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CaseStudy-18102016- InfectiousDisease

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18 Oct 2016 - General
 

A middle aged lady with background history of type 2 diabetes mellitus, increased body mass index, hypertension and smoker with 30 pack years, presented with left foot and left ankle pain, swollen, redness for 2 days with few episodes of fever. She did had a small cut on her big left toe 3 days before. Her temperature was 37.5 celcius on admission, and there was definite erythema, increased in warmness and pain over the left foot and ankle area, the area was marked with a skin marker. Blood tests showed elevated white cell count. neutrophil ,CRP and ESR. Her blood culture had growth MSSA (methicillin sensity Staphylococcus aureus ). What will be your diagnosis or differential diagnosis for this patient ? What antibiotic will be the most appropriate for her condition??

According to history, it is a probable case of cellulitis. A diabetic patient, has history of injury, and signs if inflammation are present. Though you didn't mentioned clearly, the involvement of sole and ankle indicate that the infection is spreading . Cellulitis is most commonly caused by Streptococcus, but it is not impossible to be happened by Staphylococcal infection.
I will prefer Flucloxacillin as first line treatment. As it is Methicillin sensitive, Flucloxacillin resistance is...
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