A patient with diabetes has rapidly escalating thigh pain after a trivial abrasion, pain out of proportion, dusky skin, lactate 5.2 mmol/L and

Question

A patient with diabetes has rapidly escalating thigh pain after a trivial abrasion, pain out of proportion, dusky skin, lactate 5.2 mmol/L and soft-tissue gas on radiography. Blood pressure improves briefly after fluid. Which action must not be delayed for CT characterization?

Accepted Answer

Give IV broad-spectrum antimicrobials and arrange urgent operative source control

Answer

Start oral antimicrobials and repeat examination after parenteral analgesia

Answer

Perform bedside drainage under local anesthetic for apparent superficial infection

Answer

Obtain contrast CT to define fascial involvement before calling surgical services

Answer

Initiate hyperbaric oxygen and reassess the need for debridement after stabilization

Necrotising fasciitis — RCPSC EM MCQ

A patient with diabetes has rapidly escalating thigh pain after a trivial abrasion, pain out of proportion, dusky skin, lactate 5.2 mmol/L and soft-tissue gas on radiography. Blood pressure improves briefly after fluid. Which action must not be delayed for CT characterization?