scholarly journals Overview on the Causes and Updated Management of Impetigo

2021 ◽  
pp. 50-57
Author(s):  
Abdullah Rahil Alotaibi ◽  
Rahaf Mohammad Alshahrani ◽  
Ahad Awadh Alanazi ◽  
Marwah khalil I Almalki ◽  
Saleh Asaad Alsaadoon ◽  
...  
Keyword(s):  
Streptococcus Pyogenes ◽  
Skin Infection ◽  
Secondary Infection ◽  
Topical Therapy ◽  
Oral Antibiotic ◽  
Topical Antibiotics ◽  
Oral Antibiotic Therapy ◽  
The Face ◽  
Amoxicillin Clavulanate ◽  
Insect Bites

Impetigo is the most common bacterial skin infection in children between the ages of 2 and 5. There are two main types: non-vesicular (70% of cases) and bullous (30% of cases). Non-bullous impetigo or impetigo is caused by Staphylococcus aureus or Streptococcus pyogenes and is characterized by honey-colored skin on the face and limbs. Impetigo primarily affects the skin or is a secondary infection with insect bites, eczema, or herpes lesions. Bullous impetigo caused only by S. aureus causes large, relaxed blisters and is more likely to affect the interstitial area. Both types usually resolve within a few weeks without scarring, and complications are rare, the most serious of which is streptococcal glomerulonephritis. Treatment includes topical antibiotics such as mupirocin, retapamulin, and fusidic acid. Oral antibiotic therapy can be used for impetigo with large blisters, or when topical therapy is not practical. Amoxicillin / clavulanate, dicloxacillin, cephalexin, clindamycin, doxicillin, minocycline, trimetoprim / sulfamethoxazole, and macrolides are optional, but penicillin is not.

Study of use of cefdinir versus cephalexin for treatment of skin infections in pediatric patients. The Cefdinir Pediatric Skin Infection Study Group.

1997 ◽  
Vol 41 (4) ◽  
pp. 739-742 ◽  
Author(s):  
K J Tack ◽  
C H Keyserling ◽  
J McCarty ◽  
J A Hedrick
Keyword(s):  
Streptococcus Pyogenes ◽  
Clinical Cure ◽  
Pediatric Patients ◽  
Skin Infection ◽  
Secondary Infection ◽  
Skin Infections ◽  
Randomized Controlled ◽  
Cure Rates ◽  
Infection Study ◽  
Common Infections

Three hundred ninety-four patients, aged 6 months to 12 years, entered a multicenter, randomized, controlled, investigator-blind study comparing cefdinir, 7 mg/kg of body weight twice a day, with cephalexin, 10 mg/kg four times a day, each given for 10 days. The most common infections treated were impetigo and secondary infection of preexisting dermatitis. The most common pathogens isolated were Staphylococcus aureus and Streptococcus pyogenes. Two hundred thirty-one patients were microbiologically evaluable. Microbiologic eradication rates were 164 of 165 pathogens (99.4%) in the cefdinir group and 152 of 156 pathogens (97.4%) in the cephalexin group (P = 0.14). Clinical cure rates were 116 of 118 patients (98.3%) in the cefdinir group and 106 of 113 patients (93.8%) in the cephalexin group (P = 0.056). Sixteen percent of cefdinir patients and 11% of cephalexin patients experienced adverse events (P = 0.11), the most common being diarrhea, which affected 8% of the cefdinir group and 4% of the cephalexin group. Cefdinir appears to be an effective and well-tolerated agent for the treatment of uncomplicated skin and skin structure infections in pediatric patients.

scholarly journals Miliary tuberculosis in a paediatric patient with psoriasis

2021 ◽  
Vol 14 (3) ◽  
pp. e237580
Author(s):  
Jacob Kilgore ◽  
Jonathon Pelletier ◽  
Bradford Becken ◽  
Stephen Kenny ◽  
Samrat Das ◽  
...  
Keyword(s):  
Brain Mri ◽  
Miliary Tuberculosis ◽  
Pulmonary Nodules ◽  
Chronically Ill ◽  
Community Acquired Pneumonia ◽  
Oral Antibiotic ◽  
Cavitary Lesion ◽  
Oral Antibiotic Therapy ◽  
History Of ◽  
Chest X Ray

We present a 16-year-old girl with a history of well-controlled psoriasis, on immunosuppression, who sought evaluation in the emergency department for 4 months of fever, cough and unintentional weight loss. The patient had seen multiple providers who had diagnosed her with community-acquired pneumonia, but she was unimproved after oral antibiotic therapy. On presentation, she was noted to be febrile, tachycardic and chronically ill-appearing. Her chest X-ray showed diffuse opacities and a right upper lobe cavitary lesion concerning for tuberculosis. A subsequent chest CT revealed miliary pulmonary nodules in addition to the cavitary lesion. The patient underwent subsequent brain MRI, which revealed multifocal ring-enhancing nodules consistent with parenchymal involvement. The patient was diagnosed with miliary tuberculosis and improved on quadruple therapy. Though rates of tuberculosis are increasing, rates remain low in children, though special consideration should be given to children who are immunosuppressed.

