This 57 year old male had a 5 month history of progressive left lower extremity tissue loss, starting at the foot extending proximally up the limb. No history of trauma to cause the initial cascade of tissue loss, just itching and pain in the foot. Our guess is that the root of the issue was a cellulitis, that is completely treatable with the proper antibiotic regiment. Unfortunately, due to lack of access to care/belief in modern medicines, this patient went untreated, and the bacterial infection progressed into what is seen. The cellulitis eventually turned gangrenous, slowly feeding on healthy tissue extending up his leg. Luckily, when treated here, his vitals were stable and his blood counts were within normal limits; with the exception of his white blood count, which was elevated due to this bacterial infection.
Now some of you maybe thinking, wow he was probably in so much pain getting to this point! Actually, once the cellulitis progressed into gangrene, he probably had minimal pain due to the death of the tissue. This tissue death includes the nerves that tell your body you are in pain. The smell was probably the worse part of losing this much tissue. Trust me, once you’ve smelled necrotic tissue, there is no way you can forget that smell! From this point on, he will need an above knee amputation, as the rest of the limb is unsalvageable.
So now when the doctor tells you to take the full 5 days of your antibiotic even if you’re feeling better, you can think back to this post and remember how imperative it is to tackle bacteria at the earliest point possible!