Jess ran into some unusually high readings recently with her pump, we suspected that she was coming down with something but we also did the usual pump checks, changed the insulin cartridge in the pump and changed the infusion site. When I took the old cannula out the infusion site looked a little red but nothing too serious. A couple of days later it was looking pretty red and nasty and was about the size of a 50p coin. Being the start of the weekend our gp surgery was closed so I put some hydrocortisone cream on and decided to wait and see if it would help. By the next day it was forming a head and later that day it burst and some puss came out. Put more cream on, twice a day and after it had burst it started to look better with the redness subsiding and the infected area gradually getting smaller. This morning there is still a red patch but much smaller and no signs of puss or a head forming again, I would say it's looking much better and seems to be healing. I'm keeping the infusion sites well away from this area and am still putting the cream on twice daily. The thing I noticed today is there is a lump underneath the infected site, not huge but definitely can be felt when I gently push my finger over the area. Could this have been caused by the insulin puddling up in this area and not being absorbed properly when it became infected, will it go away on it's own with some time or should I be getting our GP to check it even although the infection on the skin surface appears to be healing? I guess I'm asking if anyone has experienced anything like this before and did it go away on it's own or was some sort of treatment (antibiotics) necessary. Another question is that we were never told to prepare the skin with any sort of antibacterial wipes before inserting the cannula. Jess will bath and wash with ordinary soap before a set change. I'm wondering if it would be wise to treat the area with an antibacterial first from now on to avoid a repeat, it's the first time we've had a problem like this since pumping for a little over a year now.
Infection at infusion site
- Thread starter SophiaW
- Start Date
Hi
As yet I've never had an infection start around an infusion site after removal but that's not to say that i never will though............
I think for safety sake, you should take your little girl to a pharmacy and get a pharmacist to take a look and then they may be able to give you an antibiotic cream if needed or advise you to go to a GP.
Regarding alcohol wipes......I've not used a wipe for about 1 year... I did at first just to make sure that ereverything was going to be ok and that the adhesive would stick ok but then I got that I couldn't be bothered anymore so stopped as the Rapid D set has fairly good adhesion properties to it anyway. Do you use a steel needle set or are you using a teflon cannula? I always pull the steel needle set out very carefully so only a tiny red hole is left whereas when I used the teflon set I just yanked the set out leaving a bigger hole.
As yet I've never had an infection start around an infusion site after removal but that's not to say that i never will though............
I think for safety sake, you should take your little girl to a pharmacy and get a pharmacist to take a look and then they may be able to give you an antibiotic cream if needed or advise you to go to a GP.
Regarding alcohol wipes......I've not used a wipe for about 1 year... I did at first just to make sure that ereverything was going to be ok and that the adhesive would stick ok but then I got that I couldn't be bothered anymore so stopped as the Rapid D set has fairly good adhesion properties to it anyway. Do you use a steel needle set or are you using a teflon cannula? I always pull the steel needle set out very carefully so only a tiny red hole is left whereas when I used the teflon set I just yanked the set out leaving a bigger hole.
Yes we're using steel needles and are very careful about taking it out. The infection I think started whilst the cannula was still in place, I think this is the reason her readings went up. When I removed the cannula it did look a little red so I think the infection was already starting and the cause of the high readings. After we changed the site her bg came back into good numbers a few hours later. The hydrocortisone cream I've been using contains an ingredient used for treating skin infections so I think perhaps I'll skip the pharmacist and go straight to see our GP. It's one of those situations where I'm thinking should I or shouldn't I, am I worrying about nothing but don't want to leave it and then it turns out to be something that should have been seen to.
jopar
Well-Known Member
- Messages
- 2,222
I would take her to her GP, and get it checked out..
The lump may be nothing, but there again it may be the start of an abscess and my need antibiotics either cream or tablet version..
I know that you said that there was puss which has now gone, but if the 'seed' of infection is still under the skin, it will look like it's healing, but underneath the skin it's may be still festering away...
Normal washing with soap and water should be enough, the only problem with using alcohol/surgical spirit is that it dries the skin out, which can actually cause problems.... This is way it was stop for injections many years ago, they found that using it dried and cracked the skin actually putting the risk of infections up over a period of time!
