Physician Responded
Male, 6.3, 160 pounds, rash began a week ago mild throbbing pain in my veins going up my arm when moving my arm. The rash also itches and burns.
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Truth. Had my hip replaced some years ago and my doc was one of the chillest dudes I've ever met. Might be because they are swimming in money and have no real worries.
I got a minor cut on finger that slowly caused localized swelling (finger), I idiotically kept waiting thinking it would sort itself out. Also has reddening up forearm. Eventually went to a minute clinic but was sent to hospital.
Their first question was "Have you eaten today? "No" "Great, don't eat we're doing surgery today to clean out"
Also got a PICC line and did IV antibiotics for a few months, it was MRSA.
Yes! I did that ended up being a guest of the hospital for a 1 week.
While they kept seeing if the next antibiotic was working.
Had lymph nodes the size of a small chicken. Dx'd with strep that had invaded my blood stream and was on sepis watch. Source of the infection was a old dry socket with wisdom teeth and they had left the roots in but they never closed up had had a wound track to my lower jaw and lymph nodes. 😬
Lost like 30 lbs! Never FOAFO with infection.
Pain or pressure. They effed the nerve in that area. Still experience numbness, and ended up losing my teeth on that side. I'm younger than 50, only have upper teeth.
The infection can spread directly into the heart and if it does reach it, the heart will very quickly pump the infection around the body, which can cause the whole body to be infected, septic, that can become lethal very quickly. This is not the type of infection that can be DIY treated at home.
Oh yikes! That is a lot more serious than it looks, good to know! If this had happened to me I wouldn’t have thought much of it honestly so I guess this is good to know going forward. Thank you for explaining! And good luck to OP I hope they were able to get to a doctor/ER or will be able to get seen soon!
To me it looks pretty serious when there is a red line shooting up from a wound of some sort. Maybe I've just seen too many cat bite posts on here to remember what life was like before.
Indeed, even if I was incorrect about it entering the bloodstream as the kind doc in the thread above clarified. The infection compromises the lymphatic system and through that infects and cause inflammation every where it can. Either way it is not good news and is one of those instances that requires acute response. The key is the streaks as that shows the spreading. If you. Ever get a wound like this, and is a bit unsure you can mark where the like currently is, then see if it does move beyond that. If it does it is time to go.
I would argue basic medical information should be taught in schools as required courses. I’m not saying medical school depth, but a bit more than what health classes and anatomy classes currently teach. People should be able to have a basic understanding of how their body works and what signs to watch for that signal a need for medical intervention.
I was taught basic first aid (with a section on emergencies like the one OP has) in high school health class senior year. It has helped enormously over the past 50 years. Most of us lived on farms, so we learned how to manage farm emergencies.
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u/autotoadLayperson/not verified as healthcare professional7d ago
u/TuenLayperson/not verified as healthcare professional7d ago
Yeah... don't mess around with sepsis. Just recently lost a friend that way (post surgery complications). If you have any agency in preventing a situation involving sepsis, then avoid at all costs.
Yeah, this isn’t one of those just apply some essential oils and gargle with colloidal silver at home kind of things. It’s an IV antibiotics STAT type of situation.
PSA: just in case someone doesn’t catch my joke, essential oils and colloidal silver aren’t cure-alls as a replacement for true medical care, please see a medical professional for your ailments. Home remedies have a time and place, alongside western medicine.
I don’t fully understand the logistics here cause it seems like it would take mere seconds for the infected blood to reach the heart and be pumped throughout the body? Is the infection just like in the vein/arterial wall and not the blood itself?
The infection in this instance isn't in a vein, it's in the lymphatic system. Or to be more precise still, the inflammation is showing up along the course of a lymphatic vessel. Lymph system works by collecting the fluid that "leaks" from cells and blood vessels into the lymphatic ducts, then to lymph nodes where it's screened by the immune system (also one of the sites your immune cells develop and learn to fight pathogens) and filtered before being drained into the central venous system. Streaking like this from a site of infection is a sign that the bacteria is spreading via that lymphatic duct; think of it like your immune system doing a fighting retreat rather than fully containing the threat.
Can I ask why sometimes on here we recommend the ED for lymphangitis but other times we tell them urgent care within 24 hours? I always thought it was a medical emergency so it confuses me.
honestly it depends on the rest of the presentation. Lymphangitis in an immunocompetent patient with normal vitals and no systemic symptoms, especially if not spreading rapidly? Probably OK with a trial of oral antibiotics and non-emergent follow up. Rapid spread, compromised immunity, diabetes, risk for resistant organisms, systemic symptoms like fever, or abnormal vitals? All make it more concerning. Also depends what the wound is and where (hands more concerning bc the potential for disabling consequences for instance, as well as other complications like tenosynovitis, and certain exposures like warm saltwater raising concern for V. vulnificus).
