A 36-Year-Old Man Comes to the Emergency Department with Severe

question 538

Multiple Choice

A 36-year-old man comes to the emergency department with severe pain in his left leg.  He is a carpenter and recalls that he had a small puncture wound from a wood splinter yesterday in his workshop.  The patient washed the wound and applied a small adhesive bandage.  This morning, he experienced severe pain in his left thigh and calf, and the pain has worsened since.  He has no other medical problems and takes no medications regularly.  His temperature is 39.4 C (103 F) , blood pressure is 90/60 mm Hg, heart rate is 96/min, and respirations are 16/min.  Physical examination of his left lower extremity shows slight erythema and swelling of the thigh and calf with severe tenderness to palpation.  Two blisters are present on the posterior aspect of his proximal calf.
Which of the following is the most likely organism responsible for this patient's condition?

• A)Clostridium perfringens
• B)Group A Streptococcus
• C)Pseudomonas aeruginosa
• D)Staphylococcus aureus
• E)Staphylococcus epidermidis

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