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Right Foot Trans Metatarsal Amputation Following COVID-19 Infection
Alvin D Sanhueza-Martinez1, Sunjeet K Brar2, Fabrice Yabit1
1Medicine, Saint James School of Medicine, Arnos Vale, VCT.
Abstract:
A 60-year-old male patient with a prior coronavirus disease 2019 (COVID-19) pneumonia diagnosis presented with a right foot ulcer. The ulcer progressed to osteomyelitis of his right fifth metatarsal with eventual amputation and resection of the affected digit. The infection recurred two months later and spread to the right fourth metatarsal and gangrene, leading to the amputation and partial metatarsal head resection of the fourth toe. A month later, the infection recurred for a second time and a decision to perform a right trans metatarsal amputation of the foot was evaluated to avoid further progression of the infection and the need for more invasive surgical intervention.
Insights
A patient with a history of COVID-19 pneumonia developed a recurring foot infection. Multiple surgeries were required, including toe and metatarsal amputations, to manage the spreading osteomyelitis and gangrene.
Area of Science:
- Infectious Diseases
- Podiatric Surgery
- Critical Care Medicine
Background:
- A 60-year-old male with a history of coronavirus disease 2019 (COVID-19) pneumonia presented with a right foot ulcer.
- The initial ulcer progressed to osteomyelitis of the fifth metatarsal, necessitating amputation of the digit.
Observation:
- Two months post-initial surgery, the infection recurred and spread to the fourth metatarsal, causing gangrene.
- This led to a second amputation and partial resection of the fourth metatarsal head.
Findings:
- A month later, a second recurrence of infection prompted evaluation for a right transmetatarsal amputation.
- This surgical consideration aimed to prevent further infection spread and avoid more extensive interventions.
Implications:
- This case highlights the potential for severe, recurrent infections following initial osteomyelitis in patients with a history of COVID-19.
- Aggressive surgical management, including transmetatarsal amputation, may be necessary to control such refractory infections.
- Early recognition and intervention are crucial to prevent limb loss and manage complex post-infectious complications.
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