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Published byJenna Forbes Modified over 11 years ago
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DAN PREECE RI Case Report
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Cc: painful red hot foot HPI: 53 yo diabetic male who presents to the ED with red, painful swollen right foot. Denies trauma, puncture, wounds etc. States that the same thing happened two years ago, was placed in a CAM walker and the problem resolved itself after 2-3 months. Denies FCNV. Says he feels fine except for pain to the foot. What do you want to know now? What would you do? What imaging do you want?
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PMH: DMII, Tobacco, hyperlipidemia, iv drug use. Meds: diclofenac, lisinopril, metformin, simvastatin, trazadone. Social: homeless, drug abuse, works as carpenter.
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Post - op Wound was flushed and packed for 4 days. Returned to OR, closed plantar wound that did not communicate with other incision, discovered dorsal pocket of purulence, drained and left drain connecting two dorsal wounds.
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Pt began to complain of severe neck pain after laying in bed for days. What would you do?
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MRI revealed abscess and osteomyelitis of C4-6, neuro surgery performed laminectomy.
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Two weeks after initial I and D
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Packed and flushed for 4 more days, closed remaining wounds, started 6 weeks of IV antibiotics. Healed completely.
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