American Board of Internal Medicine (ABIM) Certification Practice Exam

Which diagnostic method is essential for diagnosing a superficial incisional surgical site infection?

1. Imaging studies

2. Gram stain and culture of the fluid drainage from the incision site

3. Blood cultures

4. Clinical examination alone

The correct answer is: Gram stain and culture of the fluid drainage from the incision site

The essential diagnostic method for diagnosing a superficial incisional surgical site infection is the Gram stain and culture of the fluid drainage from the incision site. This approach allows for the direct identification of pathogenic organisms present in the wound. By performing a Gram stain, healthcare providers can quickly determine the presence of bacteria and observe their characteristics, which can help guide immediate management decisions regarding antibiotic therapy. In conjunction with culture, this method provides critical information about the specific microorganisms involved, facilitating targeted treatment. It's important to note that while a clinical examination can suggest the presence of infection, and imaging studies might provide additional information in complicated cases, they do not offer the concrete bacteriological evidence that Gram staining and culture provide. Blood cultures are relevant in scenarios of systemic infection, but they are not the primary method for diagnosing localized surgical site infections. Thus, Gram stain and culture are pivotal for confirming superficial incisional surgical site infections and determining the best course of treatment.