Ms. Henry is a 47-year-old female with a history of insulin-dependent diabetes. She came to the emergency room with an infected blister of her left foot. She stated that she was wearing this shoe (Fig 1) for her friend’s dancing party and when she came home, she noticed a blister on the side of her left foot (Fig 2). After a few days, she noticed the redness and pain had increased so she came to our emergency room.
When I examined this patient in the emergency room, the skin abscess on her left foot was infected and the redness was extending toward the ankle. The blister had to be incised and pus had to be drained (Fig 2).
She was admitted to the hospital for infection treatment. The infection was eventually resolved, but even with months of numerous wound care attempts to close this wound defect, the foot was left with a large non-healing hole in the foot (Fig 3). When I have a suspicion that the bone under the wound was also infected, I ordered MRI of the foot.
The bone next to the ulceration was infected which showed on MRI images (Fig 4). At this point, the infected bone had to be removed(Fig 5) so that within a month the wound was finally resolved (Fig 6) and she was finally able to return to her normal activity.