Non-healing Ulcer on the Foot as Cellulitis: A Case Report

Abstract

Introduction: Cellulitis is a serious bacterial skin infection. The skin is swollen and red, and it feels warm and uncomfortable to the touch. Cellulitis is most commonly found in the lower legs, although it can also appear on the face, arms, and other regions of the body. Bacteria enter the body through a crack or break in the skin. The infection can spread to your lymph nodes and bloodstream if left untreated, creating a major health danger. It is rarely passed down from one generation to the next.
 Clinical Findings: The patient presented with a non-healing ulcer for 30days, due to the insect bite 1month ago on right foot which is being developed into non-healing ulcer on right foot. A 20x6cm wound over the right foot was seen on a plain film radiograph of the knee. It consists of necrotic debris, underlying tendons exposed, peripheral cold and pigmentation. Foul smelling is not present. Based on the appearance of the spreading erythema and radiographically confirmed findings, cellulitis was diagnosed. 
 Diagnostic Evaluation: Blood test- Hb-8.6gm%, MCV-91.1fl, MCH-30.9Pico-gm, MCHC-33.9%, Total RBC Count-2.78 millions/cu.mm, RDW-16.8%, HCT-25.3%, Total WBC Count-7400 cu.mm, Monocytes-04%, Granulocytes-75%, Lymphocytes-20%, Eosinophills-01%, Basophills-00%, Total Platelet Count-2.06lacs/cu.mm Peripheral Smear: RBCs-Normocytic hypochromic Platelets Adequate on smear, No Haemoparasite seen.
 Therapeutic Intervention: Inj. Ceftriaxone 1gm IV BD; Inj. PAN 40mg IV OD; Inj. Emset 4 mg IV TD; Inj. Neomal 100 ml IV TDS; Inj. MVI IV OD; Tab. Dolo 650 mg TDS; Tab Limcee 500 mg OD; Cap. Becosute OD; Protein powder; Tab Shelcal 500 mg OD; Tab. Duphalac 15 ml. 
 Conclusion: My patient was admitted to Surgery Ward, A.V.B.R.H with a known case of Cellulitis and he had a complaint of non-healing-ulcer over the right limb. After getting appropriate treatment his condition was approved.