patient had infected wound in left great toe since 3 days.yncontrolled t2dm k/c/o dm since 13 years.your suggestions.
Dibetic foot.. A diabetic foot is a foot that exhibits any pathology that results directly from diabetes mellitus or any long-term (or "chronic") complication of diabetes mellitus. Uncontrolled diabetes can damage your nerves. If you have damaged nerves in your legs and feet, you might not feel heat, cold, or pain there. This lack of feeling is called "sensory diabetic neuropathy." If you do not feel a cut or sore on your foot because of neuropathy, the cut could get worse and become infected. The muscles of your foot may not work properly because nerves to the muscles are damaged. This could cause your foot to not align properly and create too much pressure on one part of your foot. Peripheral vascular disease...is another cause of cellulitis..
Long standing diabetes Presenting with infected wound lt foot Virtually it looks cellulitis for 3 days First of all assess the diabetic status control glycemia with insulin Local debridement of dead skin Broadspectrum antibiotics like amoxyclav625mg 1bd and tab lenazolinid 600mg 1bd Antiinflamatory Immobilization Dress with bactigrass It should recover
IT'S A..CASE OF.. CELLULITIS..WITH..UNCONTROLLED DIABETES.. ? DIABETIC FOOT.. * STRICT GLYCEMIC CONTROL WITH ANTIDIABETIC MANAGEMENT WITH EXPERTS OPINION.. * CLEANING DEBRIDEMENT AND DRESSING WITH MUPIROCIN..& WOUND MANAGEMENT WITH SURGEONS OPINION.. * ANTIBIOTICS WITH NSAIDS AS PER REQUIREMENT.. * INVESTIGATIONS.. HEMOGRAM.. URINE ROUTINE.. BSR HBA1C.. SWAB C AND S EXAMINATION.. X-RAY STUDY..
There is huge abscess in distal foot with circumferential involvement of great toe Adv Strict control of diabetes with insulin Check for diabetic ketoacidosis and correct it Check for renal function and prerenal type of renal failure and correct it Check electrolyte and correct any abnormalities Do ECG and look for IHD Start appropriate Antibiotics Do arterial Doppler to look for arterial insufficiency optimisation followed by surgical drainage of abscess Complete drainage of pus and infected tissue is required, some times amputation may also be required, obtain necessary consent of same before hand
Diabetic ulcer diabetic foot See for vaculopathy Strict control of diabetes with insulin & OHA Several dressings with EUSOL If wound become healthy Skin grafting If arterial pulsation week May have to go for Amputation Antibiotics orally Antibiotics ( T Bact ) oint dressings Tab Gabapentine 300 mg b d
Diabetic Foot. Diabetic Ketoacidosis Adv:- Strict Controll of Diabetes Orally Augmentin625 NSAIDS Cleaning nd Dressing Carefully. Follow up investigations in routine
Diabetic ketoacidosis Diabetes mellitus Peripheral vascular Ds. D.Neuroapthy Antibiotics Analgesics Cleaning and dressing Ointments
Diabetic foot ask for X-RAY foot AP and Lateral, coloured USG of foot to ruled out DVT clean wound and dressed, Injection Meropenem 1gm iv bd Tab Algesia sp one bd, Start insulin
Diabetic foot and infection Dressing regularly and Orally broad spectrum Antibiotics like cv625 mg trice daily with NSAIDs brufen 600 mg twice daily Reviews every 3rd day
Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!
Cases that would interest you
- Login to View the image
A 65 years old lady presented with a case of non healing ulcer over right fore foot 2nd toe plantar aspect since 2 years and left foot for foot over since 3 years associated with history of foul smelling pis discharge and cellulitis and fever since 15days for this they came. BP 160/90 Lab routine TC 16000 DC (N) 84% HB 13 gm RBS 317mg/dl ABI bilateral 0.9 TBI bilateral 0.8 Provisional diagnosis Grade2 B Neurotrophic ulcer bilateral A/ w cellulitis and osteomyelitis ? Over 2nd phalanx right foot Type 2 Diabetes MELLITUS Hypertension Diabetic peripheral Neuropathy Discussion open my dear colleagues and respected seniors
Dr. Anudeep Puvvula6 Likes22 Answers - Login to View the image
80 year old male with history of DM, PVD, related to non healing diabetic foot ulcer. Now has this area on top of left foot. Has had this scab since earlier this year. Has not grown in size. No odor, no drainage, no pain. Reports no fevers. Has mild neuropathy to LLE. Suggestions on any further treatment options/tests? Worried about what may be presenting underneath the scabbed area with his Hx of PVD/DM.
Dr. Somesh Sharma1 Like17 Answers - Login to View the image
50year old Male,known case of diabetes on irregular treatment presented with pain,swelling,ulcer with discharge and discolouration of Left big toe since 2weeks... Diagnosis and management?
Dr. Dhilipan Pradap Rangaraju10 Likes45 Answers - Login to View the image
58 yr old pt having infected wound on right leg (index toe) .. Onset: 1 month ago K/C/O - DM BP- 130/70 mmHg. RBS- 176 mg/dL
Dr. Parekh Neelkanth95 Likes142 Answers - Login to View the image
Give relevant details about the case. Images help other Doctors give a better response.
Dr. Durai Raj16 Likes44 Answers
4 Likes