Identifying and managing acute infection

Mr A was a 74-year-old man
who was a retired builder who
was currently suffering from
venous leg ulceration (Figures
1a and b). He had smoked
for 40 years but had recently
given up. He also had a 20-
year history of type 2 diabetes.
Throughout this time he had
hypertension and, for the past
15 years, dyslipidaemia (raised
lipid levels in the blood). He had
suffered myocardial infarction
two years previously and had
a previous history of chronic
foot ulceration (Figure 2). The
presence of retinopathy (disease
of the retina of the eye due
to diabetes) meant Mr A was
unable to see his legs and feet
which had led to a delay in
seeking treatment in the past.