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Cellulitis — MCCQE Part 1 MCQ

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EasyRashCellulitisMCCQE Part 1

57-year-old man with diabetes presents with painful red swollen lower leg. The area is warm, tender and expanding; he is febrile. Which of the following is the most appropriate next step?

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Correct answer: A — Start empiric antibiotics targeting streptococci/staphylococci and mark borders with follow-up

Start empiric antibiotics targeting streptococci/staphylococci and mark borders with follow-up is best because unilateral warm tender erythema with fever suggests cellulitis. Treat with topical therapy only despite systemic or red-flag features is suboptimal because local treatment alone is inadequate when systemic disease is possible; Delay assessment for several months is suboptimal because red-flag musculoskeletal or dermatologic presentations require timely assessment; Use antibiotics for every presentation is suboptimal because many rashes and painful joints are inflammatory, malignant or mechanical rather than bacterial; Provide opioids or reassurance as the sole management is suboptimal because symptom relief alone does not address diagnosis, function or safety. Bilateral red legs are less likely cellulitis.

Reference: AMMI Canada skin and soft tissue infection guidance