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Hi all -- a small problem for which I would appreciate advice and input --
Patient is 74 yr old fit , healthy retired medic who has had a problem with medial side of left hallux -- initially presented as involuted / in growing nail - but little evidence of nail spike. Her summation of history is -- 1.' She had onset of redness, swelling and throbbing of soft tissues around nail bed, medial side of nail and tissues distal to nail - maximal proximal and medial to nail, betweennail and distal interphalangeal joint'. 2. Started Fludoxacillin 500mg qds for 2 weeks -- reco mmendedby GP to continue for further 2 weeks. No improvement.
3. Four weeks later Clarithromycin prescribed for 1 week -- little change but swelling reduced. Additionally -- FBC and blood sugar normal. Canestan HC appliednightly and toe covered for10 days - slight improvement especially in cold weather . 4. Now has erythemawith throbbing and tingling persistant , particularly when warm at night. No flaking of nail. No sign of ingrown nail. No joint stiffness or joint pain'

Okay guys -- any thoughts as to what the hell is going on here? Thanks rdavis

 

A bit of good old fashioned advice. Hydrogen Peroxide 10 vols. Run it down the side of nail. try a cotton bud soaked in it and press it in. If it bubbles you have got something somewhere. But what? if there is still an infection somewhere that will show you.

Also you can use an instrument to carefully get the puss out of the side of the nail. It is worth a try and afterwards when i was sure there was no more infection. Then i would run some friars balsam around the nail.

Given to me by an old retired Chiropodist, old fashioned yes, but sometimes effective.

Cyril Almond.