Case Report on Cellulitis

Introduction: Cellulitis is a bacterial infection that causes an inflammatory condition of the skin that affects the dermis and subcutaneous tissues. 2016 (Lee and Levell). Cellulitis of the lower limbs is a potentially dangerous condition (Halpern et al, 2008). Rubor or erythema, which is warm to the touch and often combined with a degree of localised oedema, is the most common symptom. However, because diagnosis is dependent exclusively on clinical data, it is commonly misdiagnosed [1]. There are a number of different illnesses that have symptoms that are similar to cellulitis. The purpose of this page is to provide information on the clinical symptoms of lower limb cellulitis as well as treatment options ensuring that practitioners are capable of making an accurate diagnosis and developing successful treatment programmes [2]. Clinical Findings: Fever, pain over right lower leg, wound present right dorsal foot, weariness, malaise, and swelling were the patient’s main complaints. Case Study Ughade et al.; JPRI, 33(60B): 334-338, 2021; Article no.JPRI.78901 335 Diagnostic Evaluation: Haemoglobin 14.7%,total RBC count 4.77, total WBC count 16100, platelet count 1.56, KFT – UREA -57 CREATININE -2.0 potassium4.6, LFT ALKALINE PHOSPHATE -105, ALBUMIN30 TOTAL BILIRUBIN1.4 micro report is normal. His liver function and coagulation studies were normal. A diagnostic work-up that includes blood cultures, dengue, malaria smear, typhoid, and other tests. The following tests were sent: leptospirosis, monospot and stool investigations, and Clostridium difficile PCR [3]. Therapeutic Intervention: Four primary analgesic drugs, antibiotics drug in penicillin. Conclusion: My patient, a 65-year-old man, was hospitalised to the Hospital's medicine ward on June12, 2021.Fever, pain over right lower leg, wound present right dorsal foot, fatigue, malaise, and edema were among the symptoms that the patient had. His health improved when he received appropriate treatment. The patient was follow up after 1 weak [4].


INTRODUCTION
Cellulitis is a common surgical complication that is defined as a skin and subcutaneous tissue infection that spreads. The severity of the illness can range from minor to life-threatening.Lower limb cellulitis risk factors, common causal organisms, and their sensitivity are all hotly debated topics. The goal of this study is to determine the relative frequency of predisposing factors. To aid in the better management of lower meghe Wardha's medical ward. Chief complaints of Fever, pain over right lower leg, wound peresent right dorsal foot, fatigue , malaise, and edoema were among the symptoms that the patient had [5].

PRESENT MEDICAL HISTORY
A patient was 65year old was admitted in surgery ward in Hospital Wardha .Fever, pain over right lower leg, wound present right dorsal foot, weariness, and other symptoms were diagnosed, Malaise. The patient displayed symptoms such as malaise and edoema.

PAST MEDICAL HISTORY
My patient has a history of tuberculosis,COVID-19 pulmonary illness, and no other medical conditions such as hypertension.

FAMILY HISTORY
My patient's family consists of four members, and he was diagnosed with maxillary sinusitis despite the fact that no one in his family had an abnormal genetic history.
He is a member of nuclear family that lives together.

PAST INTERVENTION AND OUTCOME
Fever, pain in the right lower leg, wound present right dorsal foot, fatigue, and other symptoms were identified in the patient.
HRCT scan will be performed in Hospital on, and x-ray will be performed in Hospital Wardha.

PHYSICAL EXAMINATION
In a head to foot examination, there are few abnormalities; the patient is obese, with a dull appearance. He is frail and uncooperative. Despite the fact that the patient had Fever, pain over right lower leg, wound present right dorsal foot, weariness.

Medical Management
My patient was hospitalised to on, and was prescribed inj.penicillin.
IV fluid in normal saline in 500 ml [6]

Surgical Management
There is no prior surgical history.

Nursing Management
This case belong to the medicine as well as medicine department therefore using care played a vital role in every aspect.

