Gas gangrene of lower limb

Case contributed by Kewal Arunkumar Mistry
Diagnosis certain

Presentation

History of ignored trauma to left heel. Swelling over left leg and thigh with crepitus, High grade fever. Neutrophilia and high ESR. RBS within normal range.

Patient Data

Age: 45 years
Gender: Male
x-ray

Multiple foci of gas seen in intramuscular planes in left calf and thigh. Note the soft tissue defect overlying left heel with cortical irregularity of calcaneum.

ultrasound

Large intramuscuar collection in calf involving gastrosoleus. Heterogeneous echotexture of thigh muscles with multiple interspersed air foci. Left inguinal lymphadenopathy.

Note low resistance flow in SFA and  increased flow in SFV.

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