546 Management of Pediatric Pavement Burns

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S121-S122
Author(s):  
Syed F Saquib ◽  
Paul J Chestovich ◽  
Joseph T Carroll ◽  
Carmen E Flores
Keyword(s):  
Ambient Temperature ◽  
Average Length ◽  
Topical Therapy ◽  
Total Body Surface Area ◽  
High Ambient Temperature ◽  
Unknown Etiology ◽  
Oral Antibiotic ◽  
Superficial Infection ◽  
Plantar Aspect

Abstract Introduction Pavement burns are common in a dry high heat climate. This study reviews the etiology, management and outcome of pavement burns in children. Methods All patients age < 18 who suffered contact burns from hot pavement from Jan 1, 2014 to Dec 31, 2019 were reviewed. A total of 45 patient charts met inclusion criteria. High ambient temperature on each date, and zip code of each injury was extracted from Weather Underground (www.wunderground.com) Results In this study, 45 patients met criteria and were reviewed, of whom 27 patients (60%) were male. Average age was 3.29 years (SD 0.69), made up two discrete age groups: age under 3 (n= 40, 89%) and 14+ (n=5, 11%). 38 patients (84%) had no known medical history. All had 2nd degree burns and one patient (2%) had third degree burns. Mean total body surface area (TBSA) was 2.5% (SD 1.4%, range 0.75% to 5.5%). Burn etiology included 31 patients (69%) walking barefoot on pavement, 6 (13%) falling onto pavement, and other/unknown etiology for the remaining 8 patients (18%). 30 patients (67%) had injuries on the plantar aspect of bilateral feet, 2 (4%) to bilateral palms of hands, 4 (9%) to other parts of upper extremities and 10 (22%) to other parts of lower extremities. Thirty-four (34) patients (76%) were managed without any hospitalization. Those that were hospitalized had an average length of stay (LOS) of 2.72 days (range 1–9 days). All burns were managed non-operatively with topical therapy alone. 35 patients (78%) were managed initially with Silvadene, and 6 (13%) with bacitracin. Aquacel was utilized in 10 patients at a follow-up visit (22%). Three patients (6.7%) were treated with collagenase enzyme therapy. One patient developed a superficial infection requiring oral antibiotic therapy. There were no mortalities in this group. The high ambient temperature on date and location of each injury was 101 F (SD 1.10 F, range 73F-111F). Of the thirty that continued to follow up in clinic, the average time to the burn being 95% healed was 10.50 days (SD 8.97 days, range 2–40 days). Conclusions Pavement burns in children are partial thickness and are safely managed with topical therapy alone, with good outcomes. Patients age 3 and under are a vulnerable population and therefore at particular risk of injury.

scholarly journals SELULITIS DENGAN ULKUS VARIKOSUM

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Andravita F. Mitaart ◽  
Herry E. J. Pandaleke
Keyword(s):  
Subcutaneous Tissue ◽  
Topical Therapy ◽  
Venous Blood ◽  
Clinical Signs ◽  
Lower Limbs ◽  
Body Region ◽  
Venous Blood Flow ◽  
Oral Antibiotic ◽  
Varicose Ulcer ◽  
Days Of Therapy

