Transcript Case Report
Case Report
DAN PREECE RI
Cc: painful red hot foot
HPI: 53 yo diabetic male who presents to the ED
with red, painful swollen right foot. Denies trauma,
puncture, wounds etc. States that the same thing
happened two years ago, was placed in a CAM walker
and the problem resolved itself after 2-3 months.
Denies FCNV. Says he feels “fine” except for pain to
the foot.
What do you want to know now? What would you
do? What imaging do you want?
PMH: DMII, Tobacco, hyperlipidemia, iv drug use.
Meds: diclofenac, lisinopril, metformin, simvastatin,
trazadone.
Social: homeless, drug abuse, works as carpenter.
Post - op
Wound was flushed and packed for 4 days.
Returned to OR, closed plantar wound that did not
communicate with other incision, discovered dorsal
pocket of purulence, drained and left drain
connecting two dorsal wounds.
Pt began to complain of severe neck pain after laying
in bed for days. What would you do?
MRI revealed abscess and osteomyelitis of
C4-6, neuro surgery performed
laminectomy.
Two weeks after initial I and D
Two weeks after initial I and D
Packed and flushed for 4 more days, closed
remaining wounds, started 6 weeks of IV
antibiotics. Healed completely.