Multisystem Processes & Disorders

{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This middle aged man has presented with fever and progressive leg swelling, in a background of poorly controlled diabetes mellitus.\n\nExamination reveals the left lower limb to be erythematous and tender, with ipsilateral inguinal lymphadenopathy; this appears to be acute cellulitis.\n\nNote also the presence of altered mentation and a blood pressure \u2264100 mmHg; his qSOFA score is 2 points, indicating that he is likely to be septic.\n\nGiven his comorbidities, this is highly concerning; sepsis may instigate acute kidney injury (AKI), give rise to acid-base disturbances, and precipitate diabetic emergencies, such as a hyperglycemic hyperosmolar state (HHS).\n\nHis renal functions turn out to be only mildly deranged, with the disproportionately ele"}]}

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