Abstract: Cellulitis is an acute bacterial infection of dermis and subcutaneous tissue which manifests as an erythematous lesion with an undefined border accompanied with inflammatory signs. It is mainly found in the elderly; more frequently in females than males; with a history of malaise, fever, and pain as the prodromal signs, and enlargement of local lymph nodes. Cellulitis can occur in any body region, most commonly on the lower limbs, followed by the arms, head, and, neck. It tends to occur in sites with prior lesions such as dermatitis, static ulcers (including varicose ulcers), animal bites, or trauma. A varicose ulcer is an ulcer located on the lower limb caused by a disturbance in the venous blood flow. We reported an 80-year-old woman, presented with cellulitis and varicose ulcers. The diagnosis was based on history, clinical signs, and laboratory findings. The therapy consisted of limb elevation; oral antibiotic clindamycin (300 mg), mefenamic acid (500 mg), and mebhydroline napadisilate (50 mg), each three times daily; and a topical therapy that was comprised of a wound dressing using NaCl 0.9% for 30 minutes three times daily and an application of sodium fusidate cream twice daily. After ten days of therapy, there were clinical improvements with wound healing without any sign of cellulitis.Keywords: cellulitis, varicose ulcer  Abstrak: Selulitis merupakan infeksi bakteri akut pada dermis dan jaringan subkutan yang ditandai lesi kemerahan berbatas tidak jelas dan disertai tanda-tanda radang. Umumnya selulitis ditemukan pada usia lanjut, perempuan lebih sering daripada laki-laki, dengan riwayat lesu, demam, dan rasa nyeri sebagai gejala prodromal, disertai pembesaran kelenjar getah bening setempat. Selulitis dapat terjadi pada bagian tubuh manapun dengan predileksi pada tungkai bawah diikuti lengan, kepala, dan leher. Selain itu, selulitis biasanya timbul pada lokasi dengan lesi yang telah ada sebelummya, yaitu dermatitis, ulkus stasis (termasuk ulkus varikosum), luka tusuk, gigitan binatang, atau trauma. Ulkus varikosum ialah ulkus pada tungkai bawah yang disebabkan gangguan aliran darah venosa. Kami melaporkan kasus seorang perempuan berusia 80 tahun dengan selulitis dan ulkus varikosum. Diagnosis ditegakkan berdasarkan anamnesis, gejala klinis, dan pemeriksaan penunjang. Penatalaksanaannya ialah elevasi tungkai; antibiotik oral klindamisin 300 mg, asam mefenamat 500 mg, dan mebhidrolin napadisilat 50 mg, masing-masing 3 kali sehari; kompres solusio NaCl 0,9% selama 30 menit 3 kali sehari, dan natrium fusidat krim dioleskan 2 kali sehari. Setelah 10 hari paska terapi, terdapat perbaikan klinis berupa luka yang mulai mengering tanpa disertai tanda-tanda selulitis.Kata kunci: selulitis, ulkus varikosum

scholarly journals Pasteurella Multocida tenosynovitis of the flexor pollicis longus caused by a rabbit bone wound

2020 ◽  
pp. 50-56
Author(s):  
Blasco Alejandro ◽  
Cuñat-Aragó Borja ◽  
Baixauli Emilio ◽  
Amaya-Valero Jose
Keyword(s):  
Emergency Department ◽  
Pasteurella Multocida ◽  
Oral Antibiotic ◽  
Flexor Pollicis Longus ◽  
Indication For Surgery ◽  
Subcutaneous Edema ◽  
Show Evidence ◽  
Amoxicillin Clavulanate ◽  
Limited Function ◽  
Rabbit Bone

A 29-year-old man was admitted to our emergency department with a painful thumb, feverredness, and swelling and limited function. Five days before he was wounded with a rabbitbone. He was given amoxicillin-clavulanate with a lack of improvement. He was admitted forhospitalization and an ultrasound confirmed tenosynovitis as well as subcutaneous edema, sosurgical debridement was performed. Cultures were positive to Pasteurella multocida.Hospital stay was 9 days, and he continued oral antibiotic for 10 days after discharge. Fourmonths postoperatively, the patient had complete function and didn’t show evidence ofrecurrence. To conclude, rapidly developing cellulitis, tenosynovitis, fever and drainage fromhand wounds after a cat or dog bites should suggest Pasteurella multocida infection.However, P. multocida tenosynovitis can be also produced after a rabbit bone wound.Absence of response after 24-48 of antibiotic treatment, especially if cellulitis has progressedto tenosynovitis, is an indication for surgery.

scholarly journals Effectiveness of early switching from intravenous to oral antibiotic therapy in Staphylococcus aureus prosthetic bone and joint or orthopedic metalware-associated infections

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hélène Boclé ◽  
Jean-Philippe Lavigne ◽  
Nicolas Cellier ◽  
Julien Crouzet ◽  
Pascal Kouyoumdjian ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Therapy ◽  
Treatment Failure ◽  
Cox Model ◽  
University Hospital ◽  
Empiric Antibiotic Therapy ◽  
Oral Antibiotic ◽  
Intravenous Antibiotic ◽  
Oral Antibiotic Therapy ◽  
Intravenous Antibiotic Therapy