Hopefully this is a one off or a rare event.. But if you do start experience it happening more often then perhaps changing over to Teflon cannula's might help out!
The lump may be nothing, but there again it may be the start of an abscess and my need antibiotics either cream or tablet version..
I know that you said that there was puss which has now gone, but if the 'seed' of infection is still under the skin, it will look like it's healing, but underneath the skin it's may be still festering away...
Normal washing with soap and water should be enough, the only problem with using alcohol/surgical spirit is that it dries the skin out, which can actually cause problems.... This is way it was stop for injections many years ago, they found that using it dried and cracked the skin actually putting the risk of infections up over a period of time!
Hopefully this is a one off or a rare event.. But if you do start experience it happening more often then perhaps changing over to Teflon cannula's might help out!
Thanks, I will get her to see the doctor. I phoned but the soonest our GP can see her is Thursday, very unusual for our surgery. I'll phone again later today or tomorrow and might be lucky to get a cancellation.
phoenix
Expert
- Messages
- 5,671
- Type of diabetes
- Type 1
- Treatment type
- Pump
Re cleaning the site, they spent ages at pump training insisting on the importance of cleaning hands, not touching anything else, swabbing top of vial and site, keeping things away from nose etc
I'm prescribed unidose chlorhexidine in aqueous solution like this http://www.cooper.fr/produit_cooper_CHL ... %25+COOPER and gauze squares.
(have to pay for them though) The squares come two to a packet. I use one to swab the top of the insulin vial and the other to swap the site. At the start I was prescribed a sterile plastic mat to lay things out on but they've stopped prescribing that.
(that's the counsel of perfection, I'm not always as thorough as I was told to be )
Hope Jess gets a cancellation, I'm sure that you've done the right things but agree with the others that it's best to get it checked out.
I'm prescribed unidose chlorhexidine in aqueous solution like this http://www.cooper.fr/produit_cooper_CHL ... %25+COOPER and gauze squares.
(have to pay for them though) The squares come two to a packet. I use one to swab the top of the insulin vial and the other to swap the site. At the start I was prescribed a sterile plastic mat to lay things out on but they've stopped prescribing that.
(that's the counsel of perfection, I'm not always as thorough as I was told to be )
Hope Jess gets a cancellation, I'm sure that you've done the right things but agree with the others that it's best to get it checked out.
If you cannot get an earlier appt with yr GP, then have you got a walk in health centre where you live at all that you could go to for medical help? If not, then most pharmacists are knowledgeable about an abscess looming or not.
Phoenix your pump training was a little different to what we were told. We were advised to keep hands washed, cannula site clean (soap and water), not touch cannula and not to breathe over anything but were never advised to clean the top of the insulin vial or the skin site prior to inserting the cannula with any sort of wipe or cleansing agent.
To update I took Jess along to our local small hospital where there is a nurse led dept that deals with minor injuries. The nurse there felt that Jess should be prescribed some oral antibiotics and didn't feel that waiting until Thursday was a good idea. She phoned our GP surgery and got us an emergency appointment with our GP for this afternoon. Just got back now from that appointment, have been prescribed some oral antibiotics and she recommended I continue using the cream that I have been using. Tried two pharmacies so far, one was out of stock of the antibiotic and the other I got there 1 minute after closing time. Hubby has gone off now to the bigger Tesco pharmacy across town, hopefully they will have in stock. Pleased I went to the minor injuries unit now and thank you everyone for the advice, it was one of those situations where I wasn't quite sure how important seeing a GP would be but now pleased we got to see her today and hopefully the infection will clear up soon.
To update I took Jess along to our local small hospital where there is a nurse led dept that deals with minor injuries. The nurse there felt that Jess should be prescribed some oral antibiotics and didn't feel that waiting until Thursday was a good idea. She phoned our GP surgery and got us an emergency appointment with our GP for this afternoon. Just got back now from that appointment, have been prescribed some oral antibiotics and she recommended I continue using the cream that I have been using. Tried two pharmacies so far, one was out of stock of the antibiotic and the other I got there 1 minute after closing time. Hubby has gone off now to the bigger Tesco pharmacy across town, hopefully they will have in stock. Pleased I went to the minor injuries unit now and thank you everyone for the advice, it was one of those situations where I wasn't quite sure how important seeing a GP would be but now pleased we got to see her today and hopefully the infection will clear up soon.
jopar
Well-Known Member
- Messages
- 2,222
Glad you saw somebody and it's being sorted..
