I have a 55 hr old rusty nail, very shallow, non festering puncture area and no booster. should i have booster or img ?

Depends: For a puncture wound, if you have completed your tetanus series more than 5 years ago, get a vaccine today. If vaccine status is unknown, you will need a vaccine and immunoglobulin today. If you received the vaccine less than 5 years ago, nothing is recommended at this time, just get your next dose every 10 years from your previous vaccine dose.

R/O CELLULITIS: Cellulitis is a superficial skin infection that can be caused after an abrasion Or puncture wound. Keep the area clean and apply topical antibiotics. Seek prompt evaluation . I would recommend TTD BOOSTER AND ORAL ABS. Augmentin (amoxicillin and clavulanate) if no PCN ALLERGY