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Image of the Month—Quiz Case

Image of the Month—Quiz Case A 43-year-old scallop fisherman from Massachusetts had left arm swelling and blisters. Two days before admission, he had cut his hand while scalloping; then he had cleansed it with the stagnant seawater in which he stored his scalloping knives. The following day, his left arm became edematous, erythematous, and painful, and he was admitted to an outside hospital. Despite treatment with broad-spectrum intravenous antibiotics and topical silver sulfasalazine, the erythema progressed and bullae developed. He was transferred to our hospital, where his physical examination results were remarkable for left-arm edema and erythema from the wrist to the shoulder, associated with multiple large, tense bullae primarily on the forearm (Figure 1). He also had a small superficial laceration at the base of his left thumb (Figure 2). Passive range of motion revealed no pain. Laboratory findings were significant for a white blood cell count of 5800 cells/mm3 without left shift. Figure 1. View LargeDownload Figure 2. View LargeDownload What Is the Diagnosis? A. Staphylococcal scalded skin syndrome B. Necrotizing fasciitis C. Vibrio cellulitis D. Frostbite injury http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Image of the Month—Quiz Case

Archives of Surgery , Volume 140 (2) – Feb 1, 2005

Image of the Month—Quiz Case

Abstract

A 43-year-old scallop fisherman from Massachusetts had left arm swelling and blisters. Two days before admission, he had cut his hand while scalloping; then he had cleansed it with the stagnant seawater in which he stored his scalloping knives. The following day, his left arm became edematous, erythematous, and painful, and he was admitted to an outside hospital. Despite treatment with broad-spectrum intravenous antibiotics and topical silver sulfasalazine, the erythema progressed and bullae...
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Publisher
American Medical Association
Copyright
Copyright © 2005 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.140.2.209
Publisher site
See Article on Publisher Site

Abstract

A 43-year-old scallop fisherman from Massachusetts had left arm swelling and blisters. Two days before admission, he had cut his hand while scalloping; then he had cleansed it with the stagnant seawater in which he stored his scalloping knives. The following day, his left arm became edematous, erythematous, and painful, and he was admitted to an outside hospital. Despite treatment with broad-spectrum intravenous antibiotics and topical silver sulfasalazine, the erythema progressed and bullae developed. He was transferred to our hospital, where his physical examination results were remarkable for left-arm edema and erythema from the wrist to the shoulder, associated with multiple large, tense bullae primarily on the forearm (Figure 1). He also had a small superficial laceration at the base of his left thumb (Figure 2). Passive range of motion revealed no pain. Laboratory findings were significant for a white blood cell count of 5800 cells/mm3 without left shift. Figure 1. View LargeDownload Figure 2. View LargeDownload What Is the Diagnosis? A. Staphylococcal scalded skin syndrome B. Necrotizing fasciitis C. Vibrio cellulitis D. Frostbite injury

Journal

Archives of SurgeryAmerican Medical Association

Published: Feb 1, 2005

Keywords: edema,cellulitis,physical examination,erythema,necrotizing fasciitis,frostbite,lacerations,leukocyte count,pain,staphylococcal scalded skin syndrome,sulfasalazine,thumb,vibrio,wrist,arm,blister,forearm,seawater,shoulder region,silver,antibiotic therapy, intravenous,shift to the left,passive range of motion,laboratory test finding

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