Help, friend got scratched during scuba diving, now got a skin infection

wswgin on 01/10/2016 - 19:34
Last edited 01/10/2016 - 19:51 by 1 other user

Hi all,

A friend recently visited Carins went scuba diving, leg got scratched by a coral or rock, the first 2 days were fine, she went back overseas, it quickly turned into a rash and infection, itchy and hurting. Went to the local doctor, but they seem to have no idea what it is, gave her antibiotics for 2 days, doesn't seem to be working. The rash turned to be worse, and some part of skin turned black.

Now it's been almost 3 weeks since she got scratched, still hasn't show signs of getting better, she does not have a fever or other symptoms.

I want to help them, but not sure where to ask, fellow ozbargainers, if any of you have any knowledge about this or know where can I go to get help, please let me know.

Thanks a lot, I've uploaded a few photos, link below

This one was taken about 4 days after, rash starting to show
http://i63.tinypic.com/rrvchs.jpg

This one was taken yesterday
http://i67.tinypic.com/j73lp0.jpg

Thanks a lot

Health & Beauty

Comments

  • spackbace on 01/10/2016 - 19:36
    +7

    Tell your 'friend' to either go back to the same GP, or go to the hospital.

    Makes sense doesn't it?

    • wswgin on 01/10/2016 - 19:39
      +16

      Don't know what you mean, my friend was on a holiday to Cairns, she went back overseas to her home country, the doctors over there have no idea what it is

      • spackbace on 01/10/2016 - 19:50
        -3

        There will be blood tests involved, among other tests. You don't seriously expect a diagnosis from a random internet forum do you?

        Did she try a doctor, or a hospital?

        • wswgin on 01/10/2016 - 19:59
          +44

          She's been to hospital and seen doctors, also taken some tests, the doctors overseas can't figure it out, they've never seen this kind of rash before.

          I wasn't asking for a diagnosis, was simply asking if anybody here have any knowlodge, maybe it is quite common here in Australia, I'm not a beach and scuba diving person, so I have no knowledge about this.

          I posted here because i thought theres lots of people here and always very helpful

      • nikey2k27 on 04/10/2016 - 13:54
        +8

        Tell them call Townsville (07) 4433 1111 or Cairns base hospital (07) 4226 0000 ask they pop on to some in ED if they no help ask them pop on to put on to 13 HEALTH (13 43 25 84) it look like what i had after reef walking a few year back. you take drug and wound care stuff.

    • captobvious on 02/10/2016 - 13:17
      +66

      With my vast internet knowledge my recommendation would be to amputate the leg.

      • McFly on 02/10/2016 - 13:45
        +35

        Best to be safe - do both legs.

        • StewBalls on 02/10/2016 - 18:42
          +20

          I say we take off and nuke the entire site from orbit. It's the only way to be sure.

        • cameldownunder on 04/10/2016 - 12:33
          +1

          @StewBalls: Nah. Proton Torpedoes orbital bombing with disruptor beams support should do.

        • StewBalls on 05/10/2016 - 22:29

          @cameldownunder: All right. We got seven canisters of CM-20. I say we roll them in there and nerve gas the whole f..kin' nest.

      • humdingaling on 02/10/2016 - 18:08
        +11

        Dr house says it's lupus

        • hymio on 03/10/2016 - 08:00
          +6

          It's never Lupus!

      • Scrooge McDuck on 03/10/2016 - 12:48
        +1

        With my vast internet knowledge my recommendation would be to amputate the leg.

        It's too late for that, the virus has probably already made its way to her brain. It's only a matter of time now before she turns…

        • subywagon on 07/10/2016 - 00:11
          +1

          Amputate the brain?

      • ghostdom on 04/10/2016 - 14:39
        -4

        show some respect to others.

      • Alfonso on 06/10/2016 - 16:48
        +2

        buy eneloops or SSDs. That should fix it. If not, wait for an ebay 10-20% deal. See if that helps.

    • covert on 06/10/2016 - 23:45
      +2

      Put some Windex on it. Windex will fix it. It can fix almost everything.

      • McFly on 07/10/2016 - 00:26

        And then cover with gaffer?

    • dlf73 on 01/10/2016 - 21:24
      +2

      What BS. Tress jump out and cause car accidents all the time, I am sure coral does the same thing!

