Valerie Doyle (Archived)
Activity
Tutorial
Valerie Doyle is a 58-year-old female with a history of diabetes, hypertension and obesity. She takes an ACE-inhibitor/diuretic combination and metformin and has no history of medication or other allergies. Valerie presents to your walk-in clinic with concerns about her leg. A year ago she underwent an open cholecystectomy and 3 days post-operatively, on her planned day of discharge, she developed a swollen, mildly erythematous right lower leg with calf pain. She was diagnosed with a deep vein thrombosis and treated for 6 months with anticoagulation. Today she woke up in the morning feeling warm, with significant pain and redness in her right leg again and she immediately thought “not again”. She asked her husband to take her to the clinic immediately. On examination, you notice that Valerie is hemodynamically stable, her temperature is 37.9o C and that she has redness circumferentially around her ankle and spreading up the anterior aspect of her lower leg. Her pedal pulses are palpable, the reddened areas are warm and tender, the leg appears swollen but she has no calf tenderness. You notice she has significant varicose veins. Given her history, you obtain an ultrasound of her leg that is negative for a DVT. You diagnose her with a cellulitis and prescribe her a course of cephalexin.
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Tags

Archived
Archived
Discipline
Dermatology Infectious Diseases
MCC Presentations
Localized Edema Pruritus Skin and Integument Conditions
MeSH
Cellulitis [C17.300.185] Cephalexin [D02.065.589.099.249.200] Cephalexin [D02.886.675.966.500.249.200] Connective Tissue Diseases [C17.300] Erythema [C17.800.229] Skin Diseases, Infectious [C17.800.838] Venous Insufficiency [C14.907.952]

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