Case presentation A 45-year-old man with a history of alcoholism and cirrhosis undergoes evaluation for severe left leg pain and fever. He says that his symptoms began after he scraped the lateral aspect of his knee at home three days ago. He has had subjective fevers for the past two days and noticed decreased urinary frequency. He has been self-medicating with aspirin for these symptoms. He is a heavy smoker and drinks a lot too. Examination : Temperature : 39.2°C (102.6°F) PR : 110 beats/min BP : 115/78 mm Hg RR : 28 breaths/min His skin is mildly icteric.
His cardiopulmonary examination is unremarkable. His abdomen is soft and without hepatosplenomegaly or ascites. The left leg is edematous from the ankle to the upper thigh. The skin is tense and exquisitely tender; however, it is without erythema, fluctuance, necrosis, or vesicular changes. Examination of the other leg reveals…