Problem with cannula's if for some reason they react or introduce a infection, the seat of the infection is under the skin, and because the cannula is microfine, the puncture wound on the skin seals very quickly after we've taken it out... So effectively sealing the infection in..
Using the cream would have done a lot of good, as yes it won't quite get to the route of the problem but will certainly hold it at bay and a course of antibiotics should deal with the infection underneath that the cream can't reach..
Abscesses are nasty things because because the initial infections creates what they call a 'seed' which antibiotics can't sort out, only calm down then if flares again, when they drain a abscess what they are doing is getting rid of the puss, then cutting out the 'seed' the wound it creates has to be healed from inside out, so it's packed to prevent it from sealing over...
Thankfully I haven't had an abscess caused by a cannula in 4 years of pumping, but did have an abscess on my back around 8 years ago, which took 8 weeks of intensive treatment and 2 lots of antibiotics to sort out!
Problem with cannula's if for some reason they react or introduce a infection, the seat of the infection is under the skin, and because the cannula is microfine, the puncture wound on the skin seals very quickly after we've taken it out... So effectively sealing the infection in..
Using the cream would have done a lot of good, as yes it won't quite get to the route of the problem but will certainly hold it at bay and a course of antibiotics should deal with the infection underneath that the cream can't reach..
Abscesses are nasty things because because the initial infections creates what they call a 'seed' which antibiotics can't sort out, only calm down then if flares again, when they drain a abscess what they are doing is getting rid of the puss, then cutting out the 'seed' the wound it creates has to be healed from inside out, so it's packed to prevent it from sealing over...
Thankfully I haven't had an abscess caused by a cannula in 4 years of pumping, but did have an abscess on my back around 8 years ago, which took 8 weeks of intensive treatment and 2 lots of antibiotics to sort out!
Jopar 8 weeks sounds like a long time and a horrible experience. Let's hope that this is a one-off for Jess and it won't happen again anytime soon. I'm not sure if this might have had any impact on Jess developing this infection but when I did the set change which resulted in this infection I was not very well myself. I had been in hospital with a very bad chest infection bordering on pneumonia. Perhaps me breathing whilst doing the set change somehow contaminated the area and caused the infection? I was very careful to wash my hands thoroughly and not cough anywhere near the set tubing or cannula or whilst I was inserting the cannula. Anyway, I've been into school to give her the next dose of antibiotics and the infection is looking better already so it looks like it will clear up nicely. The antibiotics are a tricky one because they're a four times a day one and have to be taken on an empty stomach, no eating 2 hours before or an hour afterwards. For a child who eats and snacks regularly it's going to be hard work but we will manage 
jopar
Well-Known Member
- Messages
- 2,222
Glad you can see improvements already..
I think I know the antibiotic's you are talking about, and yep it's a nightmare trying to take them on an empty stomach then avoid food for 2 hours, fingers crossed hopefully she's only got the 5 day course and not the 7 day one..
I should imagine it was just one of those things, rather than a specific..
It wasn't pleasant and was a long haul... And left quite a deep scar which my kids refer to has the bullet wound! I can't quite see it has it sits on my bottom rib cage on my back... did see the packing they took out and was quite shocked by the amount, more so because the wound packing procedure is something I used to via working in the care field..
It all started with a insect bite and I must have scratched it...
I think I know the antibiotic's you are talking about, and yep it's a nightmare trying to take them on an empty stomach then avoid food for 2 hours, fingers crossed hopefully she's only got the 5 day course and not the 7 day one..
I should imagine it was just one of those things, rather than a specific..
It wasn't pleasant and was a long haul... And left quite a deep scar which my kids refer to has the bullet wound! I can't quite see it has it sits on my bottom rib cage on my back... did see the packing they took out and was quite shocked by the amount, more so because the wound packing procedure is something I used to via working in the care field..
