Problem at Little River

[madeline]

I dove Little River yesterday, in climbing up the rocks I either scraped against something, or was bitten by something my hand itched like h--- then started to swell, today it is swollen and the welling has progressed up the arm, has anyone mentioned anything in or around the waters edge that would cause this??

[Dive-aholic]

I don't know of anything in particular at Little River that would do that (though there are snakes in all the waters of Florida), but you need to go to the emergency room. If the swelling is progressing up your arm, you probably have an infection that needs to be treated with antibiotics. Unfortunately, hand infections can be some of the worst infections.

[madeline]

already did that, on lots of different stuff to get better, just thought that others had complained, there were lots of little kids jumping all over the rocks, by the exit

[Capt Jim Wyatt]

already did that, on lots of different stuff to get better.

Did the Doc give you any hint as to what it could be?

[madeline]

infection of some sort, could be bacterial, from something on the rocks, just gave me big white pills ,levaquin 750mg and methylprednisolone he hopes that will solve the problem, as of this evening, pain up to shoulder, figure it will take several days for pills to take effect. just wonder what was on the rocks.

[Capt Jim Wyatt]

Please keep us posted on your progress. I hope your recovery is fast!! I am planning to dive Little River Monday and I appreciate the heads up about this.

I hope you do not mind that I separated this thread from the original one.

Jim

[Dive-aholic]

Most ER docs will only diagnose cellulitis - inflammation of the tissue. Levaquin and steroids are the typical treatment. However, it sounds like you may need to get some IV antibiotics (Levaquin). If the swelling and pain are still migrating up your arm you should definitely get rechecked.

[jimdiverman]

I dove Little River yesterday, in climbing up the rocks I either scraped against something, or was bitten by something my hand itched like h--- then started to swell, today it is swollen and the welling has progressed up the arm, has anyone mentioned anything in or around the waters edge that would cause this??

Could this be a brown recluse spider bite? Those can spread like that too. I am not sure the treatment would be different than antibiotics though.

[TSandM]

Brown recluse spider bites cause a necrotic ulcer, and it takes some time to develop. This sounds like a cellulitis (unless the OP was snake bit) but a rather bad one. There may well have been nothing in particular on the rocks; the environment, and soil in particular, is full of bacteria.

By today (48 hours on antibiotics) you should be seeing some improvement in the swelling and pain. If you are not, you need to present for reevaluation. Levaquin was prescribed because it is a broad spectrum antibiotic which SHOULD cover most organisms that cause cellulitis, but it is always possible to be infected with something which is resistant to the antibiotic, and if you are not responding, you may need a change of medication.

[divindoc]

Did you have a fever with this swelling and redness?

The history sounds more like "diffuse local reaction to insect sting" than cellulitis to me. This is a local toxic effect of insect stings, causes considerable swelling and redness of the limb, but not associated with fever. Steroids and antibiotics are not indicated for treatment, as a matter of fact, nothing much helps except elevation of the extremity. I see this all the time here in sunny 'ol Fla; that being said, I can't fault the docs decision to put you on that treatment regimen, as differentiating the two can be difficult, and delaying treatment for an aggressive cellulitis of the arm is problematic. If one has the choice, close follow-up, with the patient taking his/her temp. 4x/day and immediate return for treatment as needed is how I handle these things - *but not over the Internet*!