This is M & M presentation for Internal medicine resident:
admitting team they missed compartment syndrome on first day which is a medical emergency. please review initial assessment on 10/17 to see if pt had sign and symptoms of compartment syndrome. I also upload orthopedic report and all imaging. ill will going to upload more stuff!
below is brief hospital course.
Hospital Course
50-year-old male presents for left lower extremity pain. Patient also reports having sore throat for the past few days that has improved. Ultrasound of the left lower extremity showed a nonocclusive thrombus in the left posterior tibial vein. Labs remarkable for sodium 126 and creatinine 1.42. Patient was admitted and later found to have suspected necrotizing fasciitis and compartment syndrome requiring fasciotomy and subsequent debridement procedure with orthopedic surgery. Patient noted to have anemia and hematology was consulted., Did downtrend and needed transfusion. Patient also received IV iron. Patient was maintained on anticoagulation for his DVT. Infectious disease was consulted and patient placed on IV antibiotics. Patient noted to have strep wound infection as well as bacteremia and recommendation is for continued IV antibiotics for 6 weeks with an end date of 11/29/2023 with cefazolin. Of wound vacs were placed and will need to be changed every 3 days. Patient will need continued PT as well. Discussed with patient need to follow-up with primary care, cardiology, orthopedic surgery, plastic surgery as well as infectious disease after discharge. Discussed with the patient the need to followup with their PCP and the specialists listed above after discharge for further management. Also instructed the patient to return to the ED should their symptoms return/worsen. The patient understood and agreed with the discharge plan and was discharged to facility in stable clinical condition.
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