A 60 year old male presents to ED with a 3 day history of a swollen, red painful left ankle.
He has felt systemically unwell and is unable to weight bear. He returned from Thailand 1 week previously. There is no history of trauma. An ankle athrocentesis is performed and below are the initial results:
Description – 30ml of turbid fluid
Microscopy – Leucocytes 45667 /uL
- Polymorphs 95%
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Mononuclear 5%
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Erthrocytes 50 /uL
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No crystals observed
Microscopy – No bacteria seen
- Describe and interpret the above results, including a differential diagnosis
- Describe the process of aspirating an ankle joint