Reef nutrition

Finger infection

Mario, I hope that you are OK... saying prayers for your health. I saw this thread on RC recently, and it is scary.
http://www.reefcentral.com/forums/showthread.php?t=1821465&highlight=hospital+infection
There are posts from microbiologist Christine Williams (Spracklcat, BAYMAC speaker) on pages 4 and 5 that might provide some useful information.
 
Chris, thank you for joining our site and weighing in with your thoughts about Mario's infection. Very important information for all of us to remember.
 
Thank you Christine and welcome to BAR.

Saturday I had to go back for a check up at Urgent Care; the hand surgeon was not present to look at the X-rays and mi hand.
As you mention

If you suspect an infection from your tank, always ask to be seen by an Infectious Disease Specialist. These are doctors trained in weird tropical diseases and are more likely to recognize your infection for what it is than your typical doc. Remember, the things in your tanks are NOT normal. Smile (This is by no means a put-down of ER or general practitioners)
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First visit to UC, the Dr. who saw me sent me straight to ER after I explained what happened and she saw the red streak. The Dr. had someone walk me there having in mind a possible granuloma forming (which I had no idea of what it would be).
Saturday's visit was faster but the Dr. that saw said the progress on the recovery was great and saw no need for the surgeon to look at my hand, just keep up with the AB. I expressed my concern about a granuloma, as Jeremy posted in reply to me wondering Why a hand surgeon?
The Dr. had me set for an appointment with a hand surgeon for tomorrow.
I will express my concern since my finger is still sensitive in some way and now that is not swollen I can feel two little bumps; one where the cut is/was, shows a black round under-skin coloration and about 1/2" away from the cut I feel another bump.

I'm not good with medications but these ones am sure to be taking as prescribed !

I do have a question; a lot of us, if not all, get wet hands/arms while doing something in the aquariums; a few wear gloves and don't know how many use shoulder length gloves; myself I use the Nitrile powder free examination gloves (but not this time and must admit most of the time I wear a glove on my right hand only and I tend to get my left hand wet too). I rinse my hands and arms with plenty of water after-wards; Would you recommend the use of rubbing hand sanitizers after done working in the aquarium as an extra measure?

I'm a little hesitant about getting my hands in the tank even with gloves...

Thanks again to everyone who expressed concern and support God bless you all !!
 
Just posting what worked in inaccessible locales, and I left it intentionally nebulous as I was sure someone would disagree. Just to clarify, I did not mean people should rely on whatever local cure is recommended, I intended that to promote planning before travel. Regardless of what treatment you prefer, having it on hand and in your travel bag or at home can save you a lot of grief. Plan ahead.

However I stopped short of recommending that people travel with antibiotics (other than bag balm or neosporin or similar) due to varying drug laws in other countries. I have a prescription antibiotic in my medicine cabinet from a work injury but I would never consider tossing it in my bag to travel abroad.

Thank you for posting Chris, very helpful info.

If I may ask a question here, in regards to bag balm or neosporin or anything similar, it's always been regarded as a preventative measure, not a cure. Do you feel it's valueless for this? As an example, whenever I would get a cut fishing I would apply some to the cut to prevent infection. Is this practice not advised as well? Is there something we can do to lessen the chance of a small wound that occurs in our aquarium getting infected that might be better?

How about iodine dip. I always have that around. :)

As an example, say I'm rearranging rocks in the tank and a vermetid snail pokes me. Shortly after this occurs, with no sign of infection, I would generally put neosporin on this if I think about it, due to the habit formed while fishing. Is there a better option?
 
Mario,

Just stumbled on this thread - how scary! Glad to hear you are feeling better and I hope you make a full recovery. I can appreciate your hesitation to get your hands wet again. I had a similar thing happen a few months ago, but in my backyard. I was gardening and cut my leg on a brick. Two days later massive infection with similar symptoms of spreading and pain that had me at the doctor's office, urgent care, and an x-ray. All better now...

