The Rational Clinical Examination
David L. Simel, Drummond Rennie
Chronic Wound Infection
Madhuri Reddy, Sudeep S. Gill, Wei Wu, Sunila R. Kalkar, Paula A. Rochon
Clinical Scenario, Why Is This Diagnosis Important?, Methods, Results, Limitations of the Literature, Scenario Resolution, Clinical Bottom Line, References
"An 89-year-old nursing home resident with dementia and limited mobility and no other medical illnesses presents with a stage III pressure ulcer in his coccyx region. The wound has been present for 3 months and has recently been increasingly painful. Appropriate support surfaces and transfer mechanisms have been initiated to ensure that pressure in the area has been significantly reduced. On examination, there is no fever, wound erythema, or purulent exudate. Swabs taken from the surface of the wound show moderate growth of mixed bacterial flora. Is this chronic wound infected?..."
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