WSI23-111-Case-18

WSI23-111-Case-18

Case #18 - The patient is a 62-year-old female with past medical history significant for obesity, type II diabetes mellitus, severe aortic stenosis, atrial fibrillation on warfarin, peripheral vascular disease, and end-stage renal disease on hemodialysis. She has had progressive ulcerated skin lesions of the groin which now involve her lower extremity. She endorses severe pain. Relevant laboratory results: Creatinine 7.04 mg/dL (reference interval 0.6-1.50 mg/dL), calcium 9.4 mg/dL (reference interval 8.5-10.5 mg/dL), phosphate 5.6 mg/dL (reference interval 2.6-4.5 mg/dL), PTH 504 pg/mL (reference interval 10-60 pg/mL). On exam, there are multiple wounds involving lower extremity and abdomen, some with black eschar and some with foul-smelling discharge (see clinical photograph #18). An excisional biopsy is performed.

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December 31, 1969 7:00:00 PM