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What Causes Shortness Of Breath After Discontinuing Clindamycin When Diagnosed With Cellulitis?
Question: I was diagnosed with possible cellulitis. Seen in walk in clinic by sports medicine physician. Put me on clindamycin 600 mg three times a day. Within 24 hours did not feel well - flu like symptoms. Went to emergency room. Blood test, EKG normal, blood pressure slightly elevated. Given 1 gram vancomycin. 8 hours later another 1 gram vancomycin. Both times took 1/1/2 hours for complete infusion. First emerg MD said yes to cellulitis, second MD said no. Sent to outpatient IV clinic. Orders were for 1 gram vancomycin IV in 12 hours intervals. Appointment the next day given 1.5 g vancomycin. Nurse said it would be done in an hour. Within half hour light headed, nurse said lie down to take dose. Within a few minutes extreme shaking on right side, arm and leg (given IV on left side).Would not stop, blood pressure over 200. Nurse concerned with stroke. Paramedics called determined no stroke. Transported to emergency room. Shaking stopped within half hour, before got to emergency. Seen in emergency. Blood, EKG normal. Blood pressure started coming down. CT scan of head showed no damage. Emergency physician thought it was cellulitis. Discharged. Back to IV clinic next day to see Infectious Disease doctor. That doctor not sure it was cellulitis. Determined I was given 1.5 grams vancomycin. Pharmacist countermanded doctors orders because protocol at clinic is when over 75 just one dose a day. ID doctor discharged me from clinic and told me to continue taking clindamycin in a lower dose. One 300mg every 6 hours for 5 days. Probiotic pill Align taken each day. After 4 days, really not feeling well - shaking, ringing in ear, headache, weakness stopped clindamycin because noticed as it wore off was feeling better. Next day, tingling in hands, feet, mouth, face and shortness of breath.
Brief Answer:
proper investigation may solve this case
Detailed Answer:
Hello,
cellulitis is a serious infection and certain findings are expected in the blood tests. The white blood cell count is expected to rise (with polymorphonuclear predominance) and inflammation markers like the C-reactive protein may become sky high in just a couple of days. High fever is expected as well.
The infected extremity (usually an extremity, you haven't clarified the infected part of your body) is red, swollen and hot. When the inflammed area is clearly demarcated, it is usually erysipelas, which is a similar infection (with similar treatment).
The symptoms you've had during vancomycin infusion can be probably attributed to the drug. The faster the infusion the higher the rate of side effects. Vancomycin is a well-known toxin for the ears and may cause various symptoms including ringing and even deafness. I can't fully explain the rest of your symptoms because they probably cannot be attributed to either antibiotic. Not feeling well and shaking may be a sign of fever...
Shortness of breath is a symptom that requires immediate investigation to determine its cause. Pulse oxymetry is a fast and easy way to get an idea of what might be going on. Abnormal pulse oxymetry readings would raise concerns for serious disorders that would require a visit to the ER.
If the doctors are pretty sure there is an infection then taking an antibiotic (either clindamycin or alternatives) is essential for an uneventful recovery. If they're not then perhaps further testing (as suggested above) would help.
Kind Regards!
proper investigation may solve this case
Detailed Answer:
Hello,
cellulitis is a serious infection and certain findings are expected in the blood tests. The white blood cell count is expected to rise (with polymorphonuclear predominance) and inflammation markers like the C-reactive protein may become sky high in just a couple of days. High fever is expected as well.
The infected extremity (usually an extremity, you haven't clarified the infected part of your body) is red, swollen and hot. When the inflammed area is clearly demarcated, it is usually erysipelas, which is a similar infection (with similar treatment).
The symptoms you've had during vancomycin infusion can be probably attributed to the drug. The faster the infusion the higher the rate of side effects. Vancomycin is a well-known toxin for the ears and may cause various symptoms including ringing and even deafness. I can't fully explain the rest of your symptoms because they probably cannot be attributed to either antibiotic. Not feeling well and shaking may be a sign of fever...
Shortness of breath is a symptom that requires immediate investigation to determine its cause. Pulse oxymetry is a fast and easy way to get an idea of what might be going on. Abnormal pulse oxymetry readings would raise concerns for serious disorders that would require a visit to the ER.
If the doctors are pretty sure there is an infection then taking an antibiotic (either clindamycin or alternatives) is essential for an uneventful recovery. If they're not then perhaps further testing (as suggested above) would help.
Kind Regards!
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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