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Infectious
bacterial disease
staphylococcal infections
A 25-year-old man presents to the urgent care clinic with a rapidly worsening painful lesion on his right forearm. He first noticed a small, tender red bump three days ago, which has since grown significantly and become exquisitely painful. He reports feeling generally unwell, with subjective fevers and chills, though he hasn't measured his temperature. His medical history is significant for chronic atopic dermatitis, for which he uses intermittent topical emollients and corticosteroids. On examination, his temperature is 37.9 0C (100.2 0F), pulse 92/min, blood pressure 128/78 mmHg, and respiratory rate 16/min. Skin examination of the right forearm reveals a 5-cm, exquisitely tender, warm, and fluctuant lesion with a central pustule, surrounded by a wide area of spreading erythema and palpable induration. There is also mild ipsilateral axillary lymphadenopathy. His generalized atopic dermatitis is well-controlled, with some residual lichenification in flexural areas. Given these findings, what is the most likely diagnosis and the most critical initial management strategy to prevent common complications?
| Lab Parameter | Value | Reference Range |
|---|---|---|
| White blood cell count | 13.5 x 10^9/L | 4.0-10.0 x 10^9/L |
| Neutrophils | 80% | 40-75% |
| C-reactive protein | 75 mg/L | <5 mg/L |
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