Concluded Case

60 F Severe pain ,swelling,no fever ,Bp 160 80 P 100 temp 99 , hb 10 Tlc 10100 ESR 25 Mx 22 DD and treatment

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IT'S A CASE OF.. ? CELLULITIS.. .. ? NON HEALING ULCER.. ? DIABETIC.. ? VASCULOPATHIC LESION.. ? VENOUS ULCER.. NEED'S CLINICOPATHOLOGICALLY EVALUATION..WITH. BLOOD CBC CT BT PT.. URINE ROUTINE.. BSR HBA1C.. KFT AND LFT.. SWAB C AND S EXAM.. COLOUR DOPLER STUDY.. MEANWHILE TREAT WITH.. CLEANING AND DRESSING WITH ANTISEPTIC ANTIBIOTICS OINTMENT MUPIROCIN.. LEG ELEVATION.. BROAD SPECTRUM ANTIBIOTICS WITH NSAID.. & MULTIVITAMINS.. PROCEED AS PER REPORTS WITH EXPERTS OPINION..

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IT'S A CASE OF.. ? CELLULITIS.. .. ? NON HEALING ULCER.. ? DIABETIC.. ? VASCULOPATHIC LESION.. ? VENOUS ULCER.. NEED'S CLINICOPATHOLOGICALLY EVALUATION..WITH. BLOOD CBC CT BT PT.. URINE ROUTINE.. BSR HBA1C.. KFT AND LFT.. SWAB C AND S EXAM.. COLOUR DOPLER STUDY.. MEANWHILE TREAT WITH.. CLEANING AND DRESSING WITH ANTISEPTIC ANTIBIOTICS OINTMENT MUPIROCIN.. LEG ELEVATION.. BROAD SPECTRUM ANTIBIOTICS WITH NSAID.. & MULTIVITAMINS.. PROCEED AS PER REPORTS WITH EXPERTS OPINION..

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Its a case cellulitis foot ppt by venous insufficiency.......but I think needs to b worked out in detail.....bsf n bsr lft kft cbc urine ce.....scan n a colour doppler........in the mean time debride the wound start dressing with megaheal ......good briad spectrum antibiotics with anaerobic cover plus good analgesia in low doses till kft report comes.........

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Pedal edema with Candidal intertrigo with supradded infection Check for serum creatinine and DM Check for venous insufficiency and DVT Cynosis present D/d Raynauds disease Burger disease Start broad spectrum antibiotics Limb elevation Telma H for HTN

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Hyoerpigmentation Unhealthy skin Ulcer between 4th and 5th toes. and for Sun of 4th toe . IMPRESSION PERIPHERAL arterial ischemia with gangrene Diabetic foot, Candidial intertrigo

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This is neglected infected case of dorsum of the left foot and the fingers , the web spaces shows shaggy infected wound. There is blackish colouration of the whole foot which may be due to insufficient venous drainage. Regarding investigation routine blood examination , blood sugar (f);and PP blood sugar to see wheather is diabetic or not if found diabetic , antidiabetic treatment preferbl with with Inj Insulin either by sliding or fixed doses. Kidney profile should be taken of. One collar dofflerto asses the venous blood flow or insufficiency or any obstruction. Treatment appropriate antibiotic Limb to be kept elevated position with finger and ankle movements Anti inflammatory like tab chymoral forte one tab TDS before meals Good debribement and must be done regularly or alt days

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NON. HEALING. ULCER CELLULITIS NECROTIC CHANGES... ADVISABLE COMPLETE. INVESTIGATIONS

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Cellulitis with non healing ulcer with necrose skin rule out diabetes arteriogram to see arterial supply

Cellulitis with ulcerAdv:CBC,BLOOD SUGAR,LFT,RFT,VENOGRAM,(COLOR DROPPLER) Antibiotics,multivitamins.ect.

Gangrene rule out dvt(Doppler)

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Non healing Ulcer ?Fungal ?Tuberculer ?PAD ? Infective

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