Dr. Anudeep Puvvula (Endocrinology) needs a second opinion on this medical case.
A 65 years old lady presented with a case of non healing ulcer over right fore foot 2nd toe plantar aspect since 2 years and left foot for foot over since 3 years associated with history of foul smelling pis discharge and cellulitis and fever since 15days for this they came.
Lab routine TC 16000
DC (N) 84%
HB 13 gm
ABI bilateral 0.9
TBI bilateral 0.8
Grade2 B Neurotrophic ulcer bilateral A/ w cellulitis and osteomyelitis ? Over 2nd phalanx right foot
Type 2 Diabetes MELLITUS
Diabetic peripheral Neuropathy
Discussion open my dear colleagues and respected seniors