A 38-year-old man presented to the emergency department complaining of right leg swelling and pain which was progressively over the preceding 48 hours. History: No significant medical history and no previous hospital admissions. He did not take any regular medications. Background of intravenous drug use and injected heroin into his leg veins on a daily basis. Occasionally inhaled cocaine. No history of smoking or alcohol intake. Examination: On admission, the man was febrile (38.4°C) and felt warm to the touch.
Heart sounds were normal, with no audible murmurs and his chest was clear on auscultation. The abdomen was soft and non-tender. Visible puncture wounds legs and feet, which he had used as injection sites. The lower part of his right calf was erythematous and warm to touch, with localized edema. Initial treatment: Intravenous antibiotics were given. Although the patient seemed to…
