A 65-year-old man with a 10-year history of Type 2 diabetes presents with a non-healing ulcer on his right foot. The ulcer is 2 cm in diameter, with a foul-smelling discharge. His foot is also warm to the touch and slightly swollen. What are the potential diagnoses and next steps?
This patient likely has a diabetic foot ulcer, which may be complicated by infection given the foul-smelling discharge, warmth, and swelling. He needs urgent assessment including detailed examination of the wound and possibly imaging to assess for underlying osteomyelitis. Cultures of the wound should be taken, and empiric antibiotic therapy started. Wound care including debridement may be necessary. Urgent referral to a multidisciplinary foot care team should be considered.