It all started with a insect bite and I must have scratched it...
I read your post and wanted to share with you the problems my husband has had - perhaps it might help.
He had a 6 month trial on a pump around 5 years ago.
It failed because he kept getting infections/abcesses at the site of the infusion, I should say at this point he has an allergy to plasters and all things sticky and this was the cause of the infections. Not one single infusion site escaped an infection, it was very painful for him and consequently he spent the best part of 6 months on antibiotics with horribly high blood glucose readings.
He has just recommenced a new trial on a pump but with the addition of an anti histamine which has removed the sticky plaster allergy and so far he has had no problems with infections or allergies at all.
This is a really simple solution to a problem - sadly it took so many years for someone to think of it :wink:
He had a 6 month trial on a pump around 5 years ago.
It failed because he kept getting infections/abcesses at the site of the infusion, I should say at this point he has an allergy to plasters and all things sticky and this was the cause of the infections. Not one single infusion site escaped an infection, it was very painful for him and consequently he spent the best part of 6 months on antibiotics with horribly high blood glucose readings.
He has just recommenced a new trial on a pump but with the addition of an anti histamine which has removed the sticky plaster allergy and so far he has had no problems with infections or allergies at all.
This is a really simple solution to a problem - sadly it took so many years for someone to think of it :wink:
Pollie that is great that your husband can now use a pump again. I was concerned about Jess having an allergy to the adhesive before we started pumping because she can't wear normal plasters, I think it's the latex she has an allergy to. But the sticky bits on the infusion sets she's been using have been fine so we were lucky. She's finished the course of antibiotics now and it has cleared up very well and so far haven't had any more problems, hoping it will stay that way. I'm hoping that we were just very unlucky and this was a one-off infection, it's the first one in just over a year of pumping and doing set changes every 2 days.
Hi
Ive been on the pump now for 3 years and recently Ive had the same Kind of Infection , I spoke with the pump supplier and they sent me a few different sets to try just in-case it was the plaster i was allergic to, although it looks like its a one off infection but I've avoided this area over the past few weeks. Ive also got a lump under the skin which is sore to touch and even hurts if i wear tight clothes. Although i used to suffer these same lumps when i injected 5 times per day in my legs even with rotating the sites. but after 17 years of injecting i suppose its normal. the following Web Link may hopefully help
http://www.loop-blog.com/blog/Lumps-and-Bumps-from-Insulin-Therapy
I hope Jess doesn't suffer any more infections and give the pump suppliers a call to see if they can suggest anything
Ive been on the pump now for 3 years and recently Ive had the same Kind of Infection , I spoke with the pump supplier and they sent me a few different sets to try just in-case it was the plaster i was allergic to, although it looks like its a one off infection but I've avoided this area over the past few weeks. Ive also got a lump under the skin which is sore to touch and even hurts if i wear tight clothes. Although i used to suffer these same lumps when i injected 5 times per day in my legs even with rotating the sites. but after 17 years of injecting i suppose its normal.
the following Web Link may hopefully help http://www.loop-blog.com/blog/Lumps-and-Bumps-from-Insulin-Therapy
I hope Jess doesn't suffer any more infections and give the pump suppliers a call to see if they can suggest anything
Thanks, I'll take a look at that website We've been avoiding that area for cannula sites, it seems to have healed up well and the lump is barely there now but I want to make sure it has plenty of rest time before we go anywhere near it again. Jess says it doesn't hurt if I press on that area which is a good sign because it did hurt before. For now I'm going to stay with the steel cannulas because they do work well for Jess and she likes them, but if she gets another infection then I'll definitely look into trying some other sets. Let's hope that for you and Jess it was a one off and it doesn't happen again
We've been avoiding that area for cannula sites, it seems to have healed up well and the lump is barely there now but I want to make sure it has plenty of rest time before we go anywhere near it again. Jess says it doesn't hurt if I press on that area which is a good sign because it did hurt before. For now I'm going to stay with the steel cannulas because they do work well for Jess and she likes them, but if she gets another infection then I'll definitely look into trying some other sets. Let's hope that for you and Jess it was a one off and it doesn't happen again 