Infected Second-Degree Thermal Burn with Delayed Treatment

Case at a Glance

A 15-year-old female presented with a second-degree thermal burn on her inner ankle that developed signs of infection after inadequate initial wound care and delayed treatment.

Patient's Story

The patient sustained a thermal burn to her inner ankle from contact with a hot object. Initially, the affected area appeared pink with singed hair follicles, followed by numbness at the burn site. The patient did not seek immediate medical attention or apply proper wound care. Within 24 hours, a large blister approximately half the size of a golf ball formed over the burn area. The blister spontaneously ruptured the following day. The patient attempted basic wound care with adhesive bandages and over-the-counter burn dressings but continued to expose the wound to moisture during bathing. The patient is currently on sertraline 100mg for underlying mental health conditions.

Initial Assessment

The patient presented with a second-degree thermal burn on the medial aspect of the ankle with signs of possible secondary infection. The wound was producing thick, red-orange purulent discharge with significant pain. The burn area showed evidence of tissue breakdown and inadequate healing response.

The Diagnostic Journey

Clinical examination revealed a partial-thickness burn with surrounding erythema, purulent drainage, and signs of delayed healing. The thick, discolored discharge and increased pain suggested possible bacterial superinfection. Wound culture was recommended to identify potential pathogens and guide antibiotic therapy.

Final Diagnosis

Second-degree thermal burn with secondary bacterial infection and delayed healing due to inadequate initial wound management.

Treatment Plan

Immediate wound debridement and cleaning, topical antimicrobial therapy, appropriate burn dressings with regular changes, oral antibiotics if systemic infection signs present, pain management, and patient education on proper wound care techniques. Referral to wound care specialist or plastic surgery for complex wound management if needed.

Outcome and Follow-up

Patient requires close monitoring for healing progress, infection control, and proper wound care compliance. Follow-up appointments scheduled for wound assessment and dressing changes. Mental health support maintained throughout treatment given underlying conditions and mechanism of injury.