[MARMAM] [south_sa] 'Seal finger' case

pieter.van.der.wal at accenture.com pieter.van.der.wal at accenture.com
Tue Jan 30 00:50:45 PST 2007


Hi there and Hello to whom it may concern...

 

My name is Pieter van der Wal, I was privileged enough to be the medic
for 3 expeditions, to Marion Island, Gough Island and Antarctica
respectively.

Please bear in mind that these expeditions where a few years back and
that I am no longer in the medical practice and am not current at this
stage.

 

There is very little information in your mail as to exactly how the
infection looks, and how it was acquired (bite, cut?)

As well as what the infection looks like. (pus, swollen, etc)

 

But I have run into similar type infections in my time on the
expeditions.

And I would suggest the following as a start.

 

If the wound is severe:

Move over to an stronger penicillin based antibiotic (ampliclox ) or a
combination of ampicillin and cloxacillin and gentamicin for a 1 week
period maximum.

Combine this in with very regular wound coverings with a salve mix
consisting of a iodine base salve mixed liberally with honey.

The honey acts as a osmosis catalyst and quite literally "sucks" the
infection out. 

 

I would suggest you begin with washing the wound regularly in normal
saline solution with a weak cleaning solution added to it.

Then the wound dressing as described at least every 2 hours for the
first 2-3 days. (dependant on the severity and reaction of the wound)

Tapering the regularity of the dressing off over the next 7- 10 days,
also dependant on the severity and reaction of the wound

 

 

If the Wound is Extremely severe: 

Then I suggest you start the patient off with mefoxin (if you have the
drug, and the patient is not adverse to it)

Then continuing with the prescribed antibiotics mentioned above and of
course the wound dressings also as mentioned.

 

 

You can get more information on the use of the treatment of severe Skin
and soft-tissue infections at the web site below.

And Always remember to check your patient for sensitivities to the drugs
Before you administer them. 

http://jmm.sgmjournals.org/cgi/content/full/53/1/51

 

you can get more information on Mefoxin at:

http://www.rxlist.com/cgi/generic2/cefoxitin_ids.htm

 

 

And I cannot stress this enough, get some guidance (inclusive passing
this info on for confirmation) from a land based Medical practitioner
(MD), preferably someone with experience in drug resistant severe soft
tissue infection.

But trust me on the wound dressing, it has quite literally saved a few
appendages in my past. 

 

 

I sincerely hope this helps and please feel free to update me on the
condition of your charge.

You may reach me at any of the below mentioned e-mail addresses and cell
number.

 

Kind Regards

______________________________
Pieter van der Wal

Cell +27 83 415 4673

Pieter.van.der.wal at accenture.com
<BLOCKED::mailto:Pieter.van.der.wal at accenture.com> 

pvdwal at imaginet.co.za

vanderwal.pieter at gmail.com

 

From: south_sa at yahoogroups.com [mailto:south_sa at yahoogroups.com] On
Behalf Of trevmcnt
Sent: 26 January 2007 03:10 PM
To: south_sa at yahoogroups.com
Subject: [south_sa] 'Seal finger' case

 

Posted on MARMAM today if anyone can help:

Original Message ---------------------------- 
Subject: [MARMAM] seal 
finger 
From: "Derek Lee" <dlee at prbo.org <mailto:dlee%40prbo.org> > 
Date: 
Thu, January 25, 2007 18:20 
To: marmam at lists.uvic.ca <mailto:marmam%40lists.uvic.ca>  
----------------------------------------------------------
----- 

Anyone who knows anything about the infection 'seal finger' 
recurring, 
and/or not responding to Tetracycline (1.5 g initially, 
then 500mg QID), 
please respond, we have a volunteer who is in 
danger of losing her fingers 
to an antibiotic-resistant infection 
acquired from elephant seals. Reply 
to: dlee at prbo.org <mailto:dlee%40prbo.org>  

Thank you, 

-Derek Lee 

Derek E. Lee 

Farallones Biologist 

PRBO Conservation Science 

3820 Cypress Drive, #11 

Petaluma, California 94954 

http://www.prbo.org 

_______________________________________________ 
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