How should a patient with a known infection be managed preoperatively?

• A. Proceed with elective surgery as planned; no changes needed.
• B. Treat infection when feasible; postpone elective surgery if active uncontrolled infection; optimize antibiotics and sepsis management per protocol.
• C. Ignore infection and proceed as scheduled.
• D. Refer to infectious disease consult only after surgery.

Answer: (B)

Managing a known infection before surgery means timing the procedure to minimize risk by controlling the infection first. If a patient has active, uncontrolled infection, proceeding with elective surgery raises the chances of postoperative complications such as wound infection, sepsis, and organ dysfunction. The safest approach is to treat the infection now, optimize antimicrobial therapy, pursue necessary source control (like drainage or debridement), and manage sepsis according to protocol. Only after the infection is controlled should elective surgery be scheduled, unless the surgery is urgent or emergent. This approach reduces perioperative risk and improves outcomes, whereas proceeding without addressing the infection or delaying optimization after the surgery planning would increase complications.