Differential Diagnosis
- Single most likely diagnosis
- Nephrotoxicity secondary to Amikacin: The patient's elevated serum creatinine level (4.93 mg/dL) and history of receiving injection Amikacin for two days suggest that the antibiotic may have caused nephrotoxicity, exacerbating his existing chronic kidney disease (CKD).
- Other Likely diagnoses
- Cellulitis: The patient's complaints of a swollen leg and hyperpigmented wounds near the ankle, along with a recent diagnosis of otitis externa and antibiotic treatment, suggest a possible diagnosis of cellulitis, a bacterial skin infection.
- Chronic Venous Insufficiency: The patient's swollen leg and hyperpigmented wounds near the ankle could also be indicative of chronic venous insufficiency, a condition that can cause skin changes and swelling in the legs.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Sepsis: Although the patient is being treated for otitis externa, the possibility of sepsis, a life-threatening condition, should not be overlooked, especially given the patient's compromised kidney function and potential for infection.
- Deep Vein Thrombosis (DVT): The patient's swollen leg could also be a sign of DVT, a condition that can be fatal if not promptly diagnosed and treated.
- Rare diagnoses
- Vasculitis: The patient's hyperpigmented wounds and swollen leg could be indicative of vasculitis, a rare condition characterized by inflammation of the blood vessels.
- Pyoderma Gangrenosum: The patient's wounds near the ankle could be a sign of pyoderma gangrenosum, a rare skin condition characterized by ulcerative lesions.