Necrotizing Faciitis

Mrs M, who had been receiving treatment from her General Practitioner for a weeping lower leg ulcer , was admitted to hospital on the 22/05/2010 following a marked deterioration in her general condition. She was quickly diagnosed with sepsis, secondary to a leg ulcer.
The following case study will explore the predisposing factors, and disease process of sepsis as it pertains to Mrs M's past and present medical history, and the treatment used to manage this condition. This study will also examine and critically analyse the pathophysiology, as the progression of the disease evokes a neuro-hormonal- chemical response, and related the findings to the clinical assessments undertaken throughout the varying stages.

Mrs M, a rather obese lady, 70 years of age, was brought onto the emergency department of a semi rural hospital by the metropolitan ambulance service. Mrs M had been receiving regular treatment from her General Partitioner (GP) for a weeping lower leg ulcer. On this particular visit , her GP noted a marked deterioration in her mental state, and energy levels. Further examination revealed that she had a temperature(T) of 39.2 C, blood pressure(BP) 68/40, irregular heart rate(HR) 115 beats/minute, and a Sa02 84%. She was also complaining of increased intensity   of the pain in her leg, which when examined, appeared more oedematous and reddened than on previous visits. This lead the GP to call an ambulance
Mrs M was an elderly lady, and although requiring minimal assistance from her husband with normal activities of daily living, she did require a 4 wheel walker for mobilization. Co-morbidities, not unusual for a lady of her years, did tend to be of the chronic nature. She had been receiving treatment from her GP for, atrial fibrillation(AF) controlled with warfarin and digoxin, diabetes mellitus Type 2 controlled with insulin and diet, irbesatran for hypertension, chronic leg ulcers for which she had had previous hospital admissions, and bilateral chronic...