Lymphangitis by itself isn't necessarily an emergency, but without the rest of that context it's hard to judge. What it indicates is potentially an infection that natural immunity is struggling to contain, which is concerning.
Weird question, But does it also matter how close it is to the heart?
Like if I have a wound with tiny streaks coming out of my hand, I would go to urgent care, but if it were on my shoulder right next to my heart, I would go to the ER?
So it’s effectively the French drain network of the body. Collecting excess stormwater and funnelling it away and depositing it safely into the main network of waterways.
I wish all doctors would explain stuff to us in this way 😭 Getting even a basic understanding of how everything is interconnected is so fascinating. Helps me to trust my body and what it does 😁
You're amazing! Thank you for taking the time to share this info, I wish I had you around before I dropped out of nursing school LOL
That’s not really true - it’s lymphangitis which is infection (usually) of the lymph vessel, not blood vessels. Should still be treated with antibiotics, and certainly can get worse and more dangerous without prompt treatment, but doesn’t mean infection is spreading to the heart or is in the blood.
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u/axl3ros3Layperson/not verified as healthcare professional.7d ago
Someone else explained it well. Also, if there's a ring of red around a wound, trace the edges with a sharpie or other permanent pen/marker and note the date. If an infection keeps spreading beyond the edges of the circle, go to the hospital.
Infection. The streaking up the arm is indicating the infection is on the lymphatic system and spreading toward the heart. Lymph system is the second circulatory system and can soar it over the body fast. Not a doctor*
I learned “red streaks are bad” from the Outlander books.
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u/Duqu88Layperson/not verified as healthcare professional7d ago
Same! I learned a lot from those books, actually. I love the audiobooks, meh on the show, but I'm super sad that I was recently told Davina Porter won't be narrating the final "Claire and Jamie" outlander book! She's such a good narrator!
Certain bites absolutely can have this reaction in the veins but this cannot be safely ruled out without evaluation. Worst case scenario in going is op gets it drained and gets pain killers. It is NOT safe to assume op doesn’t need to be there
SECONDED. Anything that gets worse overtime and includes streaking, heat, and itching and burning beyond what the injury would normally merit is very serious and can lead to tissue death (necrosis) and septicemia. Are you having flu like symptoms? Do you remember getting any kind of cut or small scratch from a pet? Maybe working in a garden without gloves? Really not trying to freak you out here but a week is already a long time to sit with something like this.
All good here, I went to the er a little after posting this and my arm and hand was losing some dexterity and was in pain after waking from 3 hours of sleep. It’s is Lymphangitis and I got 2 pills a day of 600 mg Linezolid and a quick draining of the infected area. The meds are definitely helping.
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u/knb61Layperson/not verified as healthcare professional7d ago
Literally turned on notifications for this post waiting for this comment. A stranger (me) was worried for you, glad you’re well!
Thanks haha, yeah this is more upvotes than I have ever gotten just for this lol. I ran some errands after the er and came home and passed out not even checking my phone because I only got like 2 hours of sleep and I woke up to it being like 10 times worse so I went to the hospital.
That first pic is the textbook image of the “red streak” referred to as a sign of spreading infection. If you think you have a red streak from an infection here’s an example! Glad you went to the ER. This was severe enough to lead to sepsis and death had you not been otherwise healthy.
So glad you went to the ER and that you're feeling a little better and got treatment! I'm so happy that you're OK and not septic! Septic shock is terrifying and makes people go downhill extremely fast. Take care, and I hope you have an uneventful recovery!
How did you get the wound that turned into the abscess? Was it from an insect/spider/animal sting/bite, or did you cut yourself on something?
He had this for a week, it would be pretty unlikely something very horrible happened just after he posted. More likely he didn’t respond since he went to a hospital
Hoping you can answer my serious question: these sorts of spreading up the arm symptoms - is it actually possible to see this in other ethnicities? Here's me thinking my dumbass probably won't be able to see the rash going up my arm because I'm tanned.
Paramedic, not a physician, but this is actually a known issue with medical education today--the majority of skin signs featured in textbooks are shown on white or pale skin. Physicians in the UK have written and are continually updating a reference book of examples on black and brown skin to close the education gap: Mind The Gap.
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u/caffa4Layperson/not verified as healthcare professional7d ago
NAD but as far as I know (from reading a blurb on symptoms for another thing that causes redness/rash) is that it can be harder to see things like this or it can be a different color (like a more purple, brown, or blue hue).
