08-07-2006, 08:11 AM
A 63 yr old Obese woman with Diabetes mellitus and Asthma is admitted to ICU with fever and Resp. failure. She was discharged from the hospital 3 days earlier when she had been admitted for a severe exacerbation of asthma precipitated by and upper resp. tract infection. Today, a CXR shows pulmonary consolidation. On admission, you note a large erythmatous patch onher lower abdomen. Within 24 hrs hemorrhagic bullae develop and progress to form large necrotic ulceration with yellow-green purulent exudate covering the base and undermined borders, Laoratory values:
ESR 120
WBC 4800 (Neutro 70%, bands 15%, Lymph 5%, Eosinophils 2% mono 7%)
Blood cultures: Gram neg rods
based on this most appropriate treatment is:
A. IV ABX and surgical debridement
B. IV ABX only
C. PO ABX and surgical debridement
D. PO ABX
E. Surgical derbidement
ESR 120
WBC 4800 (Neutro 70%, bands 15%, Lymph 5%, Eosinophils 2% mono 7%)
Blood cultures: Gram neg rods
based on this most appropriate treatment is:
A. IV ABX and surgical debridement
B. IV ABX only
C. PO ABX and surgical debridement
D. PO ABX
E. Surgical derbidement