Things have been a bit on the busy side. I have switched to night shift in the ER for the next 2 weeks and have been struggling to get used to being awake all night again. Things are going really well on this rotation and time is flying by- as I imagined it would.
This was a case I had last week. I saw a gentleman with a bad venous stasis ulcer who had just been discharged from the hospital. He was returning because the ulcer had just started to drain some rather purulent material despite being on some antibiotics. After taking his history and doing a physical I went and looked in the computer system for a x-ray of his leg- since he had an old distal femur fracture that he chose not to have repaired for some reason. I saw the x-ray and it was quite an impressive fracture but other than that, the area of his leg where the ulcer was looked pretty good. When I presented the case to the attending I mentioned that I would like to get another x-ray even though the one on file was less than a week ago. He agreed, and I ordered the films. A little while later I went to pull up the x-rays and this is what I saw:
Click on the images to enlarge them, if you are having trouble seeing, there is subcutaneous air in the soft tissue.
Diagnosis: Gas Gangrene. Pt was scheduled for amputation of the leg above the knee for the morning.
Reason # 419 to keep your diabetes under control.
No longer an intern (The Salt Lake Tribune, 7/6/13)
10 years ago
2 Comments:
damn Clostridium will get you every time. I'm hoping it's clostridium, or at least that's in the realm of possibilities, or I'm in trouble this coming Tuesday! Glad you're back blogging!
Don't be afraid to make the DX of Funyun toxicity :-)
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