Diabetic foot ulcer

70 y/o female, paraplegic since 10 yrs, had developed swelling in left foot, was on UTI Rx, On insulin therapy for diabetes management.. Chief Complaints Mild pain sensation in left thigh and swelling in left lower limb.. History Patient had h/o koch's in childhood, was not treated properly.. Had h/o koch's spine 10 yrs back, after that became paraplegic.. No bladder, bowel sensations.. On foley's for 10 yrs. so h/o recurrent UTI.. Vitals Stable Physical Examination Swelling++ Tenderness++ Investigations Hb-9 WBC- 15500 HbA1c- 9.4 Diagnosis D/D- Cellulitis? Management Please suggest..

2 Likes

LikeAnswersShare

Paraplegic diabetic pt with swelling and blisters in lt lower limb Bed ridden condition No control over bowels and bladder Pt is on catheter and recurrent uti Tlc suggest leucocytosis ie sepsis Hba1c and bsl are not under control Peripheral vasculopathy Cellulitis Nursing care with proper deflation of blisters and dressings Broadspectrum antibiotics like amoxyclav625mg 1bd Tab lenazolinid 600mg 1bd Periodically change catheter Antiinflamatory Passive physiotherapy

Thank you doctor
0

View 6 other replies

Diabetic foot with swelling and blisters left lower limb. HBa1c Ana bSL UNDER control. Peripheral Vasculopathy cellulitis Lenazolinid 600mg bd CEFTAM 1gm bd Analgesic antiinflammatory orally. Multivitamin and antioxidant orally. Asd with betadine lotion and good nutritious balanced diet. Regular monitoring and constant evaluation required. Blisters and discharge remove carefully. Keep leg raised and if possible passive physiotherapy. Reassurance and counciling required.

Thank you doctor
0

View 2 other replies

? UNCONTROLLED DIABETES WITH.. DIABETIC FOOT.. BULLOUS DIBETICORUM.. NEED'S.. STRICT GLYCEMIC CONTROL WITH ANTIDIABETIC MANAGEMENT WITH EXPERTS OPINION.. WOUND MANAGEMENT WITH SURGEONS OPINION.. HEMOGRAM.. BSR..HBA1C.. SWAB C AND S..EXAMINATION.. CLEANING DEBRIDEMENT AND DRESSING WITH MUPIROCIN.. BS..ANTIBIOTICS WITH NSAIDS AS PER REQUIREMENT..

Thanks
0

It is a case of uncontrolled diabetes, paraplegic, with loss of control of bladder and bowel with UTI having swelling and redness with blister suggestive of severe infection of foot with spreading cellulitis to lower limb with burst out blister. Management First of all strict glycaemic control with insulin To kee the elevated and passive aknkle exerscises Inj Ceftriaxone 1 gm im bd Inj Amikacin 1 gm im bd Tab Chymoral forte one tab tds for 7 days Tab analgesic one tal bd pc for 5 days then sos Blood for kidney function and LFT Urine and pus swab for culture and sensitivity for appropriate antibioc Watch for the wound for any resolution If swelling and redness less to continue If not responding and getting worse to take measure accordingly Colour Doppler to asses any any vasculopathy.

Thank you doctor
0

View 1 other reply

Cellulitis with leucocytosis with Uncontrol diabetes Diabetic diet Diabetologist Inj amikacin20 mg per kg body wt Aug625 tds 500 tds vitc Oint ensamycin sucrafil bd Clean with chlorhexadine DD tendofascitis Wet gangrene

Thank you doctor
0

Cellulitis with blister formation Please send fluid from blister for culture sensitivity IV antibiotics Antibiotic need to cover both gram positive and gram negative organisms Linezolid with Tazact will be good combination Strict control of blood sugar with insulin Keep a watch on need of surgical debridement- of required procedure can be performed under anesthesia

Thank you doctor
0

Ad.Urine Micro / Culture and Sensitivity. USG.. ABDOMEN + PELVIC. Renal and liver profile. ? Diabetic Nephropathy Cellulitis..

Thank you doctor
0

View 1 other reply

Dibetic Foot First Controll Sugar Do Raktamokshan With Jaloukacharan repeat after 15 days Vrun Dhavan With Panchvalkal Kwath Or Trifala Haridra Dway Kwath., Dressing With Vran Shodhan tail Or Jatyadi tail Or Nimb tail Gandak rasayan , Soovarna raj Vangeshwar With rakta Pachak Yog Chopchini Choorna Or Chopchini Kwath But jaloukacharan Is Must And Sugar Controll Is Also important Adv to avoid Atyamboo Pan ( Excess Drink Of Water

Thanks
0

Diabetic foot ulcer in paraplegic patient due to stasis Cellulitis severe in condition With recurrent Uti Need dual antibiotics Inj.augmebtin 1.2 gm bd Inj.lanzolid 600 mg daily 3 timesa day With monitoring of rft and serum electrolytes Leg elevation Proper dressing with immurich cap daily And mild physiotherapy

Thank you doctor
0

It's diabetic foot and cellulitis developed due to diabetic microvascular complications this need aggressive management 1. Limb elevation decrease edema and improve circulation 2. Mgso4 dressing daily to decrease edema and improve circulation. 3. Do the LFT nd KFT If normal then start linezolid and clindamycin combination drug and if deranged calculate dose accordingly. 4. Strict control of sugar with insulin long acting at night and short acting post prandial, diabetic diet and make CBG chart 5. Proper foot care 6. Lipid profile and CBC and note temperature 7. Color Doppler study of arterial system of lower extremities, if abnormality detect treat accordingly, u can add nicorandil, pentoxyphyllin, flavnoids 8. U can add methylcobalamine and pyridoxine for diabetic neuropathy.

Thank you doctor
0
Load more answers

Cases that would interest you