    • wswgin on 01/10/2016 - 21:30
      +13

      What makes you think my friend touched intentionally? The cut is on the foot ankle and it's her first time diving, people make mistakes. Besides, it might be a rock instead of coral

    • Tech5 on 02/10/2016 - 19:03
      +3

      You are an idiot

        • smartazz104 on 04/10/2016 - 07:23

          Anyone can say anything on the internet; I bet you don't even swim.

        • oscargamer on 04/10/2016 - 10:14
          -5

          @gokhanh:

          and the irony is, that swimming is not a prerequisite to being able to dive

        • obsolet on 04/10/2016 - 21:38

          @oscargamer: Actually, if I recall currently, one of the physical abilities tests one has to pass to be admitted in a diving course is the ability to swim (when I did it it was 500m) so if one has to surface at a different spot - or gets carried by the current - they can still make it back to their boat/anchor/launch point.

        • Tech5 on 04/10/2016 - 22:35

          @oscargamer:

          But not being able to swim is a prerequisite to drowning

        • oscargamer on 05/10/2016 - 16:01
          -2

          @zhuang281:

          unless you have one of those lovely regulator things in your mouth, you know, the ones that divers use

  • spackbace on 01/10/2016 - 19:55
    +3

    Google is likely to be better…

  • [Deactivated] on 01/10/2016 - 19:55
    +4

    Looks like its healing. Tell her to go back to the doctor if she's worried.

  • chumlee on 01/10/2016 - 20:08
    +6

    Probably Zachery Disease

  • StewBalls on 01/10/2016 - 20:20
    +32

    I've seen enough episodes of House M.D. to know that she's probably lying about something pertinent, and that she needs plasmapheresis whilst you break into her home & rifle through her stuff.

    • outlander on 01/10/2016 - 21:54
      +2

      Everybody lies. Universal truth. Her doctor is probably lying about it being an infection, and her pants are lying about being made of semi synthetic materials.

      • Kangal on 02/10/2016 - 08:57
        +4

        Could it be… Lupus?

      • frewer on 04/10/2016 - 10:44

        Everybody lies

        Is it true ?

  • dlf73 on 01/10/2016 - 21:36
    +6

    I am assuming you are looking to find information to pass onto your friend!
    I would suggest web searching Underwater cuts, coral cuts, Underwater rock scratches or cuts, etc, and then forward anything found onto your friend.
    Did they have travel insurance? Is there Australian doctors nearby? I see Chinese writing in one of the photos so are they in China?

    • wswgin on 01/10/2016 - 21:45
      +5

      Yes, they are from China, most Chinese doctors have never treated reef cuts.

      I'm trying to find out if this is very serious or quite common, did a bit of web search but didn't really find anything helpful, thought to post the photo online and see if any experienced diver knows better.

      I'm not sure if a GP will help if I bring them the photo, I'll give it a try tomorrow.

      She does have travel insurance, not sure if she have used it or not, it is hard to find a Australian doctor in China.

      Thanks

      • chumlee on 02/10/2016 - 08:22
        +11

        Probably good counterfeit doctors.

  • Islander on 01/10/2016 - 21:41
    +5

    Corals are living organism with bacteria spores etc…. I got scratched once and it took a while to heal plus got some antibiotics. Did you friend get some?

    • wswgin on 01/10/2016 - 21:48
      +2

      Yeah, she's been getting penicillin, doesn't seem to work, how long did it take to heal for you？ THanks

      • [Deactivated] on 01/10/2016 - 21:57
        +2

        A combination of steroids and antibiotics are usually helpful. Even then you're looking at three to five weeks for it to heal.

        You need to check that there aren't any parts of the coral still in the skin.

        • McFly on 02/10/2016 - 13:44
          +21

          A combination of steroids and antibiotics are usually helpful.

          i.e. Join the Olympic team?

      • tebbybabes on 02/10/2016 - 01:36
        +3

        Everyone's advice has been quite helpful.

        I'd also like to mention that if what your friend is getting is really just penicillin, then her coverage for whatever likely organisms causing her infection is likely to be poor.

        • Kangal on 02/10/2016 - 09:09
          +29

          @Drew22 …that's the professional advice I came to recommend, glad you posted it.

          @tebbybabes …it depends. Penicillin can now have ZERO action/affect on organisms due to stupid doctors and media from the previous gen people (who also killed the economy).

