A 55-year-old diabetic woman presents with 2 days of rapidly progressive pain, swelling, and redness of her left lower leg. Rigors and vomiting yesterday. Started on oral flucloxacillin 3 days ago for cellulitis.
Examination: Temp 38.7°C, HR 125, BP 95/60. Erythematous swollen left lower leg, purple patches, blistering, crepitus palpable. CRP 285, WCC 22, lactate 4.2.
What is the most appropriate immediate management?
A
IV flucloxacillin only, admit under medical team
B
CT scan to confirm diagnosis before any treatment
C
Bedside incision and drainage in the ED
D
IV clindamycin only, admit for observation
E
IV antibiotics, fluid resuscitation, surgical review