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A 64-year-old woman presents with left lower quadrant abdominal pain and constipation. On physical examination, her temperature is 38.3°C and a tender left lower quadrant abdominal mass is palpable.
Laboratory studies include a normal abdominal radiograph and a complete blood cell count (CBC) showing a leukocyte count of 15.0・~109/L with a left shift.
Laboratory studies include a normal abdominal radiograph and a complete blood cell count (CBC) showing a leukocyte count of 15.0・~109/L with a left shift.
What should you do next?
a. Obtain stool cultures and blood cultures and perform flexible sigmoidoscopy.
b. Obtain stool cultures and schedule a return visit in 2 days for review of the culture report.
c. Obtain stool cultures, begin oral antibiotic therapy, and instruct the patient to schedule
b. Obtain stool cultures and schedule a return visit in 2 days for review of the culture report.
c. Obtain stool cultures, begin oral antibiotic therapy, and instruct the patient to schedule
a return appointment if her symptoms do not improve.
d. Admit her to the hospital, give her nothing by mouth, administer IV fluids and antibiotics, and obtain a surgical consultation.
e. Recommend emergency surgery.
d. Admit her to the hospital, give her nothing by mouth, administer IV fluids and antibiotics, and obtain a surgical consultation.
e. Recommend emergency surgery.