The Swollen Scrotum

List 4 clinical features found in >90% of patients presenting with necrotizing fasciitis.

The patient is anxious to leave but you persuade him to have some investigations performed.

Which blood test results would increase the likelihood of this being necrotizing fasciitis?

His blood results are as follows. Haemoglobin 11.7, White cell count 17.4, Platelets 420, Sodium 130, Potassium 4.1, Urea 9.3, Creatinine 157, CRP 405, Glucose 15.7.

It is now 11pm. You work in a hospital without out of hours Urology cover. The surgical Middle Grade who sees the patient thinks the likeliest diagnosis is a scrotal abscess. He points out that there are no signs of sepsis or of Fournier’s Gangrene.

Which of the following would be appropriate next management steps?