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Old 06-28-2011
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Question groin pain and fever case

A 55-year-old male presents to the emergency room complaining of groin pain and fever. He states that over the last several days he has had increasing pain of his right hemiscrotum and recently developed nausea, vomiting, and a fever. He has a history of insulin-dependent diabetes and he says his sugars have been “higher than usual, running in the low 300s”. Vital signs are heart rate 110 beats/min, respiratory rate 14 breaths/min, blood pressure 130/77 mm Hg, oxygen saturation 98%, and temperature of 38.4°C (101.2°F). On physical examination he has severe erythema, tenderness, and warmth of his perineum. What is the mainstay of treatment for his likely condition?

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A. Intravenous antibiotics
B. Intravenous antifungals
C. Local topical wound care
D. Surgical debridement
E. Tight glycemic control
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Old 06-28-2011
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This is hard.. all seem correct. It is a Fournier disease case.

I am between D and E. I will choose D because it treats the problem, however E address the possible cause, in this case, hyperglycemina. :sorry:
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Old 06-28-2011
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I think i will opt for IV antibiotics... Once the infection is treated, then the sugar levels can be controlled...
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Infectious-Diseases, Internal-Medicine-, Step-2-Questions

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