Haiti Plus Diabetes Equals Bad

Friday, September 10, 2010

Haiti Plus Diabetes Equals Bad

 
This is the left foot of a 54 year old lady who came to clinic today.

She lives in the mountains and she has uncontrolled diabetes. She has been vomiting for weeks and her glucose is greater than 500.

Diabetics can have sensory neuropathies and with poor glucose control they can develop diabetic foot ulcers, gangrene, and osteomyelits.

Her dressing change pictured above reveals some of the extent of her pathology.

The smell in the clinic was and is terrible as the dressing was removed...and she and her son live with this medical and social and economic tragedy everyday.

Her white blood cell count is 38 thousand (normal is 5-10 thousand) and I believe she is septic from the infection in her foot.

I admitted her to the hospital and she is now on two antibiotics and if she survives sepsis, she will have an  amputation.

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Friday, September 17, 2010

Gas Gangrene

 

Diabetic foot ulcer. Look at the x-ray and you can see little dark pockets of gas within the tissues of her foot. This is gas gangrene due to bacterial infection. 

Her white count is 38 thousand with cellulitis extending up her leg.

The patient had a below-knee amputation two days ago.