A 55-year-old man presents to the emergency department 5 days after sustaining a 3-cm laceration on the anterior tibia from a gardening tool. He reports escalating pain and swelling at the injury site. Examination reveals erythema limited to the wound edges, purulent yellow drainage, warmth, and marked tenderness. His oral temperature is 38.5 °C (101.3 °F). Which complication has most likely developed?
Purulent exudate together with localized erythema, warmth, swelling, increasing pain, and fever strongly indicate a bacterial infection of the wound itself. These findings fulfill the classic criteria for a localized wound infection that has progressed from simple contamination/colonization to overt infection and now requires systemic antibiotic therapy and wound care. Normal inflammatory healing would not produce purulent drainage or fever, and chronic osteomyelitis would be unlikely within 5 days of the initial injury.
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BCEN CEN
Musculoskeletal and Wound Emergencies
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