 Nursing Diagnosis A) Acute pain in lower extremities related to pain and inflammation
Nursing intervention Rationale 1..Determine the severity of the patient's suffering.
Knowing the patient's current level of pain can help you decide what to do next. 2..Explain the causes of pain and how it affects the patient and their With the causes and consequences of pain the patient is expect 3.Teach relaxation techniques and distraction.
The patient know the distraction and relaxation technique can be practice so as if in pain.

B) Imbalance nutrition pattern less than body requirement
Nursing Interventions Rationale 1. Assess the level of nutritional pattern.
Toknow the level of weakness 2. Consultache co-ordinatewithhealth care team member of varoius department included in case.
To confirm the final diagnosis.and preapre nursing diagnosis to provide effective care.
3.Administer the medication as prescribed by the doctor .
To provide the patient with healthy diet in order to cope up with daily activity.

C) Reduce sleeping pattern related to disease condition and hospitalization
1. Assess the sleeping pattern of the patient.
To know the baseline data of the sleeping pattern.

A maintain clam and quite environment .
For well sleep of the patient 3.To give the prescribed medication as per doctor order For fell betterment of the patient.

D) Fear and anxiety related to hospitalization secondary related to disease condition
Nursing Interventions Rationale 1. Maintain rapport with the patient and his family To induse comfort so that they can share about the quires and problem. 2. provide information about the state of the disease and treatment options .
To improve the patient's and family's understanding of disease conditions and treatment option. 3. counsel the patient regarding the mention fear and anxiety.
To prepare the patient for surgery.

 Follow Up
After one month, the patient is advised to return to the hospital.
Injection penicillin 500 mg OD × 7 days Tablet Pantaparazole 40 mg OD × 7 days Tablet paracetamol 500 mg SOS × 7 days Tablet chymoral forte BD × 7 days Protein powder 2 tbsp BD × 1 months The patient was also advice : To get enough rest and prevent becoming exhausted.
To keep the body hydrated, drink enough of oral fluids.
To improve the body's haemoglobin level and immunity, eat a diet rich in iron and fiber.
Deep breathing and leg exercises, as well as everyday walking, can help to prevent blood clots and chest infections [7].

DISCUSSION
A 65-year-old male adult was hospitalized to the surgery ward with Fever, discomfort over right lower leg, wound present in right dorsal foot, fatigue, and other symptoms were diagnosed as Fever, pain over right lower leg, wound present in right dorsal foot, weariness, and other symptoms. After being diagnosed and receiving the necessary treatment, he has shown significant improvement. Psychological stress was experienced by the patient and her family, which was alleviated to some extent by being an active listener and offering appropriate counselling. All the required investigation were done. His health improved when he received appropriate treatment [8].
They graded severity using the Dundee criteria and subsequently evaluated the appropriateness of the recommended antimicrobial regimens. 17 They discovered considerable overtreatment of skin and soft tissue infections (SSTIs) (both in terms of antibiotic spectrum and method of administration), especially in the lowest severity category, where 65 percent of patients were assessed to have been overtreated [9]. Thirtyday mortality and under treatment rose with illness severity class, from 1% death and 14% under treatment in the class I severity group to 33% mortality and 92% under treatment in the class IV severity group. These data show that the existing severity grading method is not a reliable tool for directing empirical therapy. There was no significant difference in antimicrobial medication or treatment results between patients with class I and II severity, indicating that these two groups might be combined, further simplifying the categorization. Other skin and soft tissue infection severity and prognosis rating systems have been developed but have yet to be verified [10]. 18 National Institute for Health and Care Excellence (NIHCE) moderate-and high-risk criteria (Box 3 displays the high-risk criteria) may assist physicians in quickly identifying individuals with sepsis related to cellulitis who require immediate admission and examination [11].

CONCLUSION
My patient, a 65-year-old man, was hospitalized to the Hospital's medicine ward on June12, 2021.Fever, pain over right lower leg, wound present right dorsal foot, fatigue, malaise, and edema were among the symptoms that the patient had. His health improved when he received appropriate treatment. The patient was follow up after 1 week.