Ischaemic limb in a 32 year old, masquerading as cellulitis

  • Epaminondas Markos Valsamis (1) Trauma and Orthopaedics Department, Hinchingbrooke Hospital, Huntingdon, United Kingdom
  • Alexander Sagar Emergency Department Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 0QQ, United Kingdom
Keywords: limb ischaemia, cellulitis, Buerger's, vasculitis

Abstract

A 32-year old man was admitted under the care of the Trauma and Orthopaedics team at a District General hospital with a 3-month history of a painful, erythematous right foot that had been preceded by parononychia of the right big toe. The presumed cellulitis was initially treated with flucloxacillin. A 5-day course of intravenous antimicrobial treatment resulted in no improvement. Clinical re-assessment revealed critical limb ischaemia. Arterial duplex and later angiography confirmed a popliteal artery occlusion. The patient underwent a femoral to below knee popliteal artery bypass with good results. This case demonstrates the importance of performing a thorough multi-system examination in cases of presumed cellulitis to avoid missing an unusual presentation of alternative pathology.

References

1. Kohda J, Lantsberg L, Sebbag, G. Isolated popliteal artery occlusion in the young. J Cardiovasc Surg (Torino). 1992;33(5):625-628.
2. Lazarides MK, Georgiadis GS, Papas TT, Nikolopoulos ES. Diagnostic criteria and treatment of Burger’s disease: a review. Int J Low Extrem Wounds. 2006;5(2):89-95.
Published
2017-09-30
How to Cite
Valsamis, E., & Sagar, A. (2017, September 30). Ischaemic limb in a 32 year old, masquerading as cellulitis. BioMedicine and Surgery, 1(3), 148-151. https://doi.org/https://doi.org/10.5281/zenodo.1044003
Section
Case report