Chronic Osteomyelitis of 2nd toe

Posted by konniehoover @konniehoover, Feb 9, 2019

I had a toe turn bright red in late August. I found myself in the hospital the 1st week of September with cellulitis of that toe and the lower part of my shin and calf. A slip on the floor caused the skin to break on the toe and within hours I had an ulcer that was draining pus. It was x-rays as a precaution and they released me to my podiatrist a couple days later.

After 6 weeks of antibiotics the ulcer healed, the toe remained red and achey (I have severe neuropathy so it's normally numb) and my doctor took me off the antibiotics.

In December the 3rd toe developed an ulcer and infection. They did x-rays and put me on antibiotics. The x-rays showed fractures on the distal 2nd toe. Seeing my podiatrist a few days later he said "I guess the infection was worse than I thought." I am a diabetic, well controlled, with microvascular PAD. This broken bone didn't surprise me cause it hurt! I took the antibiotics for the 3rd toe for 10 days and he said to stop.

In mid January my toe pain became excruciating the week after I was released from treatment for the 3rd toe, while at my pool exercise class. The pain has been really bad since. I had the toe x-rays redone and the 2nd toe fractures had not begun to heal at all. A couple days later the podiatrist dxed chronic osteomyelitis.

The Dr said I had 2 options. Leave it alone and live with the pain or amputation of the distal toe segment. No other tests, treatment options or antibiotics for any remaining infection. Surgery is scheduled for Feb 19th but I'm a little worried. The pain is gruesome and I want it to stop but is this the right choice?

Has anyone had a similar infection? Any info on why he didn't put me on antibiotics again right away? This just doesn't sound like treatments I've looked at online. I know it's just a small bone but I like my toes!

@konniehoover Did you get a 2nd opinion ?

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@lioness – I hadn't because I'm in so much pain I wanted to get it over with & go back to my pool exercise. Having 2nd thoughts now. I don't want to ask the podiatrist for a referral so I guess I might ask the primary on Monday. I hate to delay healing from this but im worried about recurrence, especially since the other toe hurts too.

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@konniehoover I would ask p.c. Dr it's you toe he maybe right but having another opinion would confirm it Are you a diabetic?

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@lioness – while I am technically diabetic, my last 2 – A1c's have been 5.3 & 5.4, essentially normal, and I expect to discontinue metformin once my toe is cleared. The microvascular issues, including peripheral neuropathy, are probably neurogenic from spinal stenosis and arthritis in my lumbar spine. I also have higher pathology up my spine that doesnt appear to be causing any issues.

I have multiple problems with my blood vessels so I see a podiatrist regularly. This just got away from me quickly.

Thanks for chatting with me about it. It helps me sort this out.

Konnie

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@konniehoover Your welcome . My husband was diabetic and it was very disturbing to me about gangrene which he almost had but didn't . Good luck with everything. My AiC is 5.1 Dr just did a slew of blood work . At one time the Dr. put me on Metformin but told me I could go of it if I wanted . I did as had no other symptoms. I ate a large piece of cake night before so think that was the culprit. Take care

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