So now I am here in hospital, day 8 to be exact. A few days before Arzerra infusion #3 I had noted a a non-tender area of redness and thickened skin with a dark scab in center about dime sized on my left ankle. Walking about my property or in the woods, in shorts and sometimes with no socks, I figured it was a bug bite or a scratch from a thorn from the brambles that abound. I did not show my onco because it did not hurt or itch and I figured it was slow to heal...a day after Arzerra #3 the area got bigger, redder and began to hurt. I waited until 2 days later to show to onco since was there for follow-up CBC. Since I had no fever it was decided to try to treat this presumed cellulitis with amoxicillin-clav (Augmentin). I did not realize at the time that I was neutropenic (but my oncol did, thankfully) but in retrospect I guess a trial of oral meds still would have made sense Note that since I live in deer tick area and have had acute Lyme twice, this was one of the reasons for using amox-clav which would cover Lyme. My doc was worried about whether I should get my next Arzerra and scheduled an infectious disease consult for 2 days later. The sore area increased with more pain, particularly while walking and when I saw the ID doc he recommended admission for IV antibiotics.
Over the last week I have received antibiotics to cover MRSA, Pseudomonas and even Lyme (titers pending). The area of redness spread and the central dark area (necrotic tissue) enlarged. A skin biopsy was done and fungal cultures, nothing found yet. I have had packed RBC twuce and platelets 3 times. Needless to say the Arzerra was held.
Today for the first time the redness seems less and I can walk flat footed as opposed to on my toes. Still with pain but less, I think. Some studies still pending including Lyme titer and specail stains of fhe skin biopsy for weird bacteria like atypical mycobacteria. Going to get an MRI of the area to rule out bone involveent and or abcess underlying, hopefully today (maybe should hav done sooner but I am second guessing my docs here...)
So the best scenario for me is if continutes to improve and can get my Arzerra in a few days. My spleen is much smaller as are nodes in underarm area and total WBC is less than 5K.... so may have started to respond.
"Well now life throws us curve balls we never can reach" -- Jimmy Buffett
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