Question

Patient: Mr. Rogers

Gender: Male

Age: 79 4/4/2040

Setting: Medical Surgical Unit in Hospital

Pre-existing Conditions: Diabetic Type II, Chronic Leg Ulcers, Peripheral Vascular Disease, Stroke, and Aphasia.

Mr. Rogers is 79-year old male that came into the ER with complaints of Right lower leg pain. He was found to have cellulitis of his right calf.    Patient states, “I know my leg wounds have been draining a lot lately, but for the last 2 days my leg feels inflamed and burning. I have been running a temperature and have fever/chills feeling.”

Upon assessment of his right leg, there is swelling, redness, and the temperature to the leg is hot compared to surrounding tissue.

His temperature is 101.9, His pedal pulse is strong. The drainage from the right leg is purulent, with a foul odor.

Questions:

Define cellulitis and discuss its common manifestations.

What radiographical test can be used to diagnosis cellulitis?

What lab test can be used to diagnosis cellulitis?

What treatments will the health care team most likely prescribe?

Answer 1

Cellulitis is a bacterial infection of the skin. It includes dermis and also sub cutaneous tissue. It is normally seen in the lower limbs. Most common causative organisms are Staphylococcus and Streptococcus.

Manifestations: The common clinical manifestations of cellulitis are localised redness, swelling, pain, tenderness and warmth. It is associated with fever, chills and lymphatic involvement. In some cases there can be drainage of purulent material from the site.

Radiological tests: The radiological tests useful in diagnosis are X-ray and ultrasound. X-rays can help to identify any involvement of the underlying bone causing osteomyelitis or not. The ultrasound is more helpful in identifying the abscess and it’s boundaries.

Lab tests that can help in the diagnosis of cellulitis are swab culture, blood culture and focal culture. This can help us diagnose the cellulitis and also identify the causative organism which can help us in the treatment.

Treatment: The first step will be wound care. Cleaning and dressing of the wound is done. The patient is prescribed oral antibiotics. Anti diabetic treatment is also started if the patient is not receiving any. The antibiotics prescribed commonly are penicillins and cephalosporins.

This is a brief discussion on the given case study. Hope this helps you out. Please feel free to give your feedback and if you need further elaborate discussion on this topic. Thank you and have a great day.