Day 4 · 09:00
Ward round
Admitted with a hot, red, swollen left leg and treated as cellulitis. Four days of intravenous flucloxacillin and the appearance is unchanged. She is afebrile and feels well in herself. Inflammatory markers have fallen slightly.
Vitals
HR78BP134/80RR16SpO297%T36.7
Examination
- Left leg: Erythema from ankle to mid-calf, warm, mildly tender, with clear demarcation.
- Right leg: Similar erythema and warmth, slightly less marked. Nobody has commented on this before.
- Skin: Bilateral pitting oedema, hyperpigmentation over both shins, dry scaling.
- Systemic: No fever, no lymphangitis, no lymphadenopathy.
What is the single most important observation on this ward round?