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Skin Abscess

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41. The Massachusetts abscess rule: a clinical decision rule using ultrasound to identify methicillin-resistant Staphylococcus aureus in skin abscesses Full Text available with Trip Pro

The Massachusetts abscess rule: a clinical decision rule using ultrasound to identify methicillin-resistant Staphylococcus aureus in skin abscesses Treatment failure rates for incision and drainage (I&D) of skin abscesses have increased in recent years and may be attributable to an increased prevalence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA). Previous authors have described sonographic features of abscesses, such as the presence of interstitial fluid (...) , characteristics of abscess debris, and depth of abscess cavity. It is possible that the sonographic features are associated with MRSA and can be used to predict the presence of MRSA. The authors describe a potential clinical decision rule (CDR) using sonographic images to predict the presence of CA-MRSA.This was a pilot CDR derivation study using databases from two emergency departments (EDs) of patients presenting to the ED with uncomplicated skin abscesses who underwent I&D and culture of the abscess

2014 EvidenceUpdates

42. Do Oral Antibiotics After Incision and Drainage of Simple Abscesses Improve Cure Rates?

the need for hospitalization or operating room drainage. Clinical cure was de?ned as improvement or resolution of signs and symptoms without concerns for treatmentfailure.Two independent investigators screened for articles meeting the inclusion criteria. ANNALS OF EMERGENCY MEDICINE JANUARY 2015 112 Annals of Emergency Medicine Volume 65, no. 1 : January 2015approximately 3.2% of all ED visits. 2 Twenty-two percent of new skin infection visits were for abscess. 2 In one study, 63% of abscesses were (...) abscesses: a meta-analysis. Emerg Med J. http://dx.doi.org/10.1136/emermed-2013- 202571. 1. Schmitz GR, Bruner D, Pitotti R, et al. Randomized controlled trial of trimethoprim-sulfamethoxazole for uncomplicated skin abscesses in patients at risk for community-associated methicillin- resistant Staphylococcus aureus infection. Ann Emerg Med. 2010;56: 283-287. 2. Pallin DJ, Camargo CA Jr, Schuur JD. Skin infections and antibiotic stewardship: analysis of emergency department prescribing practices, 2007

2015 Annals of Emergency Medicine Systematic Review Snapshots

43. Management of community-associated methicillin-resistant Staphylococcus aureus skin abscesses in children

Management of community-associated methicillin-resistant Staphylococcus aureus skin abscesses in children Uncomplicated skin abscesses in previously well children are typically managed with drainage alone. An increasing percentage of such abscesses are due to methicillin-resistant Staphylococcus aureus infections. Although definitive data are lacking, drainage alone appears to be a reasonable strategy for methicillin-resistant S aureus skin abscesses, with antibiotics reserved for infants (...) younger than three months of age, or for children who are systemically unwell, have underlying medical problems or have significant surrounding cellulitis.  Key Words: Methicillin-resistant; Skin abscess; Staphylococcus aureus  

2011 Canadian Paediatric Society

44. Primary Care Corner with Geoffrey Modest: antibiotics for skin abscesses?

Primary Care Corner with Geoffrey Modest: antibiotics for skin abscesses? Primary Care Corner with Geoffrey Modest: antibiotics for skin abscesses? | BMJ EBM Spotlight by by Dr Geoffrey Modest A recent article found that either clindamycin or trimethoprim/sulfamethoxazole (TMP/SMX) are superior to placebo for uncomplicated skin abscesses (see Daum RS. N Engl J Med 2017;376:2545-55 ). Details: — multicenter, prospective, double-blind trial of 786 outpatient adults and children who had a skin (...) infections Commentary: — Skin abscesses are quite common, affecting 4% of people in the United States annually. Often these are treated as outpatients with clindamycin or TMP/SMX, given the large percent of community MRSA — In this study TMP/SMX was effective at a lower dose than often prescribed, though a 10-day course was given (vs 7 days). It is possible that the cure rates might have been higher with higher doses of TMP/SMX — 13 patients had resistance to clindamycin and did not fare as well (54

2017 Evidence-Based Medicine blog

45. Bacterial Etiology and Risk Factors Associated with Cellulitis and Purulent Skin Abscesses in Military Trainees. Full Text available with Trip Pro

