Question
Hello,
   I am a 51 year old female who is 5'10, weighing 150 pounds. I have had a long stint on crutches due to 6 hip surgeries.I tore my Achilles' tendon in 2001. It was repaired and healed great! Now after all this crutches business I partially tore it again. I had Achilles' tendon surgery on Septmber 2nd, 2014. I have a problem as it got infected, It has been 51/2 weeks, I was on 2 antibiotics at once for 3 weeks. My question is should it still be weeping? It is weeping yellow. It is looking much better, but it is swelling a lot. Is this just healing process or should I be worried? I am on vacuation so if it is not important then I will wait until I get home.
  Thank you for your help.

Answer
Hi, Deb,

Thank you for your question.  I'm so sorry to hear about your situation!  You have certainly been through a lot, and I'm sure your vacation is much-needed and well-deserved.

To answer your question, I need you to pay attention to a couple of things.  First, is there any warmth at or around the area that is weeping?  Second, does your skin look slightly pink or red in that area, and has that region of color gotten any bigger?  Third, is the area especially painful (more than you remember from the other surgery, or has the pain gotten any worse than it was after surgery)?  Fourth, does the yellow substance have any sort of odor, either good or bad?  Finally, do you feel generally unwell (mild fever, unusually tired, low on energy, nausea or GI upset)?  If you can answer "yes" to any of these questions, I recommend that you find a doctor where you're visiting and call the doctor who did your surgery and has been treating the infection.  Those could be signs of an infection that's still brewing.  And if you're starting to feel sick, I'd encourage you to go to the hospital immediately, because that could be a sign that the infection has gotten into your blood and is going all over.  If it doesn't hurt, isn't red or pink, you feel good, and the weeping decreases, then it might be less urgent, but I'd still suggest that you call your doctor and check with him or her.

Next, did you finish all of the antibiotics the doctor gave you?  Did the doctor take a culture of the infected area before starting you on the antibiotics?  Was a culture of the wound taken at any point?  If so, hopefully the doctor compared the culture results to the antibiotics you were prescribed, to make sure you're taking the right ones.  We usually start our patients on an antibiotic that targets the most common infection-causing bacteria, but sometimes the infection is caused by a less common bacteria and the drug doesn't work.  Also, the bacteria can sometimes develop resistance to the more common antibiotics, so that even though a drug is supposed to work, it doesn't.

Swelling and purulence (pus, which is a yellowish or greenish fluid) can both be signs of infection.  Swelling can be common for a long time after surgery, and that doesn't concern me as much as the yellow substance weeping from that area.  Because of your history, and because the Achilles' tendon can be a tough area to treat, I would recommend that you get it checked out, or at the very least, call the doctor who has been treating you.  Best case scenario, it's a false alarm and everything is fine.  But if there's an infection and it starts traveling, it can get into your hip or affect other parts of your body, which will make it much more difficult to treat.  Better to be safe than sorry.

I hope that helps.  Try to get it checked out, then enjoy the rest of your vacation, and definitely see your doctor again when you get home.

Wishing you health, happiness, and peace,
Dr. Bodart