My Strange n Surprising Summer Staycation with Cellulitis

aka Well, That Escalated Quickly

In July, I spent a break away from but near my home, not as a typical staycation, but in a hospital, for a case of cellulitis. No, not for “cellulite”, as many people have; but for an infection deep within the skin.

It started simply enough, as I played frisbee with my son in the shallow, sandy waters at Cheung Sha, Lantau. I felt a quick pricking in the bottom of my left foot when treading on the sand. Briefly, I wondered if it was a marine creature, but felt nothing more: no pain indicating venom from a stone fish, for instance.

Arriving home on Cheung Chau that evening, I was feeling unwell, but thought it must be dehydration. Yet drinking water and sports drink was little help. The next day, I had a minor fever. Though I slept well, I awoke sweating, then had a spell of intense shivering, tremors even – indicating more intense fever.

So, I headed to a doctor. I wondered if the dehydration had let to sinusitis, which I’m prone to. But the doctor found nothing wrong – including no symptoms of Covid, though was surprised my temperature was high.

Arriving home, I glanced at my lower left leg, and noticed it was swollen, reddish, with a couple of angry looking rashes. Checking symptoms online, I quickly found they fit something called cellulitis. “Cellulitis is a common, potentially serious bacterial skin infection,” reported the Mayo Clinic website. “Left untreated, the infection can spread to your lymph nodes and bloodstream and rapidly become life-threatening.”

“I’m just going out for a few minutes,” I told my son, and set off for the nearby hospital’s A&E department, figuring I’d be given some antibiotics, and sent home. Instead, a doctor confirmed it was cellulitis, and asked if I’d like to be admitted here, or on Hong Kong Island, probably for four or five days. I chose the Cheung Chau hospital.

Catheter for intravenous antibiotics treatment

Nurses fitted me with a catheter – a small, mostly plastic device, leading to a vein in the back of my left hand – and gave the first of what became three injections of antibiotics per day. Then, I was issued pyjamas, and taken to an isolation ward, since my fever made me a potential Covid patient. Happily, my wife dropped off a bag with supplies including my laptop, allowing some communication with the outside world.

After a couple of nights, my Covid test came back negative, and I was moved to a general ward. I was advised to walk, and took to pacing up and down a corridor that afforded wonderful views over Tung Wan beach to Hong Kong Island.

The treatment regime continued, and each day the doctor on duty visited during his morning round. One doctor asked if I’d had any contact with marine creatures, reminding me of the pricking sensation at Cheung Sha. I didn’t think there were sea urchins in the area, but maybe the spine of a fish hidden in the sand; the doctor even named three potential species.

I later learned from nurses that the Cheung Chau hospital quite often treats cellulitis arising from encounters with marine creatures. Sometimes, people arrive with cases that are too advanced, and are sent to larger hospitals in the city.

Online information reveals that cellulitis is common worldwide, with around 14 million cases in the United States annually. The risk is around twice as high in diabetics, and a study of a Hong Kong diabetes database revealed 45,470 hospitalisations for cellulitis from 2001-2016. While more serious complications are rare, they can be serious: I was struck by a report on an 83-year-old woman who suffered a puncture wound from a tilapia, and within two days developed an infection akin to cellulitis. In her case this became “flesh-eating disease”, properly known as necrotising fasciitis, and despite intensive treatment, she died 17 days after admission to hospital.

So on overhearing a doctor telling nurses about my case mention “necrotising fasciitis”, I was quick to check I didn’t have this. At one point, I rolled down a “compression sock” for limiting swelling, saw my ankle looked huge and purple as a beetroot, and wondered if it would soon be a case of bye-bye leg.

The antibiotics, related to penicillin, began countering the infection. Instead of reporting “Fever,” as typical in the first three days, nurses checking my temperature began telling me, “No fever.” The pain that accompanied standing after bed rest decreased; a doctor was able to squeeze affected areas of my leg without me yelling in agony.

My treatment was switched from intravenous to oral antibiotics. And after another overnight stay for more observations, a doctor came round, prescribed antibiotics to last a couple more days, and I was allowed to go.

I arrived home on a Monday morning – not after a few minutes, but six days since leaving the previous Tuesday; feeling glad to have both legs intact, and to have caught this infection in time, with treatment by a highly experienced team.

[Written for the South China Morning Post]