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Necrotizing soft tissue infection — ABEM Board MCQ

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HardInfectious disease emergenciesNecrotizing soft tissue infectionABEM Board

A 67-year-old woman arrives as ESI 2 with fever, altered mental status, and a rapidly spreading painful erythematous thigh lesion. BP 84/46, HR 132, sodium 126 mEq/L, creatinine 2.0 mg/dL, and pain is out of proportion. Which of the following is the most appropriate disposition?

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Correct answer: B — Immediate operative management pathway with ICU-level admission

Suspected necrotizing soft tissue infection with shock requires immediate surgical pathway, broad antibiotics, and ICU-level care.

Reference: IDSA skin and soft tissue infection guideline; Surviving Sepsis Campaign