22 yrs male - swelling 5 days / febrile local site - rest Unknown - Discuss further management ?



Looking this good quality photograph, it seems to be a case of spreading Cellulitis. Centre of the ulcers look black, so cutaneous anthrax and scrub typhus should be kept in mind. Cause : Mostly bacterial, may be fungal too. Investigations : 1) CBC, CRP, PROCALCITONIN etc 2) Wound swab for gram stain , C/S, if necessary KOH Preparation . Rx 1) Rest of the local part / Bed rest 2 ) Local daily dressing with NS-> H2O2 -> 5% povidone iodine lotion and Ointment ( Acts as bactericidal, sporicidal, virusidal and fungicidal ) -> STERILE GAUGE -> Micropore adhesive. 4) Suitable antibiotics covering all possible bacteria. A) Ofloxacin (200 mg ) BDPC or Cefuroxime 500 +Clavulinicacid 125 mg - BDPC or Doxycycline (100 mg ) BDPC B) Tab Chymoral forte - 1 tab TDAC C) Tab Ibuprofen 400 mg +Paracetamol 500 mg - 1 tab TDPC D) Tab Pantoprazole 40mg - 1 tab ODPC / BDAC E) Tab Multivitamin - 1 tab ODPC / BDPC. By this time reports will be in hand, have to reevaluate all reports alongwith clinical prognosis of the patient. Then change the antibiotics if necessary and manage the mode of treatment accordingly.

There are two wounds in the ankle and heel region with sorrounding area signs of inflammation suggestive of early cellulitis.The common cause is staphylococcus infection.Treat with suitable antibiotics, small I and D over the maximum area of inflammation would hasten the recovery.

Herpes zoster

a case of acute cellulitis rx accordingly with broad spectrum antibiotics and analgesic & trypsin bromolein preparation. .

Mean time investigate for any associated debilitating diseases like DM, HIV

looking like cut.vasulitis(erythematous purpuric lesions with crusting)


it is erythematous purpuric lesions


Erythematous purpuric..

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