Dr.Mukesh pd Gupta

2. CASE
PRESENTATION
PRESENTED BY:
DR. MUKESH PRASAD GUPTA

3. PARTUCULARS OF THE PATIENT
Name:Mr .X
Age:25 yr
Sex:Male
Nationality: Bangladesh
Occupation:Student
Marital status:Married
Religion:Islam
Address:Dhaka
Date of admission:18/01/2022
Date of examination:18/01/2022

4. CHIEF COMPLAINT
Pain in right great toe for 5 days.
Swelling and redness for same duration.

5. HISTORY OF PRESENTING
ILLNESS
According to the statement of the patient, he was reasonably well
5 days back. Then, he developed pain in the great toe of the
right foot. Pain was agonizing in nature. Later, the toe developed
swelling and redness with marked tenderness. He is non-diabetic
and normotensive. He didn’t give history of any trauma .His
bladder and bowel habits were normal.
So, he came to this hospital for better management.

6. PAST HISTORY
•He had undergone surgical
intervention twice for same
problem on left great toe.

7. DRUG HISTORY:
HE DIDN’T GIVE HISTORY OF
ANY DRUG INTAKE.

8. PERSONAL
HISTORY
He is a non-smoker.
He is a student.

9. FAMILY
HISTORY
•All his family members are
apparently healthy.

10. SOCIO ECONOMIC
HISTORY
•He belongs to middle-class
family.

11. PHYSICAL
EXAMINATION

12. GENERAL
EXAMINATION
• APPEARANCE: NORMAL.
• BODY BUILT: AVERAGE.
• CO OPERATION: CO-
OPERATIVE.
• ANEMIA: ABSENT.
• JAUNDICE: ABSENT.
• CYANOSIS: ABSENT.
• CLUBBING: ABSENT.
• KOILONYCHIA: ABSENT.
• LEUKONYCHIA: ABSENT.

13. • Blood pressure: 120/ 70 mm of Hg.
• Respiratory rate: 18 breaths/min.
• Pulse: 82 beats/min.
• Temperature: 99 °F.
• Edema: Absent.
• Dehydration: Absent.
• Thyroid Gland : Not enlarged.
• Lymph node: Not palpable.
• Heart : S1,S2 were normal, no added
sound was present.
• Lungs :Bilateral vesicular breath sound
was present, no crepitation or rhonchi
was present.

14. LOCAL
EXAMINATION

15. LOOK:
•Swelling of the
great toe of right
foot.
•Redness over the
swelling.

16. FEEL: •Marked
tenderness over
the swelling.
•Local temperature
raised slightly.

17. MOVE:
•Normal movements
were restricted.

18. SALIENT FEATURE
Md. Tazim Uddin,25 yrs old, non-diabetic, normotensive, student hailing
from Adabor, Dhaka got admitted to this hospital with the complaints of
pain in the great toe of the right foot for 5 days. Pain was agonizing in
nature. Later the toe developed swelling and redness with marked
tenderness. He didn’t give history of any trauma. His bladder and bowel
habits were normal.
He had undergone surgical intervention twice for same problem.
On general examination,the patient was normal looking, non-anemic, non-
icteric, there was no edema and lymphadenopathy. BP -120/70 mmhg,
Respiratory rate:18 br/min, Pulse: 82b/min, Temperature: 99°F.
On local examination, there was swelling in right great toe which was red
and tender with slightly elevated local temperature.

19. PROVISIONAL DIAGNOSIS?

20. PARONYCHIA ON THE
GREAT TOE(RIGHT)

21. DIFFERENTIAL DIAGNOSIS?

22. DIFFERENTIAL
DIAGNOSIS
Ingrowing
toenail

23. INVESTIGATIONS

24. ROUTINE
INVESTIGATION:
• COMPLETE BLOOD COUNT WITH ESR
• C-REACTIVE PROTEIN
• RBS- 5.5 MMOL/L
• BLOOD GROUPING AND RH TYPING- A POSITIVE
• ANTIHCV- NEGATIVE
• HBSAG- NEGATIVE
• RT PCR FOR COVID 19 - NEGATIVE

25. TREATMENT MODALITIES
Nail Avulsion.

26. POST
OPERATIVE CARE
• REGULAR
DRESSING
• ANTIBIOTIC
• ANALGESIC

27. THANK
YOU