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@accenture.com <BLOCKED::mailto:Pieter.van.der.wal@accenture.com> pvdwal@imaginet.co.za vanderwal.pieter@gmail.com From: south_sa@yahoogroups.com [mailto:south_sa@yahoogroups.com] On Behalf Of trevmcnt Sent: 26 January 2007 03:10 PM To: south_sa@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@prbo.org <mailto:dlee%40prbo.org> > Date: Thu, January 25, 2007 18:20 To: marmam@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@prbo.org <mailto:dlee%40prbo.org> Thank you, -Derek Lee Derek E. 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