56 y/o F PMH well controlled DMII, otherwise fairly healthy | Figure 1

SGibsonDPM

Podiatrist

56 y/o F PMH well controlled DMII, otherwise fairly healthy. No Hx of diabetic foot ulcers or open wounds of any kind. Pt stated she felt unwell, sees PCP, labs normal, few days later passes out at home husband calls ambulance. In ED labs still initially normal however quickly progress to abnormal. I don't have all the numbers at hand but WBC 30+, lactic acid 3.1, she becomes hypotension and quickly exhibits septic shock. I am consult after she has been stabilized approx 1 month later. Long story short: she developed #necrotizingfasciitis on the left leg (source still unknown to his day) and after multiple fasciotomies to try to save the leg she unfortunately went on to an AKA on the left. She was on #pressors for a prolonged period of time in the ICU that ultimately resulted in dry gangrene of the toes on the right foot and areas of ulceration on the lower leg. I was consulted for this. I waited for #demarcation of the toes and instead of doing a transmetatarsal amputation I opted to save as much of the foot as I could given that she had undergone an AKA on the left. I will connect to the post ops... #podiatricsurgery