A 56-year-old woman with diabetes has severe thigh pain, fever, hypotension, and a rapidly spreading erythematous area with bullae. Sodium is 128

Question

A 56-year-old woman with diabetes has severe thigh pain, fever, hypotension, and a rapidly spreading erythematous area with bullae. Sodium is 128 mmol/L, creatinine is 220 µmol/L, lactate is 5.6 mmol/L, and CT shows fascial gas. What is the most appropriate next step?

Accepted Answer

Immediate surgery plus broad-spectrum antibiotics and resuscitation

Answer

Oral antibiotics and reassessment tomorrow

Answer

Topical antifungal therapy

Answer

Incision and drainage under local anaesthetic

Answer

Wait for blood cultures before antibiotics

Necrotising fasciitis — RCPSC EM MCQ

A 56-year-old woman with diabetes has severe thigh pain, fever, hypotension, and a rapidly spreading erythematous area with bullae. Sodium is 128 mmol/L, creatinine is 220 µmol/L, lactate is 5.6 mmol/L, and CT shows fascial gas. What is the most appropriate next step?