In the ED, their vitals/exam are as above. Abscess +/- surrounding cellulitis***. I doubt osteomyelitis but will obtain an x-ray. I doubt has a necrotizing fasciitis patient’s pain not out of portion and rest of exam not consistent with necrotizing fasciitis and the patient is not diabetic.
– Labs/Tests: Mark cellulitis. Consider lactate, CBC, Chem 10, ESR/CRP, +/- wound culture, +/- blood cultures
– Imaging: XRs, BSUS to determine if drainable fluid collection.
– Treatments: Pain control, IV/PO*** abx (consider giving prophylactic abx 30-60 mins before I&D if patient has history of prosthetic heart valve/infectious endocarditis), I&D if confirmed purulent fluid collection
– Consults: None
– Dispo: Pending clinical resolution