Cellulitis and soft tissue infections

Question 0

Cellulitis - when to think MRSA vs MSSA

Answer 0

If abscesses and/or recurrent cellulitis and/or nasal swab –> consider MRSA

Question 1

Cellulitis - nonpharmacological treatment

Answer 1

1. Elevate/immobilize
2. Cool sterile saline dressings
3. Moist heat

Question 3

Cellulitis DOC

Answer 3

Staph - dicloxacillin (alt. macrolide Clinda)
Strep - PCN VK

Alternatives: BL/BLI, 1st gen cephalosporin

Question 4

Cellulitis (HA-MRSA) - DOC

Answer 4

IV - vanc, daptomycin, Linezolid

Question 4

Erysipelas - DOC

Answer 4

PCN

If allergic, e-mycin

Question 5

Erysipelas - clinical presentation

Answer 5

Legs/feet
Very young, very old
Infection on superficial dermis that spreads through lymphatic system

Elevated edge/sharply demarcated (different from cellulitis), painful, red, fever

Question 7

Animal bite - Treatment

Answer 7

1. Rabies immunoglobulin and vaccine?
2. Tetanus?
3. Augmentin or Dicloxacillin

2nd Doxy or Mino

Question 8

Human bite - treatment

Answer 8

1. aggressive irrigation
2. tetanus?

PCN (AMX)
if suspicious of staph - PCNase resistant PCN (dicloxacillin)

If PCN allergy - doxycycline or clindamycin

Treat 7-14 days

Question 9

Cellulitis - classical organisms

Answer 9

strep pyogenes, staph aureus (MSSA vs MRSA)

Question 10

Cellulitis - Primary vs Secondary

Answer 10

primary - normal skin before infection, single organism

secondary - skin was already damaged, multiple organisms

Question 11

Cellulitis (CA-MRSA) - DOC

Answer 11

PO - Minocycline, doxycycline

Alt. Bactrim and Clinda

Question 12

Bactrim - DDI

Answer 12

Coumadin

Question 13

Who should not get Bactrim?

Answer 13

sulfa allergy, pregnant, G6PD

Question 14

Cellulitis vs erysipelas

Answer 14

cellulitis has a diffuse edge, erysipelas have a sharp, demarcated edge

Question 15

Linezolid and Bactrim DDI

Answer 15

MAO inhibitors

Question 16

Linezolid ADE

Answer 16

BMS with long term use