Editor's quiz: GI snapshot
A rare cause of "cellulitis"
Jeroen Bosch Hospital, Department of Surgery, ’s-Hertogenbosch, The Netherlands
Correspondence to:
Dr R J A Van Wensen, Jeroen Bosch Hospital, Department of Surgery, P.O. Box 90153, 5200 ME ’s-Hertogenbosch, The Netherlands; rvanwensen@home.nl
| The first 150 words of the full text of this article appear below. |
CLINICAL PRESENTATION
A 74-year-old man presented to the emergency department with lower back pain and left lower quadrant pain. His medical history included Parkinson’s disease and left inguinal hernia repair. He was dyspnoeic and coughing.
On examination, he had fever (39.6°C), increased breath sounds and pain in left lower quadrant without rebound tenderness. Clinical examination revealed no other abnormalities, most especially the left thigh. Laboratory data showed leucocytosis (16.6x109/litre) and an elevated C reactive protein (301 mg/l). Chest x ray demonstrated pneumonia. Intravenous antibiotic treatment (amoxicillin/clavulanate, 1200 mg every 8h) was initiated. During the next few days his fever remained (38.3°C). His left leg became red, oedematous and painful. No signs of abscess formation were present. The swelling and erythema were progressive. Blood cultures grew enteric bacteria and the lower quadrant pain persisted. An abdominal computed tomography (CT) scan was performed followed by CT scans of thorax and extremities
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ANSWER
Gut 2008 57: 1089.[Extract] [Full Text] [PDF]
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