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68/m known diabetic since 10yrs got sudden swelling over rt foot 7 days back, which slowly went on increasing till ankle. the affected area is quite warm, and extremely painful that pt find it difficult to walk. please help me with the possible diagnosis and rx

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Sudden onset swelling with associated warmth and pain suggest an INFLAMMATORY CONDITION. In diabetic patient the most probability being CELLULITIS. Other common DDx to be ruled out are Sprain, Lymph oedema, Venous obstruction, Fracture. Filariasis, Arthritis, Gout, Hypothyroidism etc are less likely in only 7 days onset. ADVICE : 1. Strict control of sugar. 2. Limb elevation, Compression bandage, Ice application. 3. Trypsin / Bromelain /Rutoside as anti inflammatory. 4. Aceclofenac or Diclofenac as painkiller /anti inflammatory. 5. Broadspectrum antibiotic. 6. X Ray foot, Blood for CBC, ESR, CRP, FBS. 7. If no relief within 1 week then advice doppler study of lower limb vessels, Uric acid, TSH, RA factor.

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Sudden onset swelling with associated warmth and pain suggest an INFLAMMATORY CONDITION. In diabetic patient the most probability being CELLULITIS. Other common DDx to be ruled out are Sprain, Lymph oedema, Venous obstruction, Fracture. Filariasis, Arthritis, Gout, Hypothyroidism etc are less likely in only 7 days onset. ADVICE : 1. Strict control of sugar. 2. Limb elevation, Compression bandage, Ice application. 3. Trypsin / Bromelain /Rutoside as anti inflammatory. 4. Aceclofenac or Diclofenac as painkiller /anti inflammatory. 5. Broadspectrum antibiotic. 6. X Ray foot, Blood for CBC, ESR, CRP, FBS. 7. If no relief within 1 week then advice doppler study of lower limb vessels, Uric acid, TSH, RA factor.

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Seems to be a case of cellulitis as the PT is diabetic, quite likely to develop infection from negligible source . PT's glycaemic status strictly to be maintained if necessary with Inj Insulin. Broad spectrum antibiotic Anti inflammatory and Analgesic Filariasis and lymphangitis to be differentiated.

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D/D. Cellulitis Filariasis Gouty arthritis Please get done CBC, blood for microfilaria,s.uric acid, urine r/e,sr.creatinine

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With such symptoms in diabetic it is CELLULITIS LEG Treatement : prompt sugar control 2) broad spectrum antibiotics 3) antiinflamatory 4) seratiopeptidase or trypcin chymotripsin combinstion 5) glycerine macsulf dressing and covering Investigate with coller doppler leg to rull out DVT , cbc, rbs , hba1c , creatinine .

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If no h/o sprain or fall, then DD Filarial cellulitis or Arthritis may be due to diabetes .

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1ST POSSIBLITY =CELLULITIS 2ND " = GOUT BLOOD ,= CBC SUGAR URIC ACID URINE = MCR RX CONTROL DM ANTIBIOTIC = FOR CELLULITIS COLCHICINE / NSAID = FOR GOUT

Cellulitis Strict diabetic control Antibiotics Anti inflamm

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Cellulitis do cbc urine r/m, s.creatinine

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Cellulitis.

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Cellulitis

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