Wilderness Medicine Case – ugly feet follow up!

(Again, thanks for the images kindly supplied by Andrew of footloosefotography.com from his recent PNG trip where he provided medical support for a group on the Kokoda track)

I won’t formulate a whole Fellowship VAQ style answer to the question asked in the recent post: https://underneathem.wordpress.com/2012/05/22/a-wilderness-medicine-case-wmed/ essentially because the pain is all too recent. However, I will share a pdf of an article on immersion foot syndrome from that most readable of tomes, “Military Dermatology” (who knew?)

I received various spot diagnoses and answers via various modalities all along similar lines. I cannot bring myself to pick a winner. You all pass. I’m generous that way.

This gentleman does indeed have what I am going to call an immersion-foot-spectrum disorder. The reason I am calling it this, is because the various different types of immersion foot syndrome are categorised due to the history primarily, and the appearance secondarily, but ultimately, there isn’t much difference in how you treat them! They are characterised by significant pain for many days (see the article if you really want to get to grips with the finer points  separating the various manifestations – largely differentiated by degree and duration of dampness and the ambient/water temperature)

For what it is worth, this chap probably has pathology somewhere between warm water and tropical immersion foot,  or as I like to call it “tropical paddy swamp jungle rot.” He was treated empirically with fermented carbonated ethyl alcohol PRN orally in a 4% solution (as noted by some of my more observant readers), plus simple supportive care, consisting of drying and rest. Of interest, Dr Peacock trialled oral steroids with some success in terms of symptomatic relief. Or that could have been the beer. Who knows. RCT anyone???


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.

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