رجل عمره ٦١ سنة مصاب بالسكري منذ ١٨ سنة، عنده تنميل في القدمين. لاحظ قبل أسبوع جرحاً تحت قدمه اليمنى لم يؤلمه، والآن صار حوله احمرار ممتد وإفراز وتورم، والحرارة ٣٨٫٣. السكر ٢٩٠. ما الإجراء الأنسب؟

A 61-year-old man with diabetes for 18 years has numb feet. A week ago he noticed a painless wound under his right foot; now there is spreading redness, discharge and swelling, with T 38.3 °C and glucose 290. What is the most appropriate action?

1. Walk more on the foot to improve circulation
2. Urgent infection and perfusion assessment with antibiotics
3. Soak the foot in very hot water every day to disinfect it
4. Cover it with a dressing and wait two weeks at home

Answer: B) Urgent infection and perfusion assessment with antibiotics. An infected diabetic foot ulcer with spreading cellulitis and fever needs urgent assessment of infection depth and perfusion, antibiotics, offloading and glucose control to prevent amputation.