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Having Lupus. Not Responding To Antibiotics. On Infusion Treatment. Hard And Enlarged Calf. MRV Performed For Blood Clots
Question: I have lupus and am currently being treated for an infection in my right leg, but it is not responding to antibiotics. I have been doing infusion treatments for 9 weeks. The calf is very hard and slightly enlarged, and the area above my calf and below my knee is also very hard. There appears to be an enlarged "band" around of leg. My ID doctor, as well as myself, are very puzzled as to what we are really treating. Any insights into what my problem may be?
An MRV has been performed on my calf 2x to verify there is no blood clot.
An MRV has been performed on my calf 2x to verify there is no blood clot.
Dear XXXXXXX,
With history of lupus, infection in the form of cellulitis is a strong possibility. Is the area red and tender? Is there an ulcer or is there oozing? Presence of all these will suggest an infection. Antibiotics based on blood culture or culture of discharge will give a good response.
Second possibility is that of XXXXXXX venous thrombosis. A venous doppler will confirm its presence. The treatment will be entirely different, in the form of anticoagulation. Some forms of lupus, especially with presence of antiphospholipid antibody, will make one prone for XXXXXXX vein thrombosis. You mentioned you have some blood clotting disease. What exactly is it?
Lastly, something unrelated to lupus, such as some form of skin disease is also a possibility. Dermatology opinion may help
Good luck
Dr Jadhav
With history of lupus, infection in the form of cellulitis is a strong possibility. Is the area red and tender? Is there an ulcer or is there oozing? Presence of all these will suggest an infection. Antibiotics based on blood culture or culture of discharge will give a good response.
Second possibility is that of XXXXXXX venous thrombosis. A venous doppler will confirm its presence. The treatment will be entirely different, in the form of anticoagulation. Some forms of lupus, especially with presence of antiphospholipid antibody, will make one prone for XXXXXXX vein thrombosis. You mentioned you have some blood clotting disease. What exactly is it?
Lastly, something unrelated to lupus, such as some form of skin disease is also a possibility. Dermatology opinion may help
Good luck
Dr Jadhav
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I have had cellulitis in the past, but while there is some edema present we are certain we are not dealing with cellulitis in this case. The area is tender but not red; there is no ulcer of oozing. We have also ruled out XXXXXXX venous thrombosis.
We think we may be dealing with an abscess or possibly damaged tissues. As I indicated the area is hard and tender to the touch. I am having a CT scan in the morning to see what it may indicate.
We think we may be dealing with an abscess or possibly damaged tissues. As I indicated the area is hard and tender to the touch. I am having a CT scan in the morning to see what it may indicate.
Thats excellent. CT scan will give an accurate diagnosis. In this situation, abcess becomes a very strong possibility and needs to be ruled out with a CT scan
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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