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Necrotizing soft tissue infection — USMLE Step 3 MCQ

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HardSurgery (post-operative, follow-up)Necrotizing soft tissue infectionUSMLE Step 3

A 58-year-old man with diabetes presents 3 days after a minor leg laceration with severe pain, fever, hypotension, and confusion. Examination shows swelling, dusky skin, bullae, and crepitus. WBC is 24,000/mm3 and lactate is elevated. Which of the following is the most appropriate next step in management?

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Correct answer: B — Urgent surgical debridement with broad-spectrum antibiotics

Necrotizing soft tissue infection is a surgical emergency requiring immediate debridement and broad-spectrum antibiotics.

Reference: IDSA Skin and Soft Tissue Infection Guideline