Differential Diagnosis for Burn to R Lower Leg
- Single most likely diagnosis
- Infected partial-thickness burn: The presence of redness, broken blisters, white spots (possibly eschar), and yellow drainage in the wound suggests a burn that has become infected. The fact that the burn cream provided some relief but the wound still looks bad supports this diagnosis.
- Other Likely diagnoses
- Partial-thickness burn without infection: Although the patient mentions signs that could indicate infection, it's possible that the wound is simply in the process of healing and the described symptoms are part of the natural healing process of a burn.
- Contact dermatitis or irritant dermatitis: The reaction around the burn could be due to an irritant or allergic reaction to the burn cream or other substances applied to the wound, rather than an infection.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Sepsis: Infection in a burn wound can lead to sepsis, a life-threatening condition. The presence of infection signs (redness, swelling, pus) and the patient's denial of pain (which could mask the severity of the infection) make it crucial to consider sepsis.
- Gas gangrene: Although rare, gas gangrene (clostridial myonecrosis) can occur in burn wounds, especially if they become contaminated. The presence of white spots and the potential for necrotic tissue could be indicative of this condition.
- Rare diagnoses
- Ecthyma gangrenosum: A rare skin condition usually associated with Pseudomonas aeruginosa infection, often seen in immunocompromised patients. It presents with hemorrhagic pustules that evolve into gangrenous ulcers.
- Necrotizing fasciitis: A severe infection of the fascia, the tissue that supports and separates soft tissues in the body. It's a rare but potentially deadly condition that could be considered if there's significant pain out of proportion to the wound, or other signs of severe infection.