{"ops":[{"insert":"A 57 year old man presents with a painless ulcer of the left foot, which occurred after an episode of minor trauma 3 months ago. He was diagnosed with type 2 diabetes 5 years ago, for which he is on maximum doses of Metformin and Gliclazide. An HbA1c performed 2 weeks ago was 9.9%\n\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-S-065_en.png"}},{"insert":"\n"}]}
2
Investigate
Monofilament test
{"ops":[{"insert":"Five sites are tested per foot - all of them are negative for sensation.\n"}]}
Handheld doppler – lower limbs
{"ops":[{"insert":"All peripheral pulses are present.\n"}]}
X-Ray L/foot
{"ops":[{"insert":"The x-ray appears normal, with no evidence of osteomyelitis.\n"}]}
Wound swab + culture
{"ops":[{"insert":"Cultures are positive for Staphylococcus epidermidis.\n"}]}