Friday, November 14, 2014

Spot Diagnosis # 2

A 65 years old male patient presents with red, hot and painful right leg with some pus-filled blisters (as shown in the image below). The patient is known case of liver cirrhosis. What is your spot diagnosis?

A 60 years old male with red, hot and painful leg

Answer:

Diagnosis: Cellulitis

What is cellulitis?
Cellulitis is a serious and spreading infection of skin and underlying tissue. This infection can occur anywhere in the body; however, skin of the lower limbs is affected most of the times.

What causes cellulitis?
Cellulitis is a bacterial infection. Most often staphylococcus and streptococcus are the culprits. Other bacteria include methicillin-resistant Staph aureus, Hemophilus influenzae, Pneumococcus, and Clostridium.

What are the risk factors of cellulitis?
Cuts and cracks, insect bites, surgical incisions, weakened immune system, eczema and athlete’s foot, IV drug use and abuse, previous history of cellulitis, and chronic or debilitating disease, especially diabetes, liver cirrhosis and renal failure.

What are the sign and symptoms of cellulitis?
The patient with cellulitis presents with pain, redness and swelling of the affected area. On examination, the affected area is observed swollen, red, hot, tender and with tight glossy appearance. The patient is febrile and the skin may have sores.

What is the treatment of cellulitis? 
Depending upon the severity of the infection, oral or intravenous antibiotics are given. Penicillin is the drug of choice for cellulitis. Analgesics are used to relieve from pain. Elevation and compression dressing of the affected area are mandatory to reduce edema. Amclav 1g (Amoxicillin 875mg, Clavulanic acid 125mg) orally, twice a day, is used as adult dose in cellulitis. Amclav 1.2g IV twice a day is also used in severe cellulitis.

What to do to prevent cellulitis? 
You can prevent cellulitis by keeping the skin moist (to avoid skin cracks), treating the skin infections promptly, wearing protective covering while working and inspecting the skin on daily basis.
Keywords: Cellulitis, Cellulits treatment, Signs and Symptoms, Red hot leg, Painful, Pus-filled blisters

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