Question

How do I explain/connect the abnormal lab values to the patien's medical problems? The patient is a  77 year - old male who is admitted 2 days ago for Osteomyelitis of the great toe on the right foot and Gangrene of the great toe on the right foot. with a history of Type 2 diabetes mellitus with skin complications and coronary artery disease (CAD)

• WBC: 12.99 (H)
• Sodium: 134 (L)                  
• Potassium: 3.9                                
• Chloride: 104
• Calcium: 8.3(L)
• CO2: 25       
• Glucose: 95
• Hgb 8.4(L)
• Hct 25.6 (L)
• PLT 284

Answer 1

Introduction :

Osteomyelitis is a disease or infection which affects bone which results into swelling or inflammation . It can be Acute or Chronic. It is caused by bacteria Staphylococcus aureus. Infected bacteria reaches to the bone via bloodstream and begins to destroy bone. Diabetes Mellitus is a associated disorder of osteomyelitis.

As asked in question explanation of lab abnormal values :

As osteomyelitis most commanly causes by  Staphylococcus aureus, this bacteria uses iron to carry out vital metabolic functions. And iron found in hemoglobin. Hence bacteria utilizes this iron which results in the low hemoglobin level in the body. As hemoglobin is available in Red Blood Cells bacteria attacks on it. Which results into low levels of HCT volume.

In this disease when bones become weak due to inflammation or swelling, the bone repair and bone mineral density may significantly affects. And as Calcium is one of the main component of the bones, Calcium level drops in the blood.

As in question patient also has some skin complications, body fights against infection which increases the WBC count. And body also increases WBC in osteomyelitis to fight against infection.

During infection electrolyte disturbance occurs in the body which can result into low sodium level .