From minor scratches to death risk
A typical case is patient L.X. T (38 years old, Tuyen Quang), with a history of chronic gout for more than 10 years and uncontrolled hypertension. Due to the habit of self-treating with pain relievers of unknown origin, the patient also suffered from Cushing's syndrome - a consequence of prolonged corticoid abuse, causing a serious weakening of the immune system.
2 days before being admitted to the hospital, the patient developed red swelling and itching in the back of the left calf. Due to discomfort, the patient scratched hard causing skin scratches, then arbitrarily applied medicated oil and cold ice. These incorrect treatments caused the injured area to quickly become infected, black blisters appeared and severe pain.
After 2 days without improvement, the patient was taken to a local medical facility with a diagnosis of septicemia, patellar fasciitis on the background of gout and hypertension. However, after a week of treatment, the condition did not improve, so the patient was transferred to the National Hospital for Tropical Diseases in a state of continuous high fever and exhaustion.
Here, doctors recorded swollen and painful left calf, ruptured blisters, ulcers, and necrosis. Test results showed very severe infection accompanied by acute kidney failure. The patient was diagnosed with septicemia, cellulomytis on the background of many chronic diseases such as hypertension, chronic gout, Cushing's syndrome, liver failure and kidney failure.
Immediately after that, the patient was indicated for surgery to remove necrosis of the skin and calf, left foot, and at the same time active resuscitation to control blood pressure, adjust blood clotting disorders and support liver and kidney function.
After surgery, the patient continued to be applied negative pressure aspiration therapy to remove pus, necrotic tissue, control local infection and promote granular tissue formation.
Deep necrosis due to multidrug-resistant bacteria
Another case is Mr. H.V. T (43 years old, a construction worker in Tuyen Quang), with a history of alcohol abuse and cirrhosis. When fever and swelling and pain appeared in his left ankle, the patient was treated at a lower level for more than 20 days but the ulcerative necrosis condition did not improve.
When transferred to the National Hospital for Tropical Diseases, the patient's soles of the feet were blackened with necrosis. The culture results revealed multi-drug-resistant bacteria. Magnetic resonance imaging showed fluid buildup and deep infiltration into the posterior tibia muscle mass, long toe flexor muscle and left calf muscle.
Test indicators also showed severe infection, white blood cells increased, forcing doctors to perform emergency surgery.
BSCKI Nguyen Anh Tuan - Department of Orthopedic Trauma Surgery and Spinal Neurosurgery, Central Tropical Diseases Hospital said that both patients were admitted to the hospital in a state of severe cellulitis, sepsis on a background of immunodeficiency.
According to doctors, small skin lesions, if not treated properly and promptly, can cause local inflammation, quickly progressing into blood infection, septic shock, multiple organ damage and death.
After 2 weeks of intensive treatment with necrotic excision, negative pressure aspiration and comprehensive resuscitation, the condition of both patients has improved significantly. Necrotic tissues were completely removed, granular tissue developed well. It is expected that next week, patients will continue to undergo surgery to patch skin pores to restore motor function.
Doctors recommend that people, especially those with underlying diseases such as gout, diabetes, cirrhosis... when signs of swelling, heat, redness, and abnormal pain appear in the joint or skin area, should immediately go to a medical facility for examination.
Absolutely do not arbitrarily apply unscientific folk remedies such as applying leaves, applying oil, hot or cold compresses to open wounds.
