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BMJ Case Rep ; 20172017 Oct 04.
Article in English | MEDLINE | ID: mdl-28978574

ABSTRACT

The case commences with an innocuous right ankle injury (lateral malleolus), for which the patient, a 9-year-old boy, was placed in a temporary cast at his local hospital. Three days following this incident, the patient was diagnosed with new-onset type 1 diabetes mellitus. He was admitted to his local hospital with severe diabetic ketoacidosis appropriately treated and subsequently discharged c.1 week later clinically well. Approximately 1 week later, again he presented for a third time with a significant serosanguinous discharge from the site of the initial injury permeating through the temporary cast in place for c.2 weeks by that time. On removal of the cast, a severely invasive infection of bone and soft tissue was noted, and the patient was urgently transferred to our unit at the tertiary general hospital for further management. He underwent a series of orthopaedic and plastic surgery procedures with an eventual satisfactory outcome.


Subject(s)
Casts, Surgical/adverse effects , Diabetic Ketoacidosis/diagnosis , Osteomyelitis/diagnosis , Streptococcal Infections/diagnosis , Ankle Injuries/therapy , Child , Diabetic Ketoacidosis/complications , Diabetic Ketoacidosis/drug therapy , Diagnosis, Differential , Humans , Magnetic Resonance Imaging , Male , Osteomyelitis/complications , Osteomyelitis/diagnostic imaging , Osteomyelitis/drug therapy , Streptococcal Infections/complications , Streptococcal Infections/diagnostic imaging , Streptococcal Infections/drug therapy
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