Differential Diagnosis
- Single most likely diagnosis
- Surgical site infection (SSI): This is the most likely diagnosis given the patient's symptoms of redness, drainage, and pain at the incision site, along with fever and purulent drainage. The patient's recent surgery and presence of risk factors such as diabetes mellitus and obesity also increase the likelihood of SSI.
- Other Likely diagnoses
- Cellulitis: The patient's erythematous and warm incision site could also be consistent with cellulitis, a bacterial skin infection. However, the presence of purulent drainage suggests a more localized infection such as an SSI.
- Wound infection with methicillin-resistant Staphylococcus aureus (MRSA): Given the patient's recent surgery and hospital exposure, there is a possibility of a MRSA infection, which would require specific antibiotic treatment.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Necrotizing fasciitis: Although less likely, necrotizing fasciitis is a life-threatening condition that requires prompt diagnosis and treatment. The patient's symptoms of pain, redness, and warmth could be consistent with this condition, and the absence of signs of wound dehiscence or fluctuance does not rule it out.
- Gas gangrene: This is another life-threatening condition that could present with similar symptoms, including pain, redness, and swelling. Although rare, it is essential to consider this diagnosis in a patient with a recent surgical history and risk factors for infection.
- Rare diagnoses
- Erythema migrans (Lyme disease): Although unlikely, erythema migrans could present with a similar rash and symptoms. However, the patient's recent surgery and lack of exposure history make this diagnosis less likely.
- Sweet syndrome: This rare condition is characterized by fever, leukocytosis, and tender, erythematous skin lesions. Although possible, the patient's symptoms and recent surgical history make SSI a more likely diagnosis.