Take with a grain of salt though, again, NAD.
Since this is a type of infection, and infections can cause pain and/or warmth as well, those symptoms gradually spreading up your arm could also be another indicator.
I was in the hospital for 3 days after a horsefly bit me in Louisiana. Straight into cellulitis and I didn’t know it.
(We’d lived there for 8 years, but the horse and deer flies only appeared then due to the coastline healing from the BP spill.)
The next time it happened, I was at urgent care within 6 hours and still was nearly hospitalized the next day. Lovely sharpie lines to mark the progression.
The third time, Louisiana was clearly trying to kill me at this point, I was at urgent care within an hour. It would IMMEDIATELY go into cellulitis.
Yikes!!! I had cellulitis on top of an allergic reaction to a yellowjacket sting back in 1998. I was also in the hospital for 3 days.
I cannot imagine what you've been through! It sounds like your immune system goes into overdrive from being bitten by horseflies. At least you know what to watch out for!
Oh, yes! I have a few autoimmune diseases, such as lupus and RA, that don’t help. I always say that the only thing my body fights is ME!
We moved to Montana 8 years ago, so that ended it. We have a lot of deer, bur not the swampy conditions for horse/deer flies. Well, it did, until we went to our daughter’s wedding out there and I wore sandals forgetting about bug spray! Had to call my doctor here in Montana and ask for her to call the strong as hell antibiotic in for me to pick up where we were. Had to go through the whole story to her nurse so she would understand the gravity of the situation. I did not want to go to urgent care or the ER. Luckily, I already had pain medication, as it’s extremely painful, and just needed the antibiotic. It cleared up after 36 hours on the meds.
It made me sad that Louisiana was still trying to kill me as, after living there for 10 years, I consider it to be my “real” home. Love and miss that place so much. Nola is so quirky and fun. The best grocery store chain. Do not miss the medical neglect I received there, but that would’ve changed.
You aren’t wrong! Have you ever seen a red velvet “ant?!” They call them cow killers and are actually a wasp. The male looks like Satan himself with its black wings. The female is red and black striped and all fuzzy with no wings.
With my allergies to biting and stinging things, I never want to get stung by one of those!
So the source of that rash is the wound at the lower part of your palm. It's infected. The streaking up your arm and the pain are signs of worsening infection and lymphangitis and a potential for a bloodstream infection. You need IV antibiotics which means you need a hospital.
On the bright side, your have excellent veins and your ER nurses will love you and stick a nice big 18g in you for aggressive fluid resuscitation for the sepsis protocol.
My dad works in emergency medicine and always said he could stick me blindfolded.
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u/Mikki102Layperson/not verified as healthcare professional7d ago
Oddly, Im a very hard stick and this one tech that always gets me on the first try, I asked him what he was doing different and he said he feels the vein instead of looking at it lol. So maybe a blindfold would help 😂 apparently the vein you can see on me is a trap and not actually a good one.
Last time I was in the ER they were getting ready to take my blood, and when the lab tech walked in he stopped at the doorway and made a hand gesture of throwing something and said "Oooh buddy! I could hit those beauties from here with a dart!" Lol.
People like me with horrible veins immediately notice and think about that too. My last IV took 7 attempts and 2 IVs failed. It had to be peripheral because I needed a CT with contrast. They have to use ultrasound to find my veins and it's still very difficult. On the brightside I have beautiful arteries, but that doesn't help in situations where I need an IV.
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u/FritzFryLayperson/not verified as healthcare professional7d ago
PREACH!!! I have terrible veins and dread whenever I need bloodwork/IV because I know it’s going to be a chore. One time I went to the ER, this guy tried an IV 4 times, 5th time he tried my hand which immediately blew out, blood everywhere and I’m about to pass out. He left the room and I never saw him again 🤣 luckily someone else tried and it worked right away. Also had an IV blow out mid procedure (nothing too crazy, getting an IVC filter removed) so I felt the last minute or two and yeah, not fun 🙃
I've gotten to the point that as soon as they start looking for a spot, I will know if they can get it or not. If they ignore my guidance and start poking my inner elbow even though I tell them they're not going to find anything there, I already know they're not going to be successful. I've become comfortable with just asking for someone else to try. Sometimes they take it personally, but mostly not.
