Diabetic foot case admition on 7/12/15 57yr male pt. k/c/o DM since 15yrs recently detected CLD since 6months came to ER with c/o seizure today morning postictal confusion on admition ,BP 80/40 HR 130 , no fever but WBC : 33000 immediate central line done , NORAD started creat 3.5 & Urine only 100ml in last 24hr on admition pt.was also breathless so ABG sent & O2 started ABG : Metabolic acidosis ph. : 7.2 so NaHco3 given in stat dose then pt.shift to ICU ,Then HD done for 6hr norad , vasopin started for BP at night ST changes started , so vasopin stopped , & then today morning Trop I : 0.523 Rx Inj.Levipil 500 BD Inj.Magnex forte 1.5gm stat then 1gm 12hrl Inj.Pantodac 40 12hrly Inj.EMESET 1amp.8hrly Tab.Rifagut 550 BD culture of swab from foot suggestive of GNB NLF non lactose fermenting , so Magbex forte stopped today Inj.Metotrol 1gm 8hrly stated today morning now pt.stable Hemodynamically , but still issue for Nephropathy & Diabetic foot , may he require amputation

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nicely presented case details .

excellent case nice description that ARF may be due to Diabetic nephropathy or Rhabdomyolysis

Nephropathy may be patient going towards HEpatorenal syndrome. Inj terlipressin 1mg Iv should be started in tid doses

Pt. Will require amputation, to recover from septic shock....

Nice presentation of the case.an example for a case study.

Leg looks salvageable to me.

This is case of ARF and diabetic nephropathy nice presentation case

requires amputation

excellent presentation. require immediate amputation

Do a thorough debridement and continue dressings. This patient will not survive any radical surgery in this condition and legs show good localization of disease process. A conservative approach can work at least on the left leg, which definitely looks very viable. Some better pics of the right leg medial and posterior aspect would be helpful but from what is visible it seems that it is salvageable.

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