Abstract Background The optimal duration of intravenous antibiotic therapy in Staphylococcus aureus prosthetic bone and joint infection has not been established. The objective of this study was to compare the effect of early and late intravenous-to-oral antibiotic switch on treatment failure. Patients and methods We retrospectively analyzed all adult cases of S. aureus prosthetic bone and joint or orthopedic metalware-associated infection between January 2008 and December 2015 in a French university hospital. The primary outcome was treatment failure defined as the recurrence of S. aureus prosthetic bone and joint or orthopedic metalware-associated infection at any time during or after the first line of medical and surgical treatment within 2 years of follow-up. A Cox model was created to assess risk factors for treatment failure. Results Among the 140 patients included, mean age was 60.4 years (SD 20.2), and 66% were male (n = 92). Most infections were due to methicillin-susceptible S. aureus (n = 113, 81%). The mean duration of intravenous antibiotic treatment was 4.1 days (SD 4.6). The majority of patients (119, 85%) had ≤5 days of intravenous therapy. Twelve patients (8.5%) experienced treatment failure. Methicillin-resistant S. aureus infections (HR 11.1; 95% CI 1.5–111.1; p = 0.02), obesity (BMI > 30 kg/m2) (HR 6.9; 95% CI1.4–34.4, p = 0.02) and non-conventional empiric antibiotic therapy (HR 7.1; 95% CI 1.8–25.2; p = 0.005) were significantly associated with treatment failure, whereas duration of intravenous antibiotic therapy (≤ 5 or > 5 days) was not. Conclusion There was a low treatment failure rate in patients with S. aureus prosthetic bone and joint or orthopedic metalware-associated infection with early oral switch from intravenous to oral antibiotic therapy.

scholarly journals Oral antibiotic therapy in people who inject drugs (PWID) with bacteraemia

2020 ◽  
Author(s):  
Aurlien Emmanuel Martinez ◽  
Claude Scheidegger ◽  
Veronika Bttig ◽  
Stefan Erb
Keyword(s):  
Antibiotic Therapy ◽  
People Who Inject Drugs ◽  
Oral Antibiotic ◽  
Oral Antibiotic Therapy

scholarly journals 289. Impact of Clinician Specialty on the Use of Oral Antibiotic Therapy for Definitive Treatment of Uncomplicated Bloodstream Infections

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S144-S145
Author(s):  
Jasmine R Marcelin ◽  
Mackenzie R Keintz ◽  
Jihyun Ma ◽  
Erica J Stohs ◽  
Bryan Alexander ◽  
...  
Keyword(s):  
Social Media ◽  
Soft Tissue ◽  
Infectious Diseases ◽  
Antibiotic Therapy ◽  
Bloodstream Infections ◽  
Definitive Treatment ◽  
Oral Antibiotic ◽  
Soft Tissue Infections ◽  
Gram Positive ◽  
Oral Antibiotic Therapy

Abstract Background No established guidelines exist regarding the role of oral antibiotic therapy (OAT) to treat uncomplicated bloodstream infections (uBSIs) and practices may vary depending on clinician specialty and experience. Methods An IRB-exempt web-based survey was emailed to Nebraska Medicine clinicians caring for hospitalized patients, and widely disseminated using social media. The survey was open access and once disseminated on social media, it was impossible to ascertain the total number of individuals who received the survey. Chi-squared analysis for categorical data was conducted to evaluate the association between responses and demographic groups. Results Of 275 survey responses, 51% were via social media, and 94% originated in the United States. Two-thirds of respondents were physicians, 16% pharmacists, and infectious diseases clinicians (IDC) represented 71% of respondents. The syndromes where most were comfortable using OAT routinely for uBSI were urinary tract infection (92%), pneumonia (82%), pyelonephritis (82%), and skin/soft tissue infections (69%). IDC were more comfortable routinely using OAT to treat uBSIs associated with vertebral osteomyelitis and prosthetic joint infections than non-infectious diseases clinicians (NIDC), but NIDC were more likely to report comfort with routine use of OAT to treat uBSIs associated with meningitis and skin/soft tissue infections. IDC were more likely to report comfort with routine use of OAT for uBSIs due to Enterobacteriaceae and gram-positive anaerobes, while NIDC were more likely to be comfortable with routinely using OAT to treat uBSIs associated with S. aureus, coagulase-negative staphylococci and gram-positive bacilli. In one clinical vignette of S. aureus uBSI due to debrided abscess, 11% of IDC would be comfortable using OAT vs 28% of NIDC; IDC were more likely to report routinely repeating blood cultures (99% vs 83%, p< 0.05). Figure 1: Clinician comfort using oral antibiotic therapy to treat uncomplicated bacteremia due to specific syndromes Figure 2: Clinician comfort using oral antibiotic therapy to treat uncomplicated bacteremia due to specific organisms Conclusion Considerable variation in comfort using OAT for uBSIs among IDC vs NIDC exists, highlighting opportunities for IDC to continue to demonstrate their value in clinical practice. Understanding the reasons for variability may be helpful in creating best practice guidelines to standardize decision making. Disclosures All Authors: No reported disclosures

Sign in / Sign up

Export Citation Format

Share Document