A Wilderness Medicine case – #wmed

I have a bit of an interest (unfortunately currently an armchair interest, but will one day rectify that again) in wilderness and environmental medicine. So, occasionally a vignette will sneak on here from that arena. That is not to say that you couldn’t see a case like this in your local CBD, but most likely in an urban context it would present in some sort of night stalking denizen of the deep. Or perhaps a gent with Diogenes syndrome.

I’d like to thank Andrew Peacock for this case – he is a great photographer, in addition to being an adventure and wilderness medic. Do check out his superb images at http://footloosefotography.com and http://footloosefotography.tumblr.com/

So, on to the case – I’m going to ask it a bit like an ACEM VAQ with a twist. Not too hard, but a classic diagnosis. Answers in the comments please! Prize – merely the adulation of me and my readers (as yet a select and privileged group)

a) A 50 year old man presents to you after completing the Kokoda track with an extremely painful foot. Describe and interpret the images. (70%)

b) Outline your management (20%)

c) For the bonus 10%, write a succinct and creative history of the condition (10%)

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About dreapadoir

Emergency Physician, author of http://underneathEM.com Emergency Medicine blog, photographer at http://www.dreapadoir.com
This entry was posted in Cases, Education, Medical Musings, Photography. Bookmark the permalink.

3 Responses to A Wilderness Medicine case – #wmed

  1. keeweedoc says:

    Im guessing here but…
    The foot shows ??Ecchymotic blotches, ill shoot for a “paddy” foot(tropical immersional foot) .
    Spending 4-10 days sloshing in his wet warm boots has given him a wonderful ?fungal infection.
    He should let it dry out. keep out for signs of secondary infections and enjoy the taste of success a good tramp/hike provides. futher hydration with beverages as shown in the image is also recommended.
    for the 10% im sure this wouldnt have happened if he was not so worried about shocking the fairer sex with his feet, (size and smell) and he took his boots off and dried them out.

  2. Pingback: Wilderness Medicine Case – ugly feet follow up! | the underneaths of EM

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