Case presentation A 55-year-old woman with uncontrolled diabetes presents to the hospital with left index finger pain and swelling. She states that her symptoms began with localized pain at the tip of the finger. The pain progressively worsened and was accompanied by ascending skin redness and warmth. She visited a different hospital 2 days after symptom onset and was treated with IV antibiotics without any surgical intervention. She left that hospital against medical advice after 1 day of therapy.
She presented to the other emergency department 7 days after onset. She denied any history of trauma or recent injury to the finger. Physical exam The patient's left index finger exhibits fusiform swelling with extensive skin changes from the tip to mid-palm, including bullae and erythema. The distal aspect of the finger is cool to the touch, with firm skin and loss of underlying soft tissue…
