60 YEAR OLD MALE WITH UNCONTROLLED BLOOD SUGARS WITH RIGHT LOWER LIMB CELLULITIS

 A 60 year old male complaints of swelling of right lower limb since 5 days.



HISTORY OF PRESENTING ILLNESS

Patient was apparently asymptomatic 5-6 days ago, then he developed a swelling over right lower limb near ankle joint as he scratched over the swelling which increased gradually and is associated with pain. GRBS- 542 mg/dl.
No H/o fever, nausea, vomiting, burning micturation.

PAST HISTORY

K/C/o DM type 2 since 9 years on GLIMI-M2

N/K/C/O HTN, CVA, CAD, TB, Epilepsy, Thyroid disorder.


PERSONAL HISTORY

Diet - Mixed 
Appetite - Normal 
Sleep - Adequate 
Bowel - Hard stools 
Bladder - No burning micturation.

DAILY ROUTINE

Occupation- Tailor
6AM- Wakes up
8AM- Starts work
9AM- Breakfast
1PM- Lunch
6PM- Stops work
8PM- Dinner
10PM- Sleep


FAMILY HISTORY - Not significant 

GENERAL EXAMINATION

Patient is conscious, coherent and co operative . Well oriented to time, place and person. Moderately built and nourished.

No pallor, icterus, clubbing, cyanosis, lymphadenopathy, edema.

Vitals:

Temp-99 F

PR- 86bpm

RR-24/min

BP-160/60 mmHg

Grbs - 542 mg/dl


SYSTEMIC EXAMINATION

CVS : S1, S2 heard, no murmurs 

RS : BAE +, NVBS heard 

P/A : Soft, Non tender, No organomegaly, No distension, Bowel sounds heard

CNS: NAD








PROVISIONAL DIAGNOSIS-

RIGHT LOWER LIMB CELLULITIS WITH UNCONTROLLED BLOOD SUGARS  WITH AKI

                                                   
                                                            ON 25TH AUGUST



                                                                        ON 26TH AUGUST


                                                                       ON 30TH AUGUST


                                                                 ON 31ST AUGUST


Dressing done with papaya to form granulation tissue



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