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



limb ischaemia, cellulitis, Buerger's, vasculitis


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.


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.




How to Cite

Valsamis, E. M., & Sagar, A. (2017). Ischaemic limb in a 32 year old, masquerading as cellulitis. BioMedicine and Surgery, 1(3), 148–151.



Case report