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30-year-old man presents to his physician with a rash on his left leg. He reports that the rash started as a bug bite and is spreading. He denies any fever, chills, or malaise. His medical history is significant for type 1 diabetes mellitus, and his only medication is insulin. On examination of the left leg, there is a 4-cm area of erythema, swelling, and warmth with indistinct margins. There is no gross purulence. What antibiotic should this patient receive?Ask StudybuddyGroup of answer choicesOral dicloxacillinIV vancomycinOral cephalexinOral clindamycin

Question

30-year-old man presents to his physician with a rash on his left leg. He reports that the rash started as a bug bite and is spreading. He denies any fever, chills, or malaise. His medical history is significant for type 1 diabetes mellitus, and his only medication is insulin. On examination of the left leg, there is a 4-cm area of erythema, swelling, and warmth with indistinct margins. There is no gross purulence. What antibiotic should this patient receive?Ask StudybuddyGroup of answer choicesOral dicloxacillinIV vancomycinOral cephalexinOral clindamycin

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Solution

This patient's presentation is consistent with cellulitis, a skin infection typically caused by Streptococcus pyogenes and Staphylococcus aureus. In patients with nonpurulent cellulitis (ie, no abscess or purulent drainage), beta-hemolytic streptococci are the most common pathogens, and treatment should be aimed at these organisms. Therefore, the first-line treatment for nonpurulent cellulitis is oral or intravenous antibiotics effective against streptococci, such as cephalexin or amoxicillin. So, the correct answer is Oral cephalexin.

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