When a doctor hears a complaint of swollen legs, several questions come to mind that help them make the diagnosis. Are there particular vascular risk factors or other disease states that may be relevant to the swollen legs? The most common causes of one swollen leg are best understood if they are divided to acute and chronic conditions. Deep vein thrombosis – Perhaps the most important disease not to miss when dealing with legs that have suddenly become swollen. Lymphedema – lymphedema can present in one leg or in both and is usually not acute, but rather a condition that develops over time. There are various conditions in which one part of the body overgrows others because of a genetic or congenital reason. Disuse edema – Not using a limb causes changes in blood flow and return to and from that limb. Varicose veins – varicose veins do not cause swollen legs in themselves, but a patient may complain of their legs being swollen while actually referring to swollen varicose veins. Idiopathic cyclic edema – This is a condition in which one leg swells in correlation to the menstrual cycle. Join tens of thousands of doctors, health professionals and patients who receive our newsletters.
A century since the First World War, gangrene remains a problem, albeit a less deadly problem, for many people. The distinctive smell of that "gas gangrene" was the only means to diagnose the condition in the trenches and on the battlefield.
Use this page to learn about the modern-day factors that lead to different forms of gangrene, and how doctors today manage the conditions. Gangrene is a serious, sometimes life-threatening condition in which the skin, muscle and other tissues die as a result of lost blood supply. It is usually external, affecting the extremities, but it can also affect internal tissues. Gangrene is most commonly associated with chronic illness, such as a severe complication of diabetes, or acute causes, such as certain types of injury. Dry gangrene is caused by chronic illness, while wet gangrene - including gas gangrene - is usually an acute form involving bacterial infection and caused by injury, for example.
Surgical complication can lead to internal gangrene, which presents with signs of toxic shock.
Initial diagnosis is made based on the history leading up to the presentation, and a physical examination, including external appearance and smell. Urgent treatment is important to prevent further serious illness and death, and includes removal of dead tissue or even amputation.
Prevention of gangrene is an important part of living with certain chronic illnesses, including diabetes.
Gangrene is a disease of the skin and soft tissues - and sometimes internal tissues and organs - that results in tissue death (necrosis). Gas gangrene (also called clostridial myonecrosis) is a particularly virulent form of wet gangrene.2,3,6,7 This is the condition that is associated with poorly cleansed wounds of the kind suffered in war - deep crushing or penetrating wounds that become infected with bacteria, Clostridium in particular. The reasons behind necrosis and tissue death differ depending on the specific type of gangrene. Wet gangrene results from a sudden loss of perfusion, and is worsened by the involvement of bacteria. Dry gangrene is more likely to occur in older people with diabetic foot - a common complication of undiagnosed or uncontrolled diabetes. Complications of diabetes affecting the extremities, especially the feet, are a risk factor for gangrene, partly because painless wounds can go unnoticed. Surgery - an operation involving the ligation of an artery, as treatment of an aneurysm for example, can shut off blood supply in such a way as to cause gangrene.
Mechanical constriction - for example, gangrene can be revealed when pressure splints are removed. Severe burns, scalds and cold - heat, chemical agents (especially carbolic acid, but also caustic potash, and nitric or sulphuric acid), and cold (including frostbite) can all lead to dry gangrene.


Raynaud's disease - this condition, in which spasm of blood vessels causes impaired circulation to the ends of fingers and toes, especially in cold weather, is implicated in some cases of gangrene. Eating large quantities of coarse rye bread - long-term intake of ergot, a fungus that can infect rye is implicated in gangrene development as ergotism involves vasoconstriction.
Injury - deep, crushing or penetrating wounds that are sustained in conditions that allow bacterial infection to take hold can lead to gangrene.
Mechanical constriction - rarely, blood flow restriction caused by pressure from bandages, bone fractures, tumors, and so on, can lead to gangrene.
Embolic gangrene - the sudden occlusion of an artery due to an embolism can lead to dry gangrene, but this can also increase the risk of infection and thus lead to wet gangrene.
Any case of dry gangrene can progress to wet gangrene if there is an opportunity for bacterial infection.
In addition to the features seen in more common types of gangrene, there are certain signs and symptoms peculiar to gas gangrene, a less common form of wet gangrene. Produce a foul-smelling brown-red or bloody fluid when the tissue affected tissue is drained or leaks (a serosanguineous discharge).
Initial suspicion of gangrene calls for physical examination by a doctor, who will also take medical history, asking questions about symptoms and potential exposure to infection or trauma. If gangrene is suspected, further diagnostic tests will be used to determine the type and extent of the necrosis, and to detect or rule out gas gangrene. Olfactory tests - to detect the unique, foul smell that can indicate gangrene, especially gas gangrene.
To reduce the risk of serious complication and death, gangrene requires emergency treatment.
