Skin Disorders: Infections

what are characteristics of community associated MRSA?

• patient has lack of exposure to health care setting

• resistant only to beta lactam antibiotics

• not multiply resistant

• not a “spider bite”

what is the appearence of community associated MRSA?

• indurated, erythematous area w/ dark red to purple border

• vesicles

• necrotic or crusted center

• abscesses

• cellulitis

• necrotizing fasciitis

what is necrotizing fasciitis in MRSA?

spreads fast(mark borders)!! if already immunocompromised. this requires immediate, extensive debridement. amputation may be required

how is MRSA diagnosed?

a culure needs to be done prior to antibiotics

what is used to treat MRSA?

the antibiotic Vancomycin IVPB

what environmental controls can be done for MRSA?

• Hand hygiene

• Contain drainage

• Dispose of dressings properly

• Do NOT share personal care items

• Disinfect athletic mats, machines, and equipment

• Avoid skin to skin or machine contact

what is an abscess?

Large painful pus filled area surrounded by erythema. staph is common and there is an increased risk if immunocompromised or diabetic

how can you treat an abscess?

with antibiotics or using a warm moist compress may help bring abscess to a head. incision and drainage can also be done

what is a verruca (warts)?

Raised cauliflower-like hyperkeratotic area r/t human papilloma virus

where are plantar warts?

on the soles of the feet and there are typically multiple and painful. may look like a callus but has small dark spots and no skin lines

what are anogenital warts?

Sexually transmitted, pruritic cauliflower-like lesions on genitalia

what is the treatment for warts?

take ~12 weeks to disappear, liquid nitrogen (cryotherapy), cimetidine, topical antivirals, and topical peeling agents

what is reccomended to remove warts?

antivirals help remove the entire wart, topical is used for genital warts (podophyllin)

how does someone get herpes zoster (shingles)?

it is a reactivation of varicella so they have to had chickenpox before

what does a patient experience if they have herpes zoster (shingles)?

Pain may be severe and continue after lesions have cleared (postherpetic neuralgia)

how are herpes zoster (shingles) treated?

with antivirals within 3 days oral and prescribed otp, this is a priority patient!

• prevention shingles vaccine is also available