Okay, observing the ankle....
Look for any puncture marks, cuts, ingrown toenails, etc....if infection has set in, sepsis could have occurred. I didn't see the temp of the pt., but not all people with sepsis have a high temperature. Look for pus-filled areas, green areas, red/pink streaks.
One of the problems I see with this being sepsis is the fact that his blood pressure is so high. The majority of time, with septic pts, is that their b/p is usually lower than normal.