointment thinking I should get a second opinion regardless of what the surgeon says?

Just wondering if anyone has any advice on how to proceed from here. I would rather be proactive and do whatever is needed to prevent them having to later go in and take out the hardware.

Here is what happened:

When the PA took off the bandage at the 3 wk. visit and told me to keep it off, 3/4 of the incision looked nicely healed, but there were 2 scabs and it was a little red around them.

Since then the scabs got a lot bigger, apparently from pus oozing out onto them and drying. I developed a bright red rash all along the incision, which is full of blisters. It kept growing and extends 4" on either side of the incision. It is swollen and warm to touch. At the top there is some kind of abscess, about the size of a robin's egg under the skin. I've had a low-grade temp, not exceeding 99.6. It is scary to look at and literally everyone that sees it realizes it's badly infected.

The visiting nurse left a message for the Dr. Thursday and said I could not wait the weekend to be seen and wanted me to be seen Friday. The PA called me and then called in a prescription for 5 days of Keflex to the pharmacy that I started Thurs. night. I sent her pictures by email. She said to send another picture Monday and call her and then she would decide if I needed to come in to be seen on Tuesday.

For 3 days I've been light-headed and tired. Not sure if it's the antibiotic or the infection. Yesterday I noticed I now have swollen glands that are still swollen and tender today. The redness, blisters and abscess seem a little better, but not sure if that's wishful thinking. I stopped my daily 40 min. walks for fear the heat, humidity and sweat might irritate it and that may have helped. Also stopped using all soaps, just water and staying in AC as much as possible.

The worst pain I have is at night, in the back of my neck and head, when I lay my head on the pillow. Throughout the day my neck is sore/stiff when I turn it, hurts when turned certain ways. It hurts when touched on each side. Still have pain from graft sight and drain hole. Drain hole pain suddenly started a week ago even though it looks healed over, but red. Tylenol 3x/day is enough to get me by. Not sure if this is all normal at this point in recovery.

Unless I'm convinced otherwise, I think I will request to be seen Tuesday and not leave it up to PA to decide if it is necessary. But wondering if I should insist on tests and/or seek a second opinion.

I have learned a lot here, which has been comforting at times when I find out what is "normal" after this surgery, but also makes me wonder about what is next. Thanks so much for your time and caring to share your experiences. I hope to do the same once I make it to the other side.
"The first step toward living a happy life is to treat every other human with kindness."- Dalai Lama

7/25/16 Posterior Laminectomy C3-6, Fusion C3-6 with instrumentation, Right lcbg (Bone Graft), and corrected bone spurs and billateral foraminal narrowing in C3-6.

Optimism Is Key Optimism is Key!
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Comments

  • Ellen625EEllen625 New Jersey, USPosts: 757
    Hi worldexplorer
    I would request to be seen as well. I don't have experience with your issue but would be concerned. 
    Ellen 
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