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Necrotizing fasciitis — ABEM Board MCQ

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HardMusculoskeletal/Orthopedic emergenciesNecrotizing fasciitisABEM Board

A 51-year-old man presents as triage level 1 with severe thigh pain after minor trauma. He is febrile and hypotensive; exam shows rapidly spreading erythema, bullae, crepitus, sodium 128 mEq/L, creatinine 2.1 mg/dL, and lactate 5.2 mmol/L. Which of the following is the most important immediate intervention?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Immediate broad-spectrum antibiotics and surgical debridement

Necrotizing soft tissue infection with shock requires immediate antibiotics and operative source control; imaging should not delay surgery in unstable patients.

Reference: IDSA skin and soft tissue infection guideline; ABEM EM Model