to be worrying over an infected toenail on 4 year old?

[Abbybabbly]

Son has very wide feet, has already had a few I growing toenails that have been able to treat at home so far. I also suffer badly with them so generally know what to do however this one was particularly bad and some pus was visible last night.
Can't see / feel an ingrown toenail however whole area is very red and swollen and salt water wasn't helping.
He isn't in pain unless it's touched but took him to the doctor who have him antibiotic cream for it as was hesitant to give oral antibiotics in first instance however a lady in the chemist ( changing her prescription ) starting banging on about kids dying of scepticemia where infections have rapidly spread etc so now worrying I should have insisted.
The whole toe is red not just the side but he is happy in himself.
Annoyed as now weekend no doctors open until Monday and she's worried me :(

Use the cream... Which one have they given you? I know some like fucidin can be used up to 4 times a day and work well... If you haven't already covered his toe in cream tonight, go and do it now while he's asleep.
If he gets worse over the weekend or develops a fever etc... You'll be able to get an out of hours appointment by calling 111 so don't worry that the regular doctors is shut for the weekend!

Scepticemia is always a possibility with any injury and yes it can take hold quickly. IME however it generally doesn't happen.

In your situation I would familiarise myself with the symptoms of sepsis, then just put them to the back of your mind and continue with soaking it (hot salty water twice a day) and the antibiotic cream.

Dh had similar last year and did end up on oral antibiotics but it - TMI alert - burst on day 3 and healed up very quickly thereafter.

If pus is visible in the side of his toe, gently pushing the skin away from the nail may release it. Instant relief!

hot salty water : as hot as he can stand as salty as he can stand for as long as he can stand
(x box is good)
every day till it goes down
and be ready to repeat until his feet stop growing at 17
but its better than surgery

antibiotics do not work ( I could go into full detail, but please trust me)

Thanks for your replies
There is no more pus but the side of his toenail is now white whereas under the toe is red.
I guessed it's from the pressure of an ingrown nail however have tried to feel around and can't feel any nail in the side and he's having no trouble walking etc only when prodded and I know when I had an ingrown nail even walking was extremely painful.
That's the cream he's on, doctor suggested twice a day however on box it says 3 times so will do that.
Just worried if there is an ingrown nail how will I get it out :( but have called chiropodists and they won't see him until infection cleared anyway.
He def isn't unwell in himself, but if no better by Monday I'll head back to the doctors for the oral antibiotics - we have a walk in centre here but go adults only ( helpful ) so only other option would be a&e if bad over the weekend!

There will be a GP Out of Hours centre available to you that sees children as well as the walk-in. I'd suggest you call NHS 111 now which is how you access it. If they think you need seeing, which they will as infection in a child not responding to treatment will need seeing, they will either arrange a GP to call you back or give you an appointment at the GP centre.

TBH I can't see that topical treatment is going to work here. Phone up now.

Have you drawn round it? Do that so you can see if it is spreading.

It hasn't spread since yesterday, the day before it was just the side of the toe that was red but yesterday morning it was also red underneath the toe which is why I took him to the doctor.
The doctor couldn't see any pus but said to try this for a few days before giving oral antibiotics as they don't like to over use them in children.

As the doctor has acknowledged that oral antibiotics might be required but aren't ideal as a first course of action, I think you are moving in the right direction.

Keep soaking it, and watch to see it doesn't spread, but my gut says it should improve.

My DD has fought septicaemia repeatedly (more than twenty times in five years) and come out on the other side. The idea is terrifying, and rightfully so, but it does not happen as commonly as the education campaign would have you think. It has been a reality for her because she has a tunnelled IV catheter that terminates just above her heart and it is in use daily. She also has an immune disorder. She is as far from the average child with regard to septicaemia risk as you can get.

The education campaign is basically a response to antibiotics being refused when they are necessary and appropriate, or not being used properly. You seem to have a good grasp of what is going on, and the doctor seems receptive to oral antibiotics if the topical doesn't help.

I think he'll be just fine, and you are doing a great job advocating for him.