Necrotizing soft tissue infections Quiz: Ace Your Exams
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A 45-year-old man presents to the emergency department for evaluation of left leg pain and redness, chills, and fever that have developed over the past 3 days. The patient has a past medical history of type 2 diabetes mellitus, hypertension, hyperlipidemia, and Crohn’s disease. Temperature is 38°C (100.4°F), blood pressure is 122/60 mmHg, pulse is 117/min, respiratory rate is 14/min, and oxygen saturation is 97% on room air. The left lower extremity from the knee to the foot is moderately tender to palpation, erythematous, indurated, firm, and warm. No crepitus is palpated, and there is no evidence of necrosis. The patient states that the leg has looked the same for the past 2 days. The patient is started on IV fluids and broad-spectrum antibiotics, and blood cultures are drawn. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score is calculated from blood work and is 6, which is consistent with a moderate likelihood of Necrotizing Soft Tissue Infection (NSTI). Which of the following is the next best step in management?
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