Case Vignette – November 2021

Beware of Some Chiropodists

There have been recent reports in “The Australian” newspaper about a patient who had undergone some form of “body modification” procedure by an unqualified practitioner. As I understand, a silastic compound had been injected into a hand or a finger, had resulted in local sepsis and had not received appropriate therapy. The patient did go back to the unqualified practitioner for advice but rather than being referred to a proper medical practitioner, some form of hokey-pokey medicine was entertained for some weeks. Ultimately, that patient demised as a result of overwhelming sepsis.

The reason I refer to this recent report is that I recall a case wherein a chiropodist had treated an ingrowing great toenail. I am not certain about the appropriateness of the ministrations, but local sepsis ensued. The chiropodist attempted to treat the complication inadequately with saline baths and the like. Ultimately, that patient also became extremely ill with septic shock. The local sepsis gave rise to a gangrenous condition in the great toe and it required amputation.

This patient that I can recall did not die, but the outcome following what should have been quite straightforward management of this benign problem was vastly worse than it should have been.