Abdominal Cellulitis?

55 year-old morbidly obese female with history of Diabetes, DVT, and Elephantiasis sent to the ED by her primary care physician for evaluation of cellulitis. The patient reported swelling and redness of her right leg over the last 1 week. Patient also complained of clear discharge from her lower abdomen over the last 2 to 3 weeks. She began having redness over the lower abdomen the last few days before presenting to the ED. Physical exam showed BMI of 72, panniculus of lower abdomen with the underside consisting of erythema and multiple fluid filled pockets. On ultrasound, the lower abdomen showed cobblestone-like appearance of the subcutaneous tissue due to soft-tissue edema. This is a non-specific finding often seen on ultrasound of cellulitis.

-Joseph Kim, MS4