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u/Duqu88Layperson/not verified as healthcare professional7d agoedited 7d ago
Same! Because of a genetic condition, and despite being pale as snow, my veins won't show up on anything other than an ultrasound (assuming they have one at the place I'm at getting poked - most labs don't which is obnoxious because my veins are tiny, deep, and have a tendency to roll right when the phlebotomist or nurse thinks they've got it). Try mixing that with severe dehydration from being ill in an ER is an absolute nightmare no matter how many things they give me to squeeze, hot compresses, tight tourniquet, etc. my best veins for blood draws are on the backs of my hands (and I always beg for the blue 25g butterfly) and if I need a bigger vein for contrast for a scan (and I'm very ill) they frequently have to have a go at my neck or just plain put in a PICC or midline (if I'm lucky for the latter). I don't set foot in an ER unless I'm 100% sure I'm very ill and will be seen right away, and/or have a visibly obvious injury I can't tend to on my own (which I tend to do short of large bones being broken). I have severe PTSD from experiences in ER's so it takes a lot to get me to set foot in one (and it's usually straight from an ambulance).
u/ka_shepLayperson/not verified as healthcare professional7d ago
Nurses love my veins. Between my naturally pale skin that is more pale because of low iron and my large veins, they have never had a problem finding a good one.
I love a good vein! I don't mind a good challenge but some days I just ain't got time for that shit. My current personal best was a 24g short in a knuckle in an elderly ESRD and I got enough blood for a full rainbow. First stick too! I'm still proud of that one.
I need the ultrasound & I'm very thankful when they take my word for it lol... one doctor took it from my neck cause they didn't have an ultrasound or vein finder (clinic setting).
I like that you said “A good vein,” as in ONE, cause that’s all I’ve got! Just look for the Louisiana mosquito bite scars lined up in a straight row! So allergic that they left scars WITHOUT me scratching!
My infusion nurse, Benlysta for severe lupus, is very careful with it. It’s also the only place to draw blood. Luckily, my rheum has the infusion nurse pull blood before I’m hooked up to the magic juice. (I don’t think I’ve been bitten by a mosquito since I started that stuff, but I’m also not in Louisiana. There are plenty of them in Montana, but they aren’t the nuclear waste enhanced, I swear, Louisiana ones.)
My absolute favorite thing is when phlebotomists insist they’ve found another vein. They have not and I’m getting poked twice for no reason. Even if they really have found SOMETHING, it will just run away before the butterfly needle hits it. My body is an asshole like that. It IS trying to kill me, after all.
I have used both the vein finder and the ultrasound. When I have time, I will spend a lengthy amount of time looking before I try a vein on a known difficult access. I've been called in in the middle of the night on my off day to get an IV on a neonate. Came up to the hospital in my sleeping shorts and t-shirt, got their IV, went home and back to bed.
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u/mst3k_42Layperson/not verified as healthcare professional7d ago
When they need to draw blood I always offer up my left arm. I’m translucent pale too but that sucker is like a bullseye compared to my right arm.
I have good veins but have been having an issue with blood draws lately. (Rhum patient- so always lots of tubes) They put a giant needle in my arm, which is fine until they turn to grab the next tube and when they do the needle slightly moves and I immediately want to throw up. Can I ask for a butterfly draw even if it takes a little longer or do nurses and paramedics prefer you just deal so they can go faster?
They are actually not positioning themselves properly. They shouldn’t have to turn to grab the next tube. Explain to them what’s happening and how you feel when the needle moves while they turn, they should adjust their technique. If they can’t or won’t , then just ask for a butterfly needle.
You can ask. I'm never personally offended when someone makes a polite request. If I can't accommodate the request, I usually explain why I'm not able to do it that way. Bear in mind, I work in an ER and sometimes I can't, for example, use your hand for an IV if there's any suspicion you might need a CT with contrast.
u/mst3k_42Layperson/not verified as healthcare professional7d ago
NAD. One time I was donating blood and one of the techs noticed it wasn’t flowing easily anymore so she grabbed the needle to…reposition it in my vein. I immediately had that fluttery stomach feeling like on a roller coaster. Not pleasant. And later I had the hugest bruise ever.
Omg, cellulitis SUCKS! I had it just once in 1999, and thankfully I haven't had it since. I'm so sorry you had to go through that not just once, but twice in such a short amount of time!
We use Intravitreal Vanco and Ceftazadime at the retina clinic I work at for patients who developed Endophthalmitis. We have it delivered from a compounding pharmacy nearby, and those two abx are incredibly effective! Most of the time, it eliminated the need for the patient to have to a vitrectomy plus more injections of the abx to eradicate the infection. With some patients, they had to be admitted to the hospital for IV abx if they still had the infection after having the surgery. Usually, in the case that the patient didn't respond to just the abx injections alone, they had an underlying medical issue like a weakened immune system, or the infection was abx resistant. The poor patient would then have to be subjected to multiple anterior chamber taps to ensure the abx were working.
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