PC2 MOD 3.4

non purulent

erysipelas, cellulitis, necrotizing infections

B-hemolytic streptococci (strep. pyogenes)

purulent

furuncle, carbuncle, abscesses

pus producing lesions

main organism MRSA

symptoms associated with SSTI

local= pain, swelling, warmth, erythema

systemic= fever

erysipelas (NP)

• upper layers of the skin: epidermis

• redness erythema clearly defined

• skin lesions raised above lvl of surrounding skin

• red streaks= infection spread along lymph vessels

cellulitis (NP)

deeper skin layers: dermis & subcutaneous tissue

reddened skin less defined

dark red or purplish

orange peel, petechaie, ecchymosis

purulent

absecesses

collection of pus

deeper skin tissue well below dermis

dx non purulent

BLOOD CULTURES ARE NOT RECOMMENDED

blood cultures can be considered in ppl with comorbidities:

• malignancy chemotherapy

• neutropenia

• severe cell immediated immunodefiency

• animal bites

dx of purulent

INCISION AND DRAINAGE GOLD STANDARD TREATMENT

graim stain & culture of the pus

decision tree for NP SSTIs

mild= outpt, streoptococci focus: penicillin vk, cephalexin, cefadroxil, dicloxacillin, clinda

moderate= streptococci focused with MSSA coverage IV: ceftriaxone, ceftaroline, clinda

severe= MRSA cov IV: zozyn + vanco

decision tree for purulent SSTIs

mild= no treatment (I & D)

moderate= MRSA PO tx: bactrim, doxy, linezolid

severe: MRSA IV: VANCO, DAPTO, LINEZOLID, CEFTAROLINE

ANIMAL BITES

DOG MENTIN (AUGMENTIN)