Curofy in its endeavor to bring doctors on this collaborative platform, brings to you a glimpse of the case discussions that happen on the app and the lives that are getting saved in the process. This post has discussions regarding diseases like Barrett’s Oesophagus, Fournier’s Gangrene and Neuropathic Ulcer. With more than 60 thousand doctors from more than 350 cities in the country, Curofy has become the go to app for doctors to seek second opinion or to stay updated
46 year old male smoker with dyspepsia. Endoscopic biopsy from the esophagus revealed this image. (typical appearance of a condition)
2. 42 year old male presents with a gangrenous patch over the scrotum. Debridement is planned. Which antibiotic should be given?
This looks like Fourniers gangrene, meticulous wound debridement, radical excision of the gangrenous Slough. As far as drugs are concerned first r/o diabetes, parenteral antibiotics like Cefaperazone 2 g plus Salbactum 1 g or Piperacillin 4 g plus Tazobactum 500 mg bd & Amikacin 500 mg bd or Netromycin 200 mg bd & IV Metrogyl tid or IV ornidazole infusion bd for atleast 10 days f/b oral antibiotics depending on the situation. Please update the case,will be eagerly waiting for the prognosis.
3. Do you think VAC will help in the healing of this diabetic ulcer. blood sugar is now under control?
This is a case of Neuropathic ulcer, also known as Trophic ulcer, commonly seen in Diabetes,as a complication of sensory neuropathy, because of unequal pressure points.VAC is not going to help the case. Like wise skin graft never takes up successfully on the plantar aspect of sole. Treatment is strict glycemic control, Absolute bed rest, meticulous callus removal surgically once in 15 days. very important aspect of treatment is offloading,. Topical applications are virtually useless. Role of antibiotics is also mlnimal. If not cured go for POP slab for absolute bed rest,ulcer heals slowly,but with all the treatment i narrated ulcer certainly heals