A 58-year-old man with diabetes presents to a Darwin ED, triage category 1, with severe thigh pain after a minor graze. BP 86/50, HR 132, temp 39.4

Question

A 58-year-old man with diabetes presents to a Darwin ED, triage category 1, with severe thigh pain after a minor graze. BP 86/50, HR 132, temp 39.4 C. Skin changes are subtle but pain is extreme; sodium is 126 mmol/L, CRP 340 and lactate 5.8. What is the most likely diagnosis?

Accepted Answer

Necrotising fasciitis

Answer

Gout flare

Answer

Simple muscle strain

Answer

Deep vein thrombosis

Answer

Cellulitis without systemic involvement

Necrotising fasciitis — ACEM Fellowship MCQ

A 58-year-old man with diabetes presents to a Darwin ED, triage category 1, with severe thigh pain after a minor graze. BP 86/50, HR 132, temp 39.4 C. Skin changes are subtle but pain is extreme; sodium is 126 mmol/L, CRP 340 and lactate 5.8. What is the most likely diagnosis?