          Firstly, any small pieces of coral must be removed.
          Secondly, a blood test needs to be done, and use panels to eliminate certain bacteria.
          (It's likely bacteria, doubt it will be a protozoan, definitely not a microorganism like yeast, mould, archaea)
          Thirdly, a general course of several types of antibiotics must be started.
          Fourthly, some of that necrosis must be surgically cut out. The wound must be cleaned with antiseptics. And it must be covered to prevent re-entry by other microbes.
          Fifthly, she must STOP SCRATCHING the wound.
          Sixthly, she needs to go back to the doctor with the results of the blood test, and continue on with the treatment from there.

          It could've been a minor issue, but she seems to have exacerbated the problem.
          It will leave a scar… but scars are cool… chicks dig scars ; )

        • supnigs super skids on 02/10/2016 - 12:24
          +2

          @Kangal: uh. So snake is a GP! Snake snake. 🙌

        • eug on 04/10/2016 - 14:09

          @Kangal:

          It will leave a scar… but scars are cool… chicks dig scars ; )

          But you said she should stop scratching it.

        • [Deactivated] on 04/10/2016 - 17:38

          @Kangal:
          What's the rationale for the steroids here? The inflammation isn't life or limb threatening (as far as the information is provided). The inflammation doesn't look like it's cutting off blood supply and nowhere near air supply.

          Genuine question. Seeking new perspective.

        • MessyG on 04/10/2016 - 21:00

          @Kangal: I take umbrage at the stupid doctors comment. Penicillin is a class of antibiotic as well as an antibiotic. Flucloxacillin, an antibiotic of the penicillin class, is the standard of care for skin infections, which is evidence-based on resistance patterns. I don't think it's a good idea to dispense medical advice on the internet beyond advising people to see their doctor because nothing beats eyes-on a patient. For one you risk being sued and your medical insurer may not cover you, and for two, you're putting a patient at risk because they're not your patient, you haven't seen them, you don't know their medical history nor their test results. /rant

        • [Deactivated] on 05/10/2016 - 17:38

          @MissG:
          Up vote for principal but Kangal never claimed to be a doctor.

        • MessyG on 05/10/2016 - 20:34

          @tshow: Which makes dispensing medical advice even worse - worse for the patient and worse for him if someone followed said advice, had a bad outcome, and then decided to sue.

      • Islander on 02/10/2016 - 07:30
        +1

        It must have taken close to 6 -8 weeks. It looked horrible but it eventually healed. No trace of it anymore.

  • bobkin on 01/10/2016 - 21:44
    +1

    See this for some introductory information. It seems different antibiotics are required to the standard ones used to treat cellulitis. Healthcare professionals are usually able to access the full article which contains a very good summary of the appropriate approach.

  • Davo1111 on 01/10/2016 - 21:57
    +2

    go back to hospital and ask for "harder" stuff?

  • jzdhgkd on 01/10/2016 - 21:59
    +25

    Please do not take this as hard medical advice but only additional information which your friend may take to his/her treating doctors overseas.

    As per UpToDate article, "Soft tissue infections following water exposure," the pertinent information in the summary is as follows:

    "- Soft tissue infections can occur after both freshwater and saltwater exposure, particularly if there is associated trauma. The most common bacteria to produce soft tissue infections in association with exposure to water or water-related animals include AEEVM organisms: Aeromonas species, Edwardsiella tarda, Erysipelothrix rhusiopathiae, Vibrio vulnificus, and Mycobacterium marinum."

    "- Diagnostic tests including Gram stain (and acid-fast staining when indicated) and culture should be performed on specimens taken from soft tissue drainage or biopsies. "

    "- … empiric antibiotic coverage [is recommended] for patients who develop a soft tissue infection following water exposure … to include coverage for both S. aureus and beta-hemolytic streptococci and the AEEVM organisms, except for M. marinum (Grade 1B). Appropriate antibiotics for initial empiric therapy include:
    •Either a first-generation cephalosporin (cephalexin 500 mg orally four times daily or cefazolin 1 g intravenously [IV] every eight hours) OR clindamycin (300 mg orally four times daily or 600 mg IV every eight hours in those patients with immediate hypersensitivity reactions to penicillin) PLUS
    •Levofloxacin (750 mg once daily) PLUS either of the following if the epidemiologic risk is present:
    •Metronidazole (500 mg four times daily) if exposure to sewage-contaminated water or if soil-contaminated wound (not necessary to include if the regimen includes clindamycin) OR
    •Doxycycline (100 mg twice daily) for coverage of Vibrio species if seawater exposure"

