staph infection, retaining water, skin weeping

08-28-2008, 08:29 AM

I spent 7 hours at our local ER with my aunt last night and am seeking some input on her condition from anyone of you who may have experienced something similar. Two years ago she had a massive staph infection and was inpatient for two weeks and required weeks of at-home care with a wound nurse until she finally recovered. My aunt is very overweight and her mobility is limited, so it was a struggle for her to regain her strength. Within the past year, she developed a dry, scaly patch of skin along one of her shins. It didn't change much over time or bother her, so she just kept it moisturized with lotion, and I don't think she ever mentioned it to her primary care physician. Yesterday she woke up and felt dampness behind the leg with the dry patch and when my sister and I went over that evening to take a look, she saw what looked like a small blister that was draining clear fluid that did not have any odor. The back of this leg does not have any dry patches, just the front - but the front with the dry patch was starting to develop some small blisters as well, so we took her to the hospital, fearing the staph had returned. The site on the back of her leg continued to drain all day and all night, the nurse called it weeping and said it was due to the fluid retention. They said it wasn't staph but might be a sign of congestive heart failure, so they drew blood, did an ekg and took chest x-rays, which did show a little bit of fluid, but all the other test results were normal and the doctor didn't feel that was the cause, either. So they started her lasix (sp?) at the ER and sent her home to do a three-day run of lasix and then see her primary physician for a follow-up. The doctor said sometimes people just retain the water, but that it has to be resolved, and I'm sure her weight and lack of mobility could play a role in this. I'm just wondering if anyone else has experienced these symptoms and what their treatment/outcome was.
Thanks!
Shell

08-28-2008, 11:42 AM

Hi there, again, the doctor's advice is what you should be following, I just wanted to reassure you that what you describe is quite common in patients who are either overweight, have congestive heart failure or both.

I'm not sure of your aunt's health history, but she likely has some reason for fluid retention in her legs whether it is because:

1. Her heart is not able to pump fluid because it is weak, and the fluid builds up in her feet.

2. Her liver is not working properly and has made it so that it is hard for fluids to pass through it....as a result, fluid backs up in to the abdomen and legs.

3. Your aunt has been losing protein which helps keep fluid in the blood vessels. Without this, the fluid seeps out of the vessels in to the surrounding tissue and one of the places this happens the most is in the legs.

What the ER doctor was getting at was #1...i.e. a weak heart from years of heart attacks (which may have had NO symptoms if your aunt is diabetic) which is not able to pump blood forward--the result is that it backs up in to the lungs and then the abdomen and then the legs.

Acutely, if the heart can't pump blood forward, the fluid will back up in to the lungs causing severe shortness of breath; however, over time the lungs end up adapting. The legs can't adapt, however, and you get swelling.

Side question: have you noticed your aunt's legs are dark and discoloured below her knees?

Anyway, so if your legs start to swell, over time the skin can break down and the fluid can seep out and become trapped in small pocketed areas where the skin has become very thin but hasn't yet broken. This is likely what has happened in your aunt. These areas CAN get infected, but in the doctor's eyes, he didn't think there was any infection present. The trick is now to help remove some of that extra fluid from the body--lasix helps. Other things the doctor may have suggested are getting your aunt up to walk, pressure stockings and keeping her feet elevated when she's sititing down.

staph infection, retaining water, skin weeping

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