Section 3: Skin Infections

Question 1

Treatment of impetigo

1. Mild disease
2. Severe disease
3. Community-acquired MRSA (CA-MRSA)
4. Penicillin allergy: – Rash
5. Penicillin allergy: – Anaphylaxis
6. Penicillin allergy: - Severe infection with anaphylaxis

Answer 1

1. Topical mupirocin or retapamulin (mupirocin has greater activity against MRSA, bacitracin has less efficacy as a single agent)
2. Oral dicloxacillin or cephalexin
3. TMP/SMZ; clindamycin is sometimes useful
4. Cephalosporins are safe
5. Clindamycin, doxycycline, linezolid
6. Vancomycin, telavancin, linezolid, daptomycin

Question 2

Erysipelas

1. Causative organism
2. Site of body commonly affected
3. Why is the skin very bright red and hot?
4. Diagnostic test
5. Best initial Rx
6. Rx if typical organism is confirmed

Answer 2

1. Group A (pyogenes) streptococcus
2. Face
3. Because of dilation of the capillaries of the dermis due to locally released inflammatory mediators.
4. Blood cultures
5. Oral docloxacillin or cephalexin
6. Penicillin VK