    And from another article from UpToDate titled "Soft tissue infections following water exposure"

    "Coral injury – Local injury due to coral-related trauma may quickly become infected with marine or terrestrial bacteria. These infections often progress despite treatment with antibiotics because "coral slime," a proteinaceous material, is introduced into the wound and acts as a foreign body [70]. Any significant laceration sustained from coral should be carefully debrided and scrubbed with a brush; an anesthetic may be required. If infection does become established, it is unlike to resolve without scrubbing."

    Now remember that doctors overseas are in no way obliged to take information from a random stranger online when it comes to treating things but if they're truly as lost as you say they are then maybe the above can help in some way.

    • wswgin on 01/10/2016 - 22:13
      +6

      Thanks for your help, I'll translate this and pass it on to them

    • tebbybabes on 02/10/2016 - 01:35
      +2

      Good stuff.

    • Deridas on 02/10/2016 - 07:56
      +10

      OP, this info sounds about right. Penicillin itself is far too narrow spectrum for exotic organisms that can be isolated from coral. You will need to tell your friend relatively urgently to see an infectious diseases physician urgently for the best advice. No stock standard GP or other specialty can give you the best advice, UpToDate info sounds like a good starting point, but ultimately you want the best advice from the best expert possible. If this infection continues your friend can lose a limb.

    • cameldownunder on 04/10/2016 - 12:36

      "an anesthetic may be required." Only for Whooses.

  • 2jzzzz on 02/10/2016 - 07:48
    +3

    My wife got 4 antibiotic needles in the butt once a week to clear hers.

    • insular on 02/10/2016 - 20:24
      +9

      your wife must have a cute butt

      • BartholemewH on 02/10/2016 - 21:07
        +13

        The old 'I need to see your butt weekly' trick.

      • goingDHfast on 05/10/2016 - 19:24

        No if she had a cute butt it would need one injection daily.

  • Scot on 02/10/2016 - 12:43
    +3

    Coral scrapes do have a tendency to become both chronically irritated and infected. Occasionally, coral scrapes and cuts will have trouble healing and break out in a chronic dermatitis or a weeping wound. This is thought to be due to the persistent toxic or allergic effects of the small bits of coral (often microscopic) that are embedded in the wound at the time of the injury.
    Initially, wounds should be flushed with large quantities of vinegar or whatever sterile fluid you have available. You should get a tetanus shot and treat the wound with a combination of triple antibiotic/steroid cream until healing occurs.
    If the wound does not appear to be healing after 24 to 36 hours, check with your doctor to see if you need to undergo a procedure called debridement (removal of foreign bodies). Hyperpigmentation (dark color changes) is more difficult to manage and requires the assistance of a good dermatologist.
    The above info is available on many websites.These infections can happen anywhere n the world. Any ER Doctor should be able to diagnose and fix. May need surgery( debridement)

  • [Deactivated] on 02/10/2016 - 12:48

    Common problem for surfers around coral spore
    Takes ages to heel
    Keep out of the ocean and perhaps penicillin powder directly onto the wound
    But I think you are getting some good advice in regards to wound care and may be needed to be opened up and cleaned out
    Hopefully she can find a good doc/surgeon soon before it ends up into skin graft territory

    • McFly on 02/10/2016 - 13:46
      +3

      Takes ages to heel

      Especially if it's a wound on the heal…

  • FatBlanket on 02/10/2016 - 13:20
    +13

    First mistake, going to a real doctor. But don't worry, you're in safe hands now. Well take care of your friend. I recommend wormwood and cinnamon cloves tied in a paper bag and gently massaged into the scalp.

    • [Deactivated] on 02/10/2016 - 13:33
      -3

      Funny
      Have you thought about a career
      Maybe start a blog
      You could call it ' my humorous observations on your rare potentially life threatening medical issues '
      No, I'm sure you can figure out sumtin much funnyr
      ' witchdoctorin for dummies ' maybe

    • McFly on 02/10/2016 - 13:44
      +5

      Are you Pete Evans?

