Case 2: Why haven’t these boils responded to antibiotics?

June 3, 2009

For the past 5 years, a 30-year-old woman has had boils on her groin. She has tried at least 3 different antibiotics over the years, but none of them have been effective. She is otherwise healthy; the only medication she takes regularly is an oral contraceptive.

For the past 5 years, a 30-year-old woman has had boils on her groin. She has tried at least 3 different antibiotics over the years, but none of them have been effective. She is otherwise healthy; the only medication she takes regularly is an oral contraceptive.

Which of the following do you suspect?

A. Staphylococcal infection.
B. Methicillin-resistant Staphylococcus aureus infection.
C. Gram-negative folliculitis.
D. Hidradenitis suppurativa.
E. Herpes simplex.

(answer on next page)

Case 2: Hidradenitis suppurativa with secondary infection

Hidradenitis suppurativa, D, was suspected; culture revealed both conventional S aureus,A, and Pseudomonas aeruginosa, C. The patient was treated for both infections, and topical dapsone was prescribed as an anti-inflammatory agent.

Herpes simplex would appear as grouped vesicles on an erythematous base.

 

 

 

 

The patient suspects poison ivy caused this recurrent rash-do you agree?

How do you explain this persistent facial rash?

What caused periorbital edema in this woman?