Concluded Case

Cellulitis

40 year old male, no h/o comorbidities, presented with pain and swelling of the right foot. No h/o trauma, fall. On examination has local rise of temperature, pitting pedal oedema and tenderness. Ankle joint movements are normal. Dx and Rx please.

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Concluded answer

D/D 1.Infective - cellulitis 2.Acute Gouty arthritis 3.Insect bite followed by secondary infection 4.DVT 5.lymohangitis - bacterial or filarial 6.Bone involvement - osteomyelitis Start treatment on the lines of infective cellulitis and get S.uric acid , colour doppler study of lower limb vessels and an X - ray foot to look for any osteomyelitis . Treatment- Tab Linezolid 600 mg B.D for 10 days Tab Aceclofenac + serratiopeptidase B.D for 10 days Elevation of limb Remaining treatment depends upon the investigations reports

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Rule out gout madam

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I agree with Dr S Agrawal, add to levocetirizin 5mg od, Deithylcarbamazin 150 bd 10 day

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DVT ???? Cellulitis FBC RFT BS antibiotics Chymoral forte Liofen PCM The leg should be supported on a pillows or on footstool

REALLY I AGREED WITH DR. M SIR
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Could be veous obstruction thrombophlebiis.Feel the pulse s.Arterial occlusion can also produce edema.Lymph edema to be considered next.

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CELLULITIS/Lymphangitis ask for colour doppler to ruled out DVT

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I agree with Dr Raju N.

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Consider Cellulitis DVT Filarial lymphangitis Usg evaluation will help CBC esr Lower limb elevation Active movements If investigations are in conclusive, empirical iv antibiotics

Thank you doctor @Dr. Riju N
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Cellulitis lower leg Swelling is diffuse over dorsum foot Icepacks Broadspectrum antibiotics like amoxyclav625mg 1bd Antiinflamatory If not improved adv Incision and drainage

I agree. Thank you doctor @Dr. Shivraj Agarwal
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Prolonged time standing on foot Cardiac dis? Fluid retention Stress/strain Rule out cause..first

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