Differential Diagnosis for 76 year old female with left hand redness, swelling, and warmth
- Single most likely diagnosis
- Cellulitis: This is the most likely diagnosis given the symptoms of redness, swelling, and warmth over the proximal fingers, which are classic signs of a bacterial skin infection. The absence of a known injury does not rule out cellulitis, as it can occur without a clear source of infection.
- Other Likely diagnoses
- Deep vein thrombosis (DVT): The patient's history of aortic valve replacement and pacemaker insertion increases her risk for DVT, which can cause swelling and warmth in the affected limb.
- Septic arthritis: Although less likely, septic arthritis is a possible diagnosis, especially if the patient has a history of joint disease or recent joint injection.
- Erythema migrans (Lyme disease): If the patient lives in an area where Lyme disease is common, this diagnosis should be considered, especially if the rash has a characteristic "bull's-eye" appearance.
- Do Not Miss diagnoses
- Necrotizing fasciitis: This is a life-threatening condition that requires prompt diagnosis and treatment. Although it is less likely, the patient's symptoms of redness, swelling, and warmth could be indicative of necrotizing fasciitis, especially if she has a history of immunocompromised state or recent surgery.
- Septic emboli: Given the patient's history of aortic valve replacement, septic emboli should be considered, especially if she has a history of endocarditis or recent infection.
- Rare diagnoses
- Complex regional pain syndrome (CRPS): This condition can cause swelling, redness, and warmth in the affected limb, but it is typically associated with a history of trauma or injury.
- Sarcoidosis: This autoimmune disease can cause skin lesions and swelling, but it is relatively rare and would require further testing to diagnose.
- Vasculitis: This group of diseases can cause inflammation of the blood vessels, leading to skin lesions and swelling, but it is relatively rare and would require further testing to diagnose.