My father was diagnosed with acute paronychia on his right toe nine days back. He took tablets Augmentin BD, tablet Vizylac BD, and T- bact ointment for seven days, and that somewhere improved the condition, but the pain and watery-like discharge are there. So help, what to do now?
I have gone through the details and the images (the attachments are removed to protect the patient's identity) provided from your end. Paronychia, as you already might know, is an infection and inflammatory reaction of the tissue on the sides of the nail fold. Most often is caused due to trauma, excess washing and using strong chemicals, due to ingrown nails and cutting off nails, and so on. They may get infected most often by bacteria and sometimes by fungal pathogens as well. They usually cause pain, discomfort, redness, pus formation, and tenderness.
As you have mentioned using Augmentin (Amoxicillin and Clavulanate) and T- bact ointment (Mupirocin), which are great medications in reducing the infection, I would like to let you know that the presence of watery discharge is normal and may take time to reduce.
1. However, once the infection is usually down, the remaining infected area around the nail may be manually excised by a doctor in person to reduce the presence of bacterial elements within them.
2. Warm salt water soaking may be done twice daily for ten minutes every three weeks until the symptoms and redness are reduced.
3. Tablet Diptase (Aceclofenac) may be consumed orally after food in the morning and at night for three days. They help in reducing inflammation and redness along with pain.
In case of a previous history of allergies to Aceclofenac, this medication may be avoided.
4. Continue using T-bact ointment after the swab test.
5. Since you have mentioned the presence of secretion, I would like to advise you to make sure the secretion is tested using a swab test where the secretion is collected and a culture and sensitivity testing is done to check the type of bacteria present and the antibiotics which they are most sensitive to, may be prescribed to your father immediately to reduce further infection and inflammation as well. Usually, the test results take three days to arrive, and till then, T-bact ointment may be continued.
This test may be taken at any laboratory or by a doctor in person.
6. Tablet Limcee 500 mg (vitamin C) chewable tablet may be consumed twice daily after food which may be chewed and consumed for two months. They help with reducing the chances and recurrences of infections.
7. Make sure to avoid tight slippers, further trauma, or using harsh chemicals for cleaning the area to avoid secondary infections.
8. Further, I would also like you to consult a doctor in person for the swab test and for the doctor to examine the area if it is causing excess discomfort for further management options from their end.
Kindly consult with your doctor before taking medications.
I hope it helps.
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