Bacterial Etiology and Risk Factors Associated with Cellulitis and Purulent Skin Abscesses in Military Trainees. Military trainees are at high risk for skin and soft-tissue infections (SSTIs). Although Staphylococcus aureus is associated with purulent SSTI, it is unclear to what degree this pathogen causes nonpurulent cellulitis. To inform effective prevention strategies and to provide novel insights into SSTI pathogenesis, we aimed to determine the etiology of SSTI in this population. We (...) conducted a prospective observational study in US Army Infantry trainees with SSTI (cutaneous abscesses and cellulitis) from July 2012 through December 2014. We used standard microbiology, serology, and high-throughput sequencing to determine the etiology of SSTI. Furthermore, we compared purported risk factors as well as anatomic site colonization for S. aureus. Among 201 SSTI cases evaluated for SSTI risk factors, cellulitis was associated with lower extremity blisters (P = 0.01) and abscess

2016 PLoS ONE

46. Mastitis and breast abscess

: Symptoms do not improve, or are worsening, after 12–24 hours despite effective milk removal. Bacterial culture in breast milk is positive. A breast abscess should be suspected if the woman has: A history of recent mastitis. A painful, swollen lump in the breast, with redness, heat, and swelling of the overlying skin. Fever and/or general malaise. If a breast abscess is suspected, the woman should be referred urgently to a general surgeon for confirmation of the diagnosis and management (...) of S. aureus on a person's skin or mucous membranes (colonization) is implicated in recurrent infections. For more information, see in the CKS topic on . Previous mastitis — this association is thought to be due to inadequate treatment of previous mastitis (which can lead to a recurrence of more severe mastitis or a breast abscess) and/or inadequate management of predisposing factors. [ ; ; ; ; ; ; ] Mastitis - non-lactating women Predisposing factors for mastitis in non-lactating women Smoking

2018 NICE Clinical Knowledge Summaries

47. Dental abscess

. A fistula or sinus tract may develop that can discharge intraorally or into the overlying skin. Spread of infection (more common in immunocompromised and elderly people), for example: Maxillary sinusitis. Cellulitis/periorbital cellulitis. Osteomyelitis. Retropharyngeal abscess. Cavernous sinus thrombosis. Encephalitis and meningitis. Brain abscess. Mediastinitis. Ludwig's angina — a serious, potentially life-threatening infection of the tissues of the floor of the mouth. Symptoms include swelling, pain (...) Dental abscess Dental abscess - NICE CKS Share Dental abscess: Summary A dental abscess is a localized collection of pus in the teeth, supporting structures of the teeth, or gums. The two main types of dental abscess are: Periapical abscess (dentoalveolar abscess) — originates in the dental pulp (centre of the tooth), and is the most frequently occurring type (both in adults and children). Periodontal abscess — originates in the supporting structures of the teeth (such as the periodontal

2018 NICE Clinical Knowledge Summaries

48. Management of Anorectal Abscess, Fistula-in-Ano, and Rectovaginal Fistula

occurs more often in males than females, and may occur at any age, with peak incidence among 20 to 40 year olds. 4,8–12 in general, the abscess is treated with prompt incision and drainage. 4,6,10,13 fistula-in-ano is a tract that connects the perine- al skin to the anal canal. in patients with an anorec- tal abscess, 30% to 70% present with a concomitant fistula-in-ano, and, in those who do not, one-third will be diagnosed with a fistula in the months to years after abscess drainage. 2,5,8–10,13–16 (...) Management of Anorectal Abscess, Fistula-in-Ano, and Rectovaginal Fistula Copyright © The American Society of Colon & Rectal Surgeons, Inc. Unauthorized reproduction of this article is prohibited. 1117 Diseases of the Colon & ReCtum Volume 59: 12 (2016) t he a merican society of Colon and Rectal sur- geons is dedicated to ensuring high-quality pa- tient care by advancing the science, prevention, and management of disorders and diseases of the co- lon, rectum, and anus. t he Clinical Practice

2016 American Society of Colon and Rectal Surgeons

49. Spinal epidural abscess caused by Pasteurella multocida mimicking aortic dissection: a case report. Full Text available with Trip Pro

Spinal epidural abscess caused by Pasteurella multocida mimicking aortic dissection: a case report. Pasteurella multocida (P. multocida) forms part of the normal flora of many animals. Although it is a common causative agent of skin and soft tissue infection after an animal bite or scratch, in rare cases it can cause spinal infections in humans.A 68-year-old immunocompetent woman presented with fever and sudden onset of severe back pain mimicking aortic dissection. No findings related (...) to the pain were revealed on enhanced computed tomography or initial magnetic resonance imaging (MRI) of the