MRSA: In most instances of severe skin and adjoining structure infection, assume MRSA and choose initial antibiotics accordingly.
A 32-year-old man presents with the acute onset of a “face sore” and tender swelling of the ipsilateral eye. He works as a gardener and thinks that he poked his face with a tree branch about 3 days previously. He feels “feverish” and has anorexia.
Key point: The entire picture is consistent with traumatic ecthyma below the eye, followed by a cellulitis involving the periorbital soft tissue. The absence of pruritus speaks against the diagnosis of acute contact dermatitis-another common cause of striking periorbital swelling.
Treatment: Because of the patient’s constitutional symptoms (and an objective temperature of 101.5°F accompanied by leukocytosis), the patient was admitted for parenteral administration of antibiotics. Culture from the infraorbital crusted erosion yielded pure growth of methicillin-resistant Staphylococcus aureus (MRSA).
Note: In most instances of severe skin and adjoining structure infection, it is best to assume that MRSA is present and to choose initial antibiotic(s) accordingly.
Biden Administration Announces First 10 Prescription Drugs Slated for Price Negotiations
August 29th 2023The first 10 drugs identified for negotiations under the Inflation Reduction Act include several well advertised agents indicated to treat diabetes, heart failure, and other chronic diseases.