[52F] With swelling, redness, and pain in big toe and foot

Patient Description

A 52-year-old female presents with swelling, redness, heat to the touch, and a red streak moving up from the big toe to the top of the foot. The patient reports that the pain and numbness started last night, with the numbness spreading from the big toe to the rest of the foot within an hour. The patient suspects a bite and mentions walking barefoot recently. Additional symptoms include feeling feverish and experiencing nausea. The patient has a history of high blood pressure, diagnosed six weeks ago, and is currently taking lisinopril. She recently completed a 10-day course of doxycycline. The patient has an allergy to macrobid but no other known allergies. There have been no recent injuries to the foot or lower leg.

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Arora's Assessment

What might be happening

Based on the symptoms you described, here are some possible conditions:

  • Cellulitis: This is a bacterial skin infection that causes redness, swelling, warmth, and pain. The red streak moving up your foot could indicate that the infection is spreading. Fever and nausea are also common symptoms.

    • Treatment: Cellulitis typically requires antibiotics. Given your symptoms, it's important to seek medical attention promptly to prevent the infection from worsening.
  • Insect Bite or Sting: If you were bitten by an insect, it could cause localized swelling, redness, and pain. However, the red streak and systemic symptoms like fever and nausea suggest a secondary infection.

    • Treatment: Over-the-counter antihistamines can help with itching and swelling, but you may need antibiotics if an infection has developed.
  • Gout: This is a form of arthritis characterized by sudden, severe attacks of pain, redness, and tenderness in joints, often the big toe. However, the red streak and systemic symptoms are less typical for gout.

    • Treatment: Gout is usually treated with anti-inflammatory medications and lifestyle changes.

What you can do

  1. Seek Medical Attention: Given the red streak, swelling, pain, and systemic symptoms like fever and nausea, it's important to see a healthcare provider as soon as possible. These could be signs of a spreading infection, which requires prompt treatment.
  2. Keep the Foot Elevated: Elevating your foot can help reduce swelling.
  3. Avoid Walking Barefoot: To prevent further injury or infection, avoid walking barefoot, especially in areas where you might be exposed to bacteria or fungi.
  4. Stay Hydrated: Drink plenty of fluids, especially if you are feeling feverish.

What you should look out for

  • Worsening Symptoms: If the redness, swelling, or pain worsens, or if you develop more severe symptoms like high fever, chills, or increased nausea, seek medical attention immediately.
  • Spreading Red Streak: If the red streak continues to spread, this is a sign that the infection may be worsening and requires urgent medical care.
  • Difficulty Breathing or Swelling of the Face/Lips: These could be signs of a severe allergic reaction and require immediate medical attention.

Please remember, while I can provide information based on your symptoms, it's crucial to consult a healthcare professional for a formal diagnosis and appropriate treatment.

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6 mo ago

People Also Ask


What are the common symptoms of cellulitis?

Common symptoms of cellulitis include redness, swelling, warmth, and pain in the affected area. There may also be a red streak indicating the infection is spreading, along with systemic symptoms like fever and nausea.


How can I differentiate between an insect bite and cellulitis?

An insect bite typically causes localized swelling, redness, and itching. However, if you notice a red streak, fever, or nausea, it may indicate a secondary infection like cellulitis, which requires medical attention.


What should I do if I suspect I have a spreading infection?

If you suspect a spreading infection, seek medical attention immediately. Keep the affected area elevated, avoid walking barefoot, and stay hydrated. Prompt treatment with antibiotics may be necessary to prevent complications.


Can high blood pressure medication affect the treatment of infections?

High blood pressure medication like lisinopril generally does not interfere with the treatment of infections. However, it's important to inform your healthcare provider about all medications you are taking to ensure safe and effective treatment.


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