A 38-year-old develops fever, rapidly worsening leg pain, vomiting and confusion after a minor shin abrasion. HR 138, BP 88/52, sodium 126 mmol/L,

Question

A 38-year-old develops fever, rapidly worsening leg pain, vomiting and confusion after a minor shin abrasion. HR 138, BP 88/52, sodium 126 mmol/L, lactate 5.4 mmol/L, and the skin is dusky with bullae. What is the most appropriate next step?

Accepted Answer

Broad-spectrum antibiotics, clindamycin, resuscitation, and immediate surgical consultation

Answer

Incision and drainage under local anaesthesia in the ED

Answer

Topical antiseptic dressings and outpatient wound review

Answer

CT leg before antibiotics or surgical notification

Answer

Oral cephalexin and return precautions

Necrotising soft-tissue infection — RCPSC EM MCQ

A 38-year-old develops fever, rapidly worsening leg pain, vomiting and confusion after a minor shin abrasion. HR 138, BP 88/52, sodium 126 mmol/L, lactate 5.4 mmol/L, and the skin is dusky with bullae. What is the most appropriate next step?