Last night I had a patient who suffered a Brown Recluse bite (seems to be verified? back in August. He was initially treated with antivenin, abx, and removal of necrotic tissue.
Well he's now on my floor and has cellulitis throughout his ENTIRE left leg. They've cultured the wound and given him a dose of vanco, plus he's on q8hr zosyn.
The wound is about a quarter round, depressed with solid, dark dark red surface. The doc wanted it open to air for now. His temp was 39 overnight, I hope they can save his leg. Last CT ruled out Necrotizing fasciitis.
My question is, what is the wound surface that is hardish....looks like it crusted over like a soup might if you didn't stir it. Is that eschar or like dried blister? How'd they get a culture if it's dry like that?
I work nights so I don't get to talk to the ID docs as I would during the day. Just wonder if any of you could explain.