infection

A few months ago I had surgery for a deep infection in my ankle where I broke it two years ago.  The break was more like shattered and I have pins and rods in my ankle, traumatic arthritis, and still walk with a cane.  The surgeon said that the infection is likely to come back in which case all the metal in my leg will have to be removed.  The skin over the infection site has been scaley and peeling since the infection first started and now There is swelling, almost like a blister in the exact same spot.  Does this mean the infection is back?  I had been considering some of my options to help repair my ankle but if it is infected none of them will be possible.  Honestly I am scared out of my mind.  Is there anything else that could explain this very isolated bump of swelling?  Oh and it also feels like there is fluid inside of it.

[JainMD]

Hi,
How old are you?
I have mentioned in other post that I like your screen name.
When there is infection in the body, there would be fever, lethargies, generalized fatigue would be present amongst lot of other signs.
Having a swelling with dry skin over it does not say that it is due to infection. In infection the skin over the swelling would be tensed, red, and warm to touch.
Yes, you are right in thinking that if you have swelling then it would be mean that any treatment would fail.
This could be a localized swelling due to extravasations of fluid from inflammatory response around.
Keep me informed if you have any queries.
Bye.

[2young2feelold]

I'm 20.  
The confusion comes in because last time i didn't have the normal signs of infection.  I just had the signs that I have now and then the blistery thing like I have now ruptured and was leaking translucent yellow liquid and didn't heal.  It was like that for almost two months before I saw my orthopedist and he decided I needed surgery asap.  I never had fever or fatigue or anything.  If I had had the normal infection signs I would have sought help for it sooner but a regular physician that I saw thought that it was just my poor circulation that stopped it from healing.

[JainMD]

Hi,
If that is the case and if swelling is persisting then you can go in for incision and drainage and send for culture the fluid present inside the swelling.
Once you know about the culture report, then you can decide what kind of antibiotic to take.
This will also find the cause for swelling and also will let you understand whether the swelling is infectious or not.
An imaging study would help.
Keep me informed if you have any concern.
Bye.

[2young2feelold]

I went to the Mayo for an appointment I had scheduled before my infection worries.  My leg is infected and I will be having surgery within a couple weeks.  All the metal will be removed.  I will go to my surgeon in Minneapolis in one week to do tests to see if the infection has spread. The surgery will probobly happen a few days after that.  If the infection has spread what is the likely course of action?  I was so overwhelmed with everything I was being told that I forgot to ask.
Thanks

[JainMD]

Hi,
In case if the infection has spread, then the surgery would be deterred for a while. They would be starting you on antibiotics and would send some cultures to see for the growth of organism.
Once they have curtailed the infection then they can plan for surgery.
Surgery can also be done if there is mild infection under the cover of antibiotics.
Keep me informed if you have any queries.
Bye.