Submitted by Richard E. Schlanger, MD, PhD, FAPWCA, CWSP, FACS
This is a 58-year-old gentleman who is a truck driver by trade. He reported to his local emergency room because of general malaise, joint pain and a swollen left shoulder. According to the admission record, there were no unusual findings including no injuries, cuts and bruises. Over the next 12 hours the patient declined fairly quickly becoming hypotensive, tachycardic and required pressor support. He was transported by air to a medical center and taken emergently to the OR because of skin changes and loss of pulse and sensation. At the time of surgery most of the distal vessels were thrombosed and the muscle look like it was “cooked".
The most likely diagnosis is:
A. Septic emboli
B. Soft tissue necrosis
C. Compartment syndrome
D. Rattlesnake bite
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