Necrotizing soft tissue infections Quiz: Ace Your Exams

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A 55-year-old man is brought by ambulance to the emergency department after his wife found him unresponsive upon returning from a trip to the grocery store. The wife states that he had been complaining of left leg pain, chills, and fatigue for 1 day. The patient has a past medical history of type 2 diabetes treated with insulin, hypertension, hyperlipidemia, and obesity. The patient is responsive only to pain. Temperature is 39°C (102.2°F), blood pressure is 95/60 mmHg, pulse is 117/min, respiratory rate is 22/min, and oxygen saturation is 93% on room air. The patient appears acutely ill. The left lower extremity is shown below. It is erythematous, indurated, warm, and firm to the touch. Crepitus is felt on palpation. The patient is started on IV fluids and broad-spectrum antibiotics. Labs are ordered and pending. Which of the following is the best next step in management?  


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