Infectious Disease Specialist Opines on a Case of Unresolved Cellulitis Following a Car Accident

Case Overview

This case takes place in Hawaii and involves a seventy-two-year-old elderly female patient who was involved in a car accident when the vehicle she was driving was struck by another car. The patient was seated in the front passenger side of the vehicle, which bore the brunt of the impact. She was rushed to the hospital via ambulance. As a result of the accident, the patient sustained multiple lacerations and abrasions to her lower limbs, fractured ribs and blunt force trauma to her entire body – especially a crushing injury on her right side. Prior to the accident, the patient had been living independently in her own home and was in reasonably good health. The patient was admitted to a medical unit for two weeks and subsequently required treatment at an inpatient rehabilitation unit for three weeks after discharge from hospital. The patient’s lower extremity skin integrity was compromised by the edema. Before the accident, she had symmetrical swelling and no leg lesions. Her legs continued to swell after discharge and the abrasions she sustained turned into weeping ulcers. Several days post-discharge she was diagnosed with cellulitis at a routine follow-up appointment. She was admitted to hospital for treatment of the cellulitis which included IV antibiotics and physical and occupational therapy. The patient, who was previously fully independent, never regained her pre-accident level of mobility and was no longer able to live independently, requiring close medical daily supervision.