ID - Skin and Soft Tissue

Question 1

Purulent drainage usually associated with MRSA in cellulitis. If no purulence present then probable organism is:

Answer 1

B-hemolytic streptococcus

Question 2

Patient with liver disease cut himself with a fish hook in brackish water. What organism should you be worried about?

Answer 2

Patients who are immunocompromised, particularly those with liver disease, are at increased risk for infection with Vibrio vulnificus.

Question 3

Patient with fever, chills, AMS, hypotension. Pain disproportionate to physical exam of leg, which appears to have cellulitis. Could be?

Answer 3

Necrotizing fasciitis

To to surgery ASAP

Question 4

What medication should be used for antibiotic prophylaxis in animal bites - and under what circumstances?

Answer 4

Augmentin

Situations:
immunosuppressed
moderate to severe wounds
face/hand wounds or wounds near joint/bone
or wounds with crush damage or edema

Question 5

What medication should be used for antibiotic prophylaxis in animal bites if patient allergic to penicillin?

Answer 5

Doxycycline alone
Doxy + Cipro
Bactrim + Clinda or Flagyl

Question 6

Antibiotic ppx required in human bites?

Answer 6

yes! Augmentin