OpenHealth Q&A

Recognizing Infection Symptoms After Trauma and Amputation: When to Seek Emergency Care

A 39-year-old female, standing at 5 feet 1 inch and weighing approximately 150 pounds, follows a daily regimen including Vyvanse at 70 mg for ADHD and medical marijuana for anxiety and pain relief. Her medical history consists of ADHD, degenerative disc disease, and hypoglycemia. She is currently on a prescribed course of Amox-Clav at 875-125 mg every twelve hours, along with hydrocodone 5-325 mg to manage pain as needed. Earlier this year, on May 16, she endured a serious workplace accident while testing a smoke grenade fired from a 40 MM weapon, which malfunctioned and detonated. The incident resulted in severe injuries: her left index finger was severely damaged, the tip of her left thumb was completely lost necessitating amputation, and her forearm sustained major trauma with significant muscle and nerve damage. Additionally, she suffered large lacerations on her hand and bicep, alongside a puncture wound to her right breast. Following the trauma, she underwent surgical debridement and spent five days in the hospital. She began physical therapy on June 16. By July 14, her physical therapist observed pus exuding from the nail bed of the injured index finger. The next day, she consulted her orthopedic surgeon, who prescribed Bactrim and recommended Hi-Bicleanse soaks to be performed twice daily. However, her condition prompted concern from her therapist when they noted ongoing drainage mixed with blood. Her arm and hand exhibited swelling, color changes, and fluctuations in temperature; at one point, her hand appeared purple and felt cold, which alarmed her therapist. The previously small wound was noted to have become larger and deeper. Although the therapist advised her to seek urgent care or visit the ER, she opted to wait for her appointment with her general practitioner the following day. When she met with her GP that Tuesday, he assessed her condition as not healing adequately and took a sample of the fluid for culture, though results were pending. He administered an antibiotic injection with an anti-inflammatory agent and prescribed Amox-Clav. Despite starting the antibiotic treatment on Wednesday, the drainage continued. Since her hospitalization, she has also experienced intermittent low-grade fevers ranging from 99 to 101 degrees Fahrenheit. Concurrently, she has been suffering from significant back pain, which she attributes to her existing degenerative disc disease, although she is aware this can also signal an infection. Her physical therapists warned that the persistence of pus or blood drainage, even after several days on antibiotics, indicates the infection may not be improving. She is now contemplating whether to visit the emergency room or urgent care if her finger doesn't show signs of improvement by tomorrow. While she has an upcoming appointment with her orthopedic specialist on Tuesday, she feels anxious about potentially underreacting to her situation. Any insights would be greatly appreciated as she navigates this challenging recovery process.

Answers (1)

7/27/2025, 3:50:39 AM

OpenHealth AI

It's understandable to feel anxious about the situation you are facing, given the complexity of your recovery after such a significant injury. Your symptoms, such as ongoing drainage with blood, swelling, color changes, and low-grade fevers, raise valid concerns about the potential for infection or complications. Here’s a structured way to approach your situation:

Summary of Key Points:

• Persistent drainage, swelling, and fever after trauma can indicate an infection.
• Symptoms like fluctuating temperature and significant changes in color and temperature of the limb are concerning.
• Given your situation and the advice of your physical therapist, seeking immediate care may be necessary.

Explanation:

After traumatic injuries, the body's ability to heal can sometimes lead to complications, such as infections. The presence of pus, ongoing drainage, color changes in the hand (especially becoming purple), and fluctuating temperature suggest that your injury may not be healing as expected. Low-grade fever can also be a sign of infection, particularly when combined with other symptoms.

Next Steps:

1. Immediate Evaluation: Seek emergency care or urgent care today. Given the seriousness of your symptoms—persistent pus, low-grade fever, and significant changes in your hand's color—it’s crucial to have a healthcare professional evaluate your condition sooner rather than later.

2. Monitor Symptoms: If you notice further changes in swelling, temperature, or any new symptoms like increased pain or numbness, mention these when you seek care. These can help healthcare providers determine the severity of your condition.

3. Prepare for Your Visit: Document your symptoms, any medications you are currently taking (including dosages), and any treatments you have undergone. This information can help the medical team understand your situation better.

4. Follow-Up Care: After your emergency visit, ensure you have a clear plan for your follow-up with your orthopedic surgeon. Pay close attention to any instructions provided regarding wound care and medication use.

Reassurance:

It's completely normal to feel anxious about your health, especially under such challenging circumstances. Seeking care is a proactive step, and it’s important to trust your instincts. Your health and recovery are the priority. Know that addressing these concerns promptly can lead you towards healing more effectively. If you have any more questions or need clarity as you navigate this, feel free to ask.