They were 45 years old, construction worker.
He presented with a torpid evolution of a lesion in the first finger of the left lower limb that had been treated in his primary care center.
The patient had poor glycemic control and was taking the antidiabetic treatment chaotically.
No smoker, no dyslipidemia.
He came to the Emergency Department of the Hospital for worsening of the clinical picture with fever and deterioration of the general condition.
The analytical study showed elevated leukocytosis with left shift, mild anemia, increased ESR, increased CRP, impaired renal function, impaired coagulation study, i.e., systemic involvement.
Vascular examination showed positive pulses at all levels in both lower limbs, indicating that there was no arterial vascular obstruction; normal Doppler CW.
He also presented purulent secretion through fistula in the first finger and necrotic lesion of the second finger of that extremity, with collection in the foot sole and lower third of the forefoot colitis.
1.
In the emergency room, antibiotic treatment and drainage of the collection were initiated and the patient was transferred to the ward.
The MRI study of the foot showed signs of osteomyelitis of the first finger and collection in the sole of the foot. Once the general condition and analytical parameters improved, the patient underwent an amputation of the foot in the operating room.
Subsequently, in the plant, daily cures were performed for two weeks, until the amputation bed had good granulation tissue and was sent home to continue outpatient care.
