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Original Question

Question 21 of 50 P ID: 12075 Mark Previous Next A 58-year-old woman presents to the ED with pain in her left lower leg. She states that an insect bit her leg yesterday, and a few hours later she noticed a sore red spot at the bite location. It steadily became larger and is extremely painful today (see picture A). Her past medical history is significant for insulin-dependent diabetes and obesity. Her blood pressure is 90/70 mm Hg, pulse 115/min, respiratory rate 21/min, and temperature 39.5 C (103.1.F). Physical exam of the left lower leg shows erythema, nonpitting edema, and crepitus with severe pain on palpation of the area. The serum creatinine is 2 5 mg/dL. Broad-spectrum antibiotic treatment is initiated. An X-ray of the left lower leg is shown in picture B. Which of the following is the most appropriate next step in management? A. Culture-based antibiotic treatment O B. Leg amputation O C. Needle drainage O D. Surgical exploration OE. Reassurance Submit Ans

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