What are the reasons for swelling, upper thigh pain, and painful urination following food poisoning?

Hello,

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I have reviewed your case history and attached laboratory values (attachments removed to protect the patient's identity) in detail. My inference is as follows:

1. A swollen upper thigh with significantly raised CRP (C-reactive protein) and white blood cells on a complete blood profile is indicative of ongoing severe inflammatory or infective process and this needs to be checked for cellulitis or thigh abscess.
2. Other issues could be due to uncontrolled diabetes, as indicated by raised HbA1c (glycated hemoglobin) values.
3. Liver enzymes and GGT (gamma-glutamyl transferase) are raised when compared to other enzymes, which is suggestive of either fatty liver or alcohol-induced fatty liver (if the history of alcohol consumption is positive).
4. Painkillers are fine, but he might need antibiotics to treat his raised CRP and white blood cell counts.

I wish you good health. Do get back if you have any further queries.

Thank you.

Hi,

Welcome back to icliniq.com.

Glad to have you back.

It should be physically examined, but yes you can send pictures so that I can refer. Please check his body weight and height according to his body mass index, because it could be fatty liver secondary to poorly controlled DM (diabetes mellitus) or obesity. Tablet Paracetamol can be used as a painkiller and for significantly raised CRP, antibiotics like Tablet Amoxicillin and Clavulanic acid (Augmentin) 625 mg can be taken after every meal thrice a day for three to five days depending upon his response. And yes, I have reviewed his reports.

I hope this helps.

Thank you.

Hello,

Welcome back to icliniq.com.

From the attached reports (attachments removed to protect the patient's identity), there is no obvious redness, but there are significantly raised inflammatory markers, so I suggest you follow the management plan as advised previously. According to his height and weight, his BMI (body mass index) is 28, which falls in the overweight category. He needs to reduce his weight gradually once this current issue gets sorted out.

It was a pleasure to have you at icliniq.

Thank you.

Hello,

Welcome back to icliniq.com.

I suggest he takes the tablet Pantoprazole 40 mg half an hour before breakfast and the tablet Domperidone 10 mg half an hour before breakfast and dinner for nausea and vomiting. Monitor fever at home, and if he is febrile, he would need a physical checkup and monitoring of the vitals.

I hope this helps. Do get back if you have any further queries.

Thank you.

Hello,

Welcome back to icliniq.com.

I went through your query.

1) If he is febrile on oral antibiotics, he may need intravenous antibiotics or hospital admission, ultrasound urogenital system, and right thigh is important to rule out some other pathologies.

2) Multivitamins can be given, but there is no major benefit in the acute phase of infection. I suggest you encourage his oral diet and fluid intake.

3) There must be some source of fever in the body, so I suggest you continue with antibiotics.

4) Nuberol forte or Tonoflex P are relatively better painkillers if available at your end, otherwise you can have alternative medicines such as Paracetamol combination painkillers.

5) Protein in urine is due to uncontrolled diabetes. A urine culture should be sent too, as it might be the source of infection in elderly with uncontrolled diabetes

6) A change of diabetes medicine was necessary to control blood sugar levels

7) Raised CRP (C-reactive protein) and WBC (white blood cells) are harmful. They are suggestive of infection and need to be monitored regularly to see whether the patient is responding to antibiotics or not.

Hope it helps.

Thanks and regards.