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Emergency medicine

A middle-aged man with cellulitis

Richard Sullivan, Gordian Fulde

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Abstract

A middle-aged man presents with an extremely painful swollen red leg and signs of sepsis. He has a history of chronic venous insufficiency, obesity, diabetes, hypertension and obstructive sleep apnoea. What are your differential diagnoses and how should he be managed?

Article Extract

As a GP working in both your own practice and the local emergency department, you commonly assess and treat patients of all ages with infections of the skin.

The case

Late one evening, a middle-aged man limps into the emergency department. You note that he is pale and does not look well. His left leg is extremely erythematous. You immediately admit him to a bed in the emergency department. His blood pressure is 80/40 mmHg, heart rate 150 beats/minute and irregularly irregular, respiratory rate 28 breaths/minute and temperature 39.2oC.

Picture credit: © Dr P. Marazzi/Science Photo Library

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