Diagnosis: Cellulitis (Infection) of the 2nd Digit (Right Hand)

infection

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Diagnosis: Cellulitis (Infection) of the 2nd Digit (Right Hand) by Mind Map: Diagnosis: Cellulitis (Infection) of the 2nd Digit (Right Hand)

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1.1. **Etiology**

1.1.1. - Introduction of bacteria into the skin from a minor injury during moving.

1.1.2. - Bacterial infection from an open wound (likely Staphylococcus aureus or Streptococcus species).

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2.1. **Pathogenesis**

2.1.1. - The wound became infected, leading to inflammation of the skin and underlying tissue.

2.1.1.1. - The immune system response triggered erythema, warmth, and purulent drainage as part of the body's reaction to the infection.

2.1.1.1.1. - Infection worsened due to delayed medical intervention and ongoing physical activity.

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3.1. **Risk Factors**

3.1.1. - Lack of immediate medical care (self-care with hydrogen peroxide and Neosporin without professional wound assessment).

3.1.2. - Advanced age (65 years old) compromising immune response.

3.1.3. - Use of **Etanercept (Enbrel)** for rheumatoid arthritis, which suppresses the immune system, increasing susceptibility to infection.

3.1.4. - Recent trauma to the skin (injury during moving).

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4.1. **Clinical Manifestations**

4.1.1. - **Wound**: 4 cm x 1 cm x 2 cm lesion with purulent drainage, erythema, and warmth.

4.1.2. - **Pain**: Throbbing, sharp pain, worsened by movement, rated 8/10.

4.1.3. - Vital Signs

4.1.3.1. Temp 98.9°F

4.1.3.2. BP 134/80 mmHg

4.1.3.3. RR 18

4.1.3.4. HR 85 Bpm (higher than baseline)

4.1.4. - **Warmth**: The affected area is warm to the touch.

4.1.5. - **Redness and swelling**: Extends approximately 4 cm around the wound.

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5.1. **Comorbidities & Complications**

5.1.1. - **Rheumatoid Arthritis (RA)**: Managed with Etanercept, an immunosuppressant that may delay wound healing and increase infection risk.

5.1.2. - **Cataracts**: Previous surgery but not currently a factor in the infection.

5.1.3. - **Potential for Sepsis**: If the infection spreads, there is a risk of sepsis, particularly in immunocompromised patients.

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6.1. **Medications**

6.1.1. - **Ibuprofen** 600 mg PO QID for pain and inflammation.

6.1.2. - **Hydrocodone/Acetaminophen (Vicodin)** 5 mg/500 mg PO PRN Q4H for moderate to severe pain.

6.1.3. - **Cephalexin (Keflex)** 250 mg PO Q6H for 10 days as an antibiotic to treat cellulitis.

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7.1. **Other Treatments**

7.1.1. - **Wound Care**: Clean wound twice daily with antibacterial soap and water, apply a bandaid after patting the area dry.

7.1.2. - **Elevation**: Elevate the right hand 4 times daily for 20 minutes to reduce swelling.

7.1.3. - **Temperature Monitoring**: Check temperature twice daily and seek medical help if the temperature exceeds 99°F.

7.1.4. - **Return to Urgent Care/ER**: If the pain increases, drainage worsens, redness spreads, or a fever of 100°F develops.

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8.1. Diagnostic Tests

8.1.1. - **Wound Culture**: Sample of purulent drainage sent to the lab for culture/sensitivity to determine the causative bacteria and appropriate antibiotic.

8.1.1.1. - **Results Expected**: In 3 days.

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