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"Venous Thrombosis"[MeSH Terms] AND ultrasonography

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NHS deep vein thrombosis symptoms emergency pulmonary embolism

Your left leg venous Doppler ultrasound is essentially normal.

What it shows

  • No DVT (deep-vein thrombosis): No blood clot was seen in the deep veins of the left leg.
  • The main deep veins, including the femoral and popliteal veins, are open, compressible, and have normal blood flow. This is reassuring because a clot typically makes a vein non-compressible or obstructs flow.
  • The long saphenous vein is normal.
  • The vein junction valves are described as competent, meaning there is no evidence of abnormal backward blood flow (venous reflux) at those points.

Only abnormal finding

  • Minimal fluid in the left knee joint, termed a minimal knee effusion.
A small knee effusion can occur with minor inflammation, overuse, arthritis, an old or recent injury, or other knee conditions. It does not identify the cause by itself. If you have knee pain, swelling, stiffness, fever, trauma, or difficulty walking, a clinician may examine the knee and decide whether further assessment is needed.

Bottom line

This scan does not show a leg-vein clot. It shows a very small amount of fluid around/inside the left knee joint.
Seek urgent care if you develop sudden shortness of breath, chest pain, coughing blood, fainting, or rapidly worsening leg swelling, even though this Doppler result is reassuring.

My patient has issues when ever he gets small cut on skin its doesn’t heal but puss starts forming

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"Skin and Soft Tissue Infections"[MeSH Terms] AND diabetes

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CDC skin abscess when to seek medical care diabetes wound infection

Pus forming after even small skin cuts suggests a recurrent bacterial skin infection or abscess, not simply slow healing. Common bacteria include Staphylococcus aureus and streptococci.
It needs a prompt in-person clinical assessment, ideally today or within 24 hours, especially if this happens repeatedly. A clinician may need to examine the wound, take a swab/culture of the pus before antibiotics when feasible, and check whether there is a trapped abscess that requires drainage. Antibiotics alone do not reliably treat a walled-off abscess.

Important underlying causes to assess

  • Diabetes or poorly controlled blood glucose. Diabetes is a recognized risk factor for infection and delayed wound healing.
  • Poor circulation, especially if wounds are on the feet/lower legs.
  • Repeated skin colonization with staph, including possible MRSA.
  • Smoking, poor nutrition, anemia.
  • Medicines or conditions that suppress immunity, such as steroids, chemotherapy, HIV, kidney disease.
  • Repeated friction, scratching, eczema, fungal infection between toes, or poor foot sensation.

What to do meanwhile

  • Gently wash with clean running water and mild soap, pat dry, and cover with a clean non-stick dressing.
  • Do not squeeze, puncture, or attempt to drain pus at home.
  • Do not share towels, razors, or clothing. Wash hands after touching the area.
  • If there is an existing diabetic diagnosis, check glucose and ensure treatment adherence. The CDC diabetes skin guidance notes that high blood glucose increases susceptibility to skin problems and infections.

Seek emergency care now if

  • Fever, chills, confusion, marked weakness
  • Rapidly spreading redness, severe or escalating pain, red streaks, black/gray skin, blisters
  • Swelling of the face/around an eye
  • A foot wound in someone with diabetes
  • Inability to walk/use the limb, or the person is immunocompromised
At the visit, reasonable evaluation may include blood glucose or HbA1c, full blood count, kidney function as indicated, vascular and sensation examination, and pus culture. The accompanying leg Doppler is reassuring for no DVT, but it does not rule out skin infection, diabetes, arterial circulation problems, or an abscess.

Ecthyma

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ecthyma skin ulcers thick adherent crust clinical photograph

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ecthyma treatment

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DermNet ecthyma symptoms causes treatment

Ecthyma is a likely possibility if the lesions begin after a small cut or scratch, develop pus/crust, and then become a shallow ulcer.
It is a deeper form of impetigo: usually a bacterial infection caused by Streptococcus pyogenes and/or Staphylococcus aureus. It commonly occurs on the legs, ankles, feet, thighs, or buttocks. Typical lesions are round sores, often about 0.5 to 1.5 cm, with a thick, adherent yellow-brown or dark crust. Under the crust is an ulcer that may ooze pus and can heal with a scar. This is consistent with the description in Goldman-Cecil Medicine of thick hemorrhagic crust over an erosion or ulcer.
The DermNet ecthyma overview also lists diabetes, immune suppression, minor trauma, dermatitis, poor hygiene, and untreated impetigo as important risk factors. Given repeated poor healing, check for diabetes and assess arterial circulation, nutrition, smoking, and any immunosuppressive drug or illness.

What the patient needs

  • Clinical review promptly, ideally today or within 24-48 hours.
  • Swab/culture of pus or the ulcer base, particularly because lesions are recurrent, before antibiotics if this does not delay treatment.
  • Examination for cellulitis, abscess, diabetic foot disease, and poor blood supply.
  • Blood glucose/HbA1c, and other tests guided by the clinical assessment.
Management often includes gentle removal of softened crusts using warm-water/saline compresses, local wound care, and prescription topical and/or oral antibiotics selected according to severity, location, local resistance patterns, allergy history, and culture result. The dermatology text guidance summarized in Harrison's Principles of Internal Medicine recommends gentle crust debridement with soaks plus topical and appropriate oral antibiotics for ecthyma. Do not prescribe or reuse antibiotics without examining the patient.

At home until seen

  • Clean gently with soap and running water or saline, then cover with a clean non-adherent dressing.
  • Do not pick off dry crusts, squeeze lesions, or attempt drainage.
  • Hand hygiene and separate towels/clothing can reduce spread.

Urgent or emergency assessment now if

Fever, rapidly spreading redness, severe pain, red streaks, fast-growing swelling, black/gray skin, confusion, weakness, or a lesion on a diabetic foot is present.
Important: Ecthyma is different from ecthyma gangrenosum, which produces rapidly progressive dark necrotic lesions and can be associated with severe bloodstream infection in markedly immunocompromised people. If the lesions are black, purple, rapidly expanding, or the patient is systemically unwell, treat it as an emergency.
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