Elderly Veteran With Diabetes and Foot and Ankle Swelling

A 62-year-old veteran with poorly controlled type 2 diabetes presented with nontraumatic swelling about both his ankles and feet. He reported foot pain, fever, chills, and dyspnea on exertion. Chronic ulcers on his left 1st and 5th metatarsals plagued him over the prior year, occasionally necessitating antibiotics for cellulitis. One month prior to presentation, the patient developed a new ulcer under his right 5th metatarsal head; he was treated conservatively, because there were no signs of infection.