DEAR DR. DONOHUE: I am a 72-year-old woman and have had cellulitis for what seems like forever. Last September, I clipped my toenails and clipped part of my skin with the nail. The next morning, my lower right leg was swollen and red. My husband began alternating ice and heat. After a week, we saw the family doctor, who diagnosed it as cellulitis. We’d never heard of it. He prescribed an antibiotic and told us to keep the leg elevated. Did that for 60 days, and it went away. This past summer, I got it again in the lower left leg. We went to the doctor right away. He prescribed the same antibiotic and added a second one. After 30 days, I still had it. The doctor prescribed medicine for another 30 days. Because so many know absolutely nothing about cellulitis, please address it in your column. — P.P.

ANSWER: The “cell” of “cellulitis” refers to skin cells, and the “itis” indicates inflammation and infection of those cells. It’s a common infection. The germs involved usually are the Strep or Staph germs, both of which are found all over. These bacteria enter the skin though the smallest, even all-but-invisible, crack or scratch. Even a mosquito bite gives them an opportunity to infect the skin. Your toenail clipping provided an ideal entrance for them. People with diabetes are prone to this infection.

It spreads rapidly, turning the skin red, hot and painful. Immediate treatment with antibiotics usually can stop the infection. Sixty days is an exceptionally long time to have the infection once antibiotics are started. Most often, the infection can be controlled in a week to 10 days. Elevation of the infected leg or arm is most helpful.

People who have had one bout of cellulitis are likely to have another. You should inspect the skin between your toes to see if you have athlete’s foot. It’s another way for bacteria to gain access to skin cells.

I’m at a loss to explain why treatment took so long for you. If happens again — and you and I hope it doesn’t — a different antibiotic ought to be selected.

DEAR DR. DONOHUE: A girl in our area died of viral meningitis. Is it catchy? She had been to the beach, had gone deep-sea fishing and visited lighthouses. Could she have gotten it in any of those places? Do only young people get it? — M.S.

ANSWER: Meningitis is an infection of the brain’s coverings, the meninges. Viruses and bacteria can be the infecting agents. Viral meningitis is more often a milder form. This girl could have picked up the virus anywhere, not just in those places she visited. In the summer and fall, viruses whose natural habitat is the digestive tract are the most frequent cause of viral meningitis. They’re usually spread through a breach in sanitation. A second group of viruses are the next most common causes in those times of the year. Those viruses are transmitted through a mosquito bite. The West Nile virus, one that gained much publicity in the past few years, is an example of a mosquito-transmitted virus. Where this girl was infected may never be known. You don’t usually catch viral meningitis from a sick patient.

Severe headache, stiff neck and elevated body temperature are signs of viral meningitis. Some patients also complain of a sore throat and diarrhea. Death from viral meningitis happens, but it’s not the usual outcome. Most such infections are self-limited.

Bacterial meningitis is a far different story and can lead to death and complications. When antibiotics are given early in the course of infection, the outcome is usually good.

DEAR DR. DONOHUE: What are amino acids and how important are they for health? How does one know if one is deficient? — M.B.

ANSWER: Amino acids are the building blocks of proteins, long strands of amino acids that are the basic units for muscles and many organs. If you eat a well-balanced diet, the probability of inadequate level of amino acids is close to zero. Meats, poultry, fish, grains, vegetables, beans, nuts, eggs, cheese and milk are all sources of amino acids. It’s highly unlikely that you are deficient in them, unless your food intake is close to the starvation point.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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