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.