Not What It Seems: Deep Tissue Infection Presenting as Cellulitis
A 34-year-old male with diabetes presented to the emergency department with four days of progressively worsening redness, swelling and pain to his left buttock. The patient denied fevers, chills, rectal pain or purulent drainage from his rectum. His initial vital signs were heart rate of 82; bl...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
eScholarship Publishing, University of California
2015-10-01
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| Series: | Western Journal of Emergency Medicine |
| Subjects: | |
| Online Access: | http://escholarship.org/uc/item/3h9148p0 |
| Summary: | A 34-year-old male with diabetes presented to the
emergency department with four days of progressively
worsening redness, swelling and pain to his left buttock.
The patient denied fevers, chills, rectal pain or purulent
drainage from his rectum. His initial vital signs were heart
rate of 82; blood pressure of 146/92; and temperature of
98.2°F. The left buttock had a poorly circumscribed area of
induration; however, there was no fluctuance or crepitace.
Rectal exam was unremarkable. Because the patient’s
buttock pain was disproportionate to his exam findings,
a point-of-care ultrasound was performed to determine
if a more extensive process was present. The ultrasound
demonstrated cobblestoning, fascial thickening with edema,
and a large 4.5cm fluid collection extending and adjacent
to the rectum. |
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| ISSN: | 1936-900X 1936-9018 |