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1 | |
A patient with diabetes mellitus type 2 presents to your clinic complaining of fever, chills, and severe pain in his scrotal region. He went to his chiropractor 2 days ago when he only had pain and swelling and the chiropractor adjusted his. . .well, we won't go there. He denies instrumentation or injury. On exam the scrotum is mildly red and very tender with mild edema. There is no evidence of trauma or eschar.
At this point, you: |
| | A) | Initiate anti-Staphylococcal antibiotics (e.g., amoxicillin/clavulanate, cephalexin, dicloxacillin) as an outpatient. |
| | B) | Admit to the hospital for IV antibiotics, given that he is diabetic, and begin hot packs to the area. |
| | C) | Admit to the hospital for IV antibiotics and consult surgery about possible wide excision of the perineum. |
| | D) | Perform an ultrasound to rule out torsion. |
| | E) | Check a urinalysis to rule out nephrotic syndrome leading to scrotal edema. |
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2 | |
You admit this patient and want to start IV antibiotics. The surgeon is called and, since this is a surgical emergency, comes in off the golf course (he had finished the front nine).
The proper antibiotic coverage for this patient is: |
| | A) | Ceftriaxone and nafcillin. |
| | B) | Levofloxacin and gentamicin. |
| | C) | Clindamycin and ampicillin/sulbactam. |
| | D) | Gentamicin and ceftriaxone. |
| | E) | Any of the above. |
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