Cellulitis on the Nose: A Case Overview
A 53-year-old female, standing at 5'3" and weighing 135 pounds, who is a non-smoker and has a medical history of multiple sclerosis and asthma, along with nasal polyps, recently faced a health concern. She has been prescribed Benazepril and Voquezna, and previously used Xhance nasal spray until quite recently. The symptoms have persisted for four days. On Monday, her wife noticed that she had developed a painful swelling on the left side of her nose. This individual had previously experienced a similar condition in 2014, requiring an emergency room visit, during which she received IV antibiotics, specifically piperacillin and vancomycin, followed by a course of Augmentin upon discharge. After observing the issue on Monday, they decided to visit the emergency room. The physician assistant on duty appeared relatively unconcerned, ultimately prescribing Augmentin. As the days progressed, the redness on her nose began to extend toward the center of the bridge, showing no signs of improvement as they entered the fourth day of treatment, having consumed seven doses of the antibiotic. Unlike the previous incident in 2014, she has not experienced any fever this time; however, there is a level of concern regarding the infection's proximity to her brain. While she aims to remain calm, the absence of fever raises questions about whether this situation merits further attention. Should there be a reason to return to the emergency room and insist that she receive IV antibiotics for more effective treatment?
Answers (1)
4/3/2025, 5:40:41 PM
OpenHealth AI
It’s understandable to be concerned about the persistent swelling and redness on the nose, especially given your medical history. The symptoms you describe, particularly the lack of improvement after four days of Augmentin, warrant attention.
Key Points:
- The swelling on the nose may indicate cellulitis, and while some cases can resolve with oral antibiotics, the lack of improvement suggests that further evaluation is needed.
- The absence of fever does not rule out a serious infection; however, it can sometimes suggest that the body is managing the infection differently.
- Given your previous experience and existing health conditions, seeking additional medical care is advisable if improvement is not seen.
Explanation:
Cellulitis is a bacterial skin infection that can spread if not treated adequately. In your case, the extending redness and persistent symptoms indicate that the antibiotic may not be effectively addressing the infection. Individuals with underlying conditions like multiple sclerosis and asthma may have a heightened need for careful monitoring and treatment due to their compromised immune systems.
Next Steps:
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Seek medical attention: Given the lack of progress with oral antibiotics, it’s important to return to the emergency room or seek immediate care from a healthcare provider. Explain your medical history and previous treatment to emphasize the seriousness of your situation.
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Request assessment for IV antibiotics: Upon seeking care, advocate for a thorough evaluation, and express your concerns regarding the infection's proximity to the brain. Request an assessment that includes the possibility of intravenous therapy if deemed necessary.
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Monitor symptoms closely: Keep track of any new symptoms, such as increased swelling, pain, or changes in appearance around the infection site. Document these changes to share with healthcare providers.
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Stay calm but proactive: While it’s essential to manage your concerns, staying calm will help communicate effectively with medical professionals.
Your health is the priority, and taking proactive steps now can help ensure appropriate treatment. Please let me know if you have any further questions or need clarification.
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