How do you suggest evaluating infection of a chronic wound in patients presenting with sepsis of unclear etiology?

A few lessons/tips I learned as a medical student have stuck with me through the years and would inform my initial evaluation.

1. "How do you hide a $20 bill from an internist? Hide it under a bandage." Heard this the first time as a medical student, and it has stayed with me for 20+ years. A sharp reminder of the importance of the physical exam in this context -- you can learn an awful lot (and sometimes your patient has pictures on their phone for comparison).
2. "Wrong drug, wrong bug, or the drug...

In any case, it is a good start to obtain a thorough history from the patient or caregiver. Important questions include whether there has been increased drainage, whether the drainage has recently become purulent, whether there is surrounding cellulitis, whether the wound has developed a foul odor, and whether there has been any new pain, redness, warmth, or swelling.

If a patient presents with sepsis without an obvious source and has a chronic wound, I would be hesitant to either attribute the ...