In all cases of dry gangrene caused by chronic disease, prevention is far better than cure - simply because cure is not possible after, for example, diabetic gangrene has set in, when amputation of an extremity becomes necessary.5 The same attention to prevention is also important in avoiding the acute risks of gangrene, such as from injury or extreme cold. Hyperbaric oxygen therapy6,9-11 is used in other tissue infections and, in particular, diabetic foot ulcers that have become infected and failed to heal. The idea behind this treatment is that a hyperbaric chamber of high-pressure oxygen creates a bactericidal and bacteriostatic effect and improves oxygen supply to the wounds by encouraging the formation of new blood vessels (angiogenesis), and causing greater dissolution of oxygen in plasma. In certain settings, such as hospitals, healthcare professionals should practise measures that minimise the risk of infections such as gas gangrene.
Frostbite can lead to gangrene, as can Reynaud's, a disease that usually affects the finger tips and tends to be worse in winter.
Routinely administering, for abdominal surgery, intravenous antibiotics - before, during, and after the operation.
Please use one of the following formats to cite this article in your essay, paper or report:MLAMacGill, Markus. For any corrections of factual information, or to contact our editorial team, please see our contact page. Please note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional. Learn about pneumococcal disease - an infection caused by a common type of bacteria known as pneumococcus. Lyme disease is caused by the Borrelia burgdorferi bacterium and is transmitted to humans and animals through the bite of infected ticks. Cellulitis is an infection of the skin and is most often caused by the bacteria Streptococcus or Staphylococcus. If you develop a tender, red, warm, enlarging area on your skin, make an appointment with your physician as soon as possible to get treatment and to avoid complications that may occur if cellulitis is left untreated. Your physician will usually be able to easily diagnose cellulitis by examining the affected area. Opening a blister or pus-filled bump with a needle, scalpel, or lancet after cleansing the skin. Typically, the laboratory will have preliminary results within 48–72 hours if there are many bacteria present. Someone who appears to be very sick or who has other chronic illnesses that may complicate their recovery may need to be hospitalized to receive intravenous antibiotics.
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An AV fistula of the femoral artery can cause a swollen leg that is warm and with prominent veins.
Follow-up laboratory and imaging tests, and sometimes exploratory surgery may also be used to diagnose gangrene.
Doctors working in hospitals, especially those involved in abdominal surgery, also take steps to prevent gangrene. In such cases, the circulation of blood to the feet worsens, and there is a higher likelihood of any foot wounds going unnoticed by the patient. This can also occur in younger people with arteriosclerosis (arterial narrowing) caused by, for example, a combination of syphilis and alcohol dependency.
If treatment involves wet or oily dressings and there are septic conditions, wet gangrene can develop. In gas gangrene the infected area of skin can quickly extend, with some changes visible in just a matter of minutes. As such, it is important that anyone with suspected symptoms of gangrene seeks immediate medical attention. With treatment, there is a success rate of up to 60%7 (an improvement on the 50% rate achieved on battlefields for the soldiers serving in the World Wars1). However, the precise mechanism behind the effects of hyperbaric oxygen therapy remains unknown.
Chicago, Illinois, US: Encyclop?dia Britannica, published online by Encyclop?dia Britannica, Inc, accessed November 2014. These bacteria are able to enter the skin through small cracks (fissures), causing the sudden appearance of redness, swelling, and warmth in the skin. The involved area may rapidly become deeper red, swollen, warm, and tender and increase in size as the infection spreads.
While you are waiting for the appointment with your physician, you can elevate the involved body part in order to decrease swelling. In addition to prescribing antibiotics, your doctor will likely want to make sure that your underlying medical problems, if any, are being adequately managed. Ligaments, apart from holding, give strength to the joint and protect it from being dislocated.
This is because of diabetic neuropathy, which is a loss of sensation resulting from nerve damage caused by diabetes. Cellulitis is sometimes accompanied by fever, chills, and general fatigue.If the infection is left untreated for too long, cellulitis can result in pockets of pus (abscesses) or the spread of bacteria into the bloodstream (bacteremia). In addition to identifying the type of bacterium that is causing the cellulitis, the laboratory usually performs antibiotic sensitivity testing in order to determine the antibiotics that will be most effective in treating the bacteria.While waiting for the results from the bacterial culture, your doctor may want to start you on an antibiotic to fight the most common bacteria that cause cellulitis.
Blisters or pus-filled bumps may also be present.Cellulitis may be accompanied by swollen lymph nodes, fever, chills, and fatigue. This class of antibiotics has been the cornerstone of antibiotic therapy for staph and skin infections for decades.
Once the final culture results have returned, your physician may change the antibiotic you are taking, especially if the infection is not improving.Mild cases of cellulitis in a healthy person can be treated with oral antibiotic pills. CA-MRSA previously infected only small segments of the population, such as health care workers and persons using injection drugs. While CA-MRSA bacteria are resistant to penicillin and penicillin-related antibiotics, most CA-MRSA infections can easily be treated with commonly available nonpenicillin antibiotics. Rarely, CA-MRSA can cause a deeper skin infection, which usually requires intravenous (IV) antibiotics to treat the infection. There is an additional strain of MRSA (hospital-acquired MRSA), usually found in health care settings, that is susceptible only to intravenous antibiotics, so admission to the hospital is often needed for effective treatment.



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