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.
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
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
Cellulitis lower leg Swelling is diffuse over dorsum foot Icepacks Broadspectrum antibiotics like amoxyclav625mg 1bd Antiinflamatory If not improved adv Incision and drainage
Consider Cellulitis DVT Filarial lymphangitis Usg evaluation will help CBC esr Lower limb elevation Active movements If investigations are in conclusive, empirical iv antibiotics
DVT ???? Cellulitis FBC RFT BS antibiotics Chymoral forte Liofen PCM The leg should be supported on a pillows or on footstool
With no history of diabetis and any injury, advised to do routine blood count, Blood sugar and Serum uric acid tests, these symptoms are seen in gout,if serum uric level is normal ,then investigate for cellulitis.
Unilateral pitting oedema withblocalbruse of temperature may be due to A. Filarial lymphangitis B. Deep vein thrombosis C. Infective origin including bonny pathology D. Rheumatoid arthitis Blood examination Color doffler Serum uric acid blood sugar Treatment To keep the limb elevated Antibiotic Anti inflammatory Analgesic . Specific treatment as per underlying pathology.
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DD DVT Filarial lymphangitis . Cellulitis Suggest CBC, Venous color doppler Antibiotics, limb elevation, NSAIDs There seems to be swelling of both feet .So systemic causes like renal, cardiac, hepatic causes should be excluded.
RT.. FOOT..OEDEMA.. ? VASCULOPATHY.. ? CELLULITIS.. ? LYMPHATIC PATHOLOGY.. NEED'S.. CLINICOPATHOLOGICAL EVALUATION WITH.. X-RAY STUDY.. COLOUR DOPLAR STUDY..
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