      • [Deactivated] on 02/10/2016 - 14:03
        -3

        Maybe
        is he a sarcastic prick ?

    • Scrooge McDuck on 03/10/2016 - 13:04
      +4

      First mistake, going to a real doctor. But don't worry, you're in safe hands now. Well take care of your friend. I recommend wormwood and cinnamon cloves tied in a paper bag and gently massaged into the scalp.

      Are you crazy!?

      She clearly needs endangered species infused tea and a cosmic energy massage!!

  • MessyG on 02/10/2016 - 14:03
    +31

    Doctor here - there are plenty of good hospitals in China (although I'm not sure where she is), and laboratories that can take a swab of the wound to try and identify the organism. She needs to go to hospital, possibly for IV antibiotics if the oral ones aren't working. Doctors don't just throw their hands up when they don't know what something is, we read the literature and contact experts and I'm sure Chinese doctors do the same. Reef cuts can be many things from simple to complicated but nothing beats a pair of eyes on the real thing - diagnosis over the Internet has about a 30% success rate, or, 70% of the time you'll get it wrong, treat it wrong, and do harm.

    Please tell your friend to go to hospital and not to leave until there's some improvement.

    • Randxyz123 on 04/10/2016 - 07:07
      +3

      Can we get this comment higher up?

      Seems to be the only serious advice on here.

      • Max999 on 05/10/2016 - 00:52

        Really don't understand why so many people take the space in this thread to make jokes.

  • captobvious on 02/10/2016 - 14:23

    Maybe she wants you to send money overseas for phantom medical fees. Western union nigerian account

  • zine21 on 02/10/2016 - 17:30
    +1

    Why do you think that its not getting better ? It looks like the initial irritation and redness has reduced. Is she in pain ? You said she has no systematic symptoms which is a good sign. Also they'd put her on antibiotics for more than 2 days for infections. If oral isnt working they would/should have tried a different course of Ab and than IV antibiotics too. It could be an inflammatory reaction (is it itchy?). The black part looks like eschar. Really it could be anything though and she needs to be tested to find what it is. If the place shes at isn't great maybe she should seek a second/third medical opinion. In the mean time she should manage the wound with antiseptics and sterile & moist dressings.

  • CandyMan on 02/10/2016 - 17:32
    +1

    Maggots. Did she try using maggots to debride the bad tissue. (It works but ofcourse im being sarcastic. Please dont try this at home)

    • [Deactivated] on 05/10/2016 - 14:01

      Rambo would cauterise with a hot knife blade and a splash of alcohol and a grimace in a makeshift triage.

    • McFly on 05/10/2016 - 15:13

      I've never seen anything that couldn't be fixed with a good boweling.

  • greatlamp on 02/10/2016 - 18:11

    You could get her to see an Australian doctor online via gp2u.com.au

    Not sure how much it will cost

  • Donaldhump on 02/10/2016 - 19:24
    +2

    if the redness around the scratch is increasing, it will be cellulitis. may need to get scratch opened up and infected area removed with a blade or similar.
    oral antibiotics are hopeless, they need to go to hospital and get on a drip.
    don't delay, i ended up in hospital because of this exact problem, and it is quite boring and unpleasant.
    I knew something was wrong when i was shivering in 40+ plus degree heat in solomon islands, and sleeping 15+ hous day, and enjoying doing the vacuuming

  • wswgin on 02/10/2016 - 20:25
    +1

    Thanks everyone, I've passed on the info to them and they really appreciate it, hopefully she will be getting better soon

  • belongsinforums on 02/10/2016 - 20:30

    cut my foot on coral once. didn't think much of it - it was a little cut. ended up taking a few years for the scar to go away. even after her infection goes away, it'll take ages to heal.

  • foxmulder on 02/10/2016 - 20:51

    Try to go to Singapore and visit the local doctor there. They will surely know what is that.

  • Baebs on 02/10/2016 - 21:04

    Doesn't take a genius to visit a hospital.

    • [Deactivated] on 05/10/2016 - 14:47
      -2

      Is it life threatening? No? Then no need to visit a hospital.

      People with this type of thinking is what clogs up the system. If you have a sore throat and a cough, you don't need to be sitting in ER taking up space for someone who actually needs to be there.

      Doesn't take a genius to clog up the hospital ER.

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