Q. My wife has swelling and pain on her toe. Does she require surgery?
Hello doctor,
My wife has swelling and pain on her toe (pictures attached). Sometimes, blood and pus also secrete from it. Can you please suggest what we should do? Can this be healed through medicine? Please advise the medicine we should use. Does she require any surgery?
Please advise.
Hello,
Welcome to icliniq.com.
I have seen the pictures (attachment removed to protect patient identity).
Does she have any comorbidities like diabetes? Does she have a fever too? It looks like a condition called paronychia or periungual abscess, an infection of the nail fold and bed. It needs the following treatment:
- Antibiotics for seven days such as a combination of Amoxicillin and Cloxacillin 500 mg tablet, three times a day, before food. Incision and drainage, as there will be pus inside.
- It is best drained with an incision and drainage. A small cut is made into the pus under local anesthesia to drain the pus. This does not need admission, and she can go home after the procedure. This can be done at any hospital and is usually done by a surgeon.
- Tablet Chymoral Forte (Trypsin and Chymotrypsin) one at 8 AM, one at 8 PM, for three to four days, to be taken after food. This is an analgesic. This reduces pain and swelling.
Update me on the progress.
Hello doctor,
Thank you for the reply,
She does not have diabetes or fever, but she feels pain in the toe while walking. We do have a little baby (seven months old). Is it alright to breastfeed while taking the medicines? Also, which specialty doctor usually treats paronychia? Should we consult a general surgeon or dermatologist? Kindly let me know so that I could take an appointment accordingly at our local hospital.
Hello,
Welcome back to icliniq.com.
Please see a general surgeon. She needs a small surgery, with incision and drainage. She can take the antibiotic while breastfeeding is safe. The drug levels in milk are low. As she is breastfeeding, it is better not to take Chymoral forte. She can take tablet Diclofenac 50 mg (Nac SR), twice daily after food. This is also safe during pregnancy and breastfeeding.
I hope that answers your query.
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