Marine scientists are learning that there are about 1 million microorganisms (including bacteria) per milliliter of seawater, and that we don't know what most of those organisms are. If we approached our tanks like a microbiologist approached a mixed environmental sample that contained potential pathogenic strains, we would always wear gloves, a lab coat, eye protection, and maybe even a respiratory filter mask. Preventing cuts and preventing wounds from being exposed to seawater is really important. Elbow length thick rubber gloves (like gardening or dish gloves) are a great idea. While fragging, more precautions should be taken.
 
anathema said:
I have a prescription antibiotic in my medicine cabinet from a work injury but I would never consider tossing it in my bag to travel abroad.
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I wouldn't consider any leftover antibiotic rX as any fallback plan by any means. Self diagnosis and treatment with leftover prescription meds, especially that of an unfinished course of antibiotics, can cause way more trouble than do good. MD's prescribe courses of meds (5 days, 7 days, 10 days etc) and frequencies (twice a day, q8h, etc) with the intent to clear the infection, so even if you might feel better by the 3rd day, finishing the course is imperative. Treatment with a suboptimal med can cause antibiotic resistance in bacterial populations. My advice would be to dispose of the leftover rX properly and discus with your doctor if you feel you need any type of prophylactic med.

Be carefull, and be safe :D
 
anathema said:
Just posting what worked in inaccessible locales, and I left it intentionally nebulous as I was sure someone would disagree. Just to clarify, I did not mean people should rely on whatever local cure is recommended, I intended that to promote planning before travel. Regardless of what treatment you prefer, having it on hand and in your travel bag or at home can save you a lot of grief. Plan ahead.
Click to expand...

This is the part I feel the need to look at cautiously. The alternative treatments you recommended have a high probability or not actually working, but instead mask the pain and symptoms. This is fine in most cases with a little swelling and redness, as the body clears that up on its own. The danger is people reading the advice and thinking that Epson Salts or Bag Balm can actually cure an infection. If you are traveling somewhere and are planning ahead for a possible infection (and I think it was clear that was what you were advocating), it seems more prudent to take something along that will actually work on the infection or give you some time to get somewhere where the infection can be cured than packing something that really doesn't cure infection. Epson Salts and Bag Balm may help with minor skin infections, but won't help with anything deeper.

However I stopped short of recommending that people travel with antibiotics (other than bag balm or neosporin or similar) due to varying drug laws in other countries. I have a prescription antibiotic in my medicine cabinet from a work injury but I would never consider tossing it in my bag to travel abroad.
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I have traveled to PNG, Ireland, England, Mexico, Tonga, Australia, New Zealand, Fiji, Thailand, Canada, Peru, and more with prescription antibiotics without any problem. These were not left over antibiotics (self prescription is not something I would ever recommend), these were prescriptions specifically for each trip from a travel doctor (who would also know about any restrictions in the country you are visiting). Generally, these kinds of prescriptions are not full courses, but enough of a general antibiotic so that you can start a treatment in remote location and get yourself to a hospital where they can diagnose you and start a proper course of the right antibiotic for the particular infection you have.

Antibiotics are not something we should be playing around with. There are reasons particular ones are chosen and taking them ad hoc can lead to infections not clearing up as well as helping to create resistant strains of infection. See a doctor! :D Before travelling to a remote location see a travel doctor - not only will they get you emergency scripts cant can save a trip (digestive sickness or possible infection!) but they can also make sure you have vaccinations for the strange and bizarre diseases that may occur where you are going (Yellow Fever and Malaria anyone?). :D

Great discussion guys!
 
strange happening as I did a water change yesterday (gloveless because I was armpit deep in my tank), however right after I did a seriously good cleaning with antibiotic soap of whatever went into the tank, and even used some antibiotic cream on areas that had scrapes. However this morning I woke up with a bit of a sore throat, then I realized when starting the siphon on the hose I did put it in my mouth, I did taste salt, so a follow up question is how likely is it to get any of these nasties orally? Or is it something that needs blood contact to propagate from tank to body?
 
finalphaze987 said:
anathema said:
I have a prescription antibiotic in my medicine cabinet from a work injury but I would never consider tossing it in my bag to travel abroad.
Click to expand...

I wouldn't consider any leftover antibiotic rX as any fallback plan by any means. Self diagnosis and treatment with leftover prescription meds, especially that of an unfinished course of antibiotics, can cause way more trouble than do good. MD's prescribe courses of meds (5 days, 7 days, 10 days etc) and frequencies (twice a day, q8h, etc) with the intent to clear the infection, so even if you might feel better by the 3rd day, finishing the course is imperative. Treatment with a suboptimal med can cause antibiotic resistance in bacterial populations. My advice would be to dispose of the leftover rX properly and discus with your doctor if you feel you need any type of prophylactic med.

Be carefull, and be safe :D
Click to expand...

Excellent! If you have been given antibiotics by a doctor, you shouldn't have any left over. :D
 
Crabby said:
Mario,

Just stumbled on this thread - how scary! Glad to hear you are feeling better and I hope you make a full recovery. I can appreciate your hesitation to get your hands wet again. I had a similar thing happen a few months ago, but in my backyard. I was gardening and cut my leg on a brick. Two days later massive infection with similar symptoms of spreading and pain that had me at the doctor's office, urgent care, and an x-ray. All better now...

Marine scientists are learning that there are about 1 million microorganisms (including bacteria) per milliliter of seawater, and that we don't know what most of those organisms are. If we approached our tanks like a microbiologist approached a mixed environmental sample that contained potential pathogenic strains, we would always wear gloves, a lab coat, eye protection, and maybe even a respiratory filter mask. Preventing cuts and preventing wounds from being exposed to seawater is really important. Elbow length thick rubber gloves (like gardening or dish gloves) are a great idea. While fragging, more precautions should be taken.
Click to expand...

You can get some nasty infections from dirt as well :)
 
Excellent! If you have been given antibiotics by a doctor, you shouldn't have any left over. :D
Click to expand...

I have the whole course, and was directed to take them if any sign of infection arose. It never did. They were prescribed for a deep gouge on my leg that I incurred by falling through a deck grating at work, which is a marine environment. I asked the doctor what it was for and he said a broad spectrum antibiotic to prevent infection. It's as yet unexpired, and I'm keeping it until it does. I personally see no problem with this, but opinions may vary.

This is a great discussion though. Planning ahead beats being in the middle of the ocean with your hand swollen up and no idea what to do. I've been there, and I don't recommend THAT to anyone. :D
 
Yeah when I had my moment in infection glory one of the biologists at school (who lives on a boat) said if he was out to sea and had something like what I had he'd be very scared (I wasn't :D).... I had the whole red streak that that went from my swollen paw of a hand down my forearm. Well all it took was one time for that to happen for me to not mess around again when it happened again... which FYI no glove in the world (unless it was a steel plate gauntlet) would have protected me from, those little tube snails are viciously strong!
 
Crabby said:
Mario,

Just stumbled on this thread - how scary! Glad to hear you are feeling better and I hope you make a full recovery. I can appreciate your hesitation to get your hands wet again. I had a similar thing happen a few months ago, but in my backyard. I was gardening and cut my leg on a brick. Two days later massive infection with similar symptoms of spreading and pain that had me at the doctor's office, urgent care, and an x-ray. All better now...

Marine scientists are learning that there are about 1 million microorganisms (including bacteria) per milliliter of seawater, and that we don't know what most of those organisms are. If we approached our tanks like a microbiologist approached a mixed environmental sample that contained potential pathogenic strains, we would always wear gloves, a lab coat, eye protection, and maybe even a respiratory filter mask. Preventing cuts and preventing wounds from being exposed to seawater is really important. Elbow length thick rubber gloves (like gardening or dish gloves) are a great idea. While fragging, more precautions should be taken.
Click to expand...
Really it's even worse than that. Since we are keeping closed systems with animals more densely packed than in the wild (compared to natural dilution factors) in unnaturally high levels of dissolved organics, we should expect unnaturally high levels of bacteria. I wouldn't be surprised to hear that the bacterial count in reef tanks was many times higher than the natural count.
 
It's lower Jim (bacterial count for aquariums vs ocean), well, according to the studies I have seen. The diversity is a mere shell of the wild population of bacteria as well.
 
I think a key part of this is that his tank was at higher than normal temps just before his infection.

http://reeftools.com/news/coral-and-seahorse-vibrio-infections-temperature-related/
Vibrio coralliilyticus does not normally cause disease in healthy, lab raised Pocillopora damicornis coral specimens at a temperature of 75°F, but becomes pathogenic at higher temperatures. Temperatures above 80°F increase the acceleration and severity of the infection.
Click to expand...
 
That is one of a thousand Vibrios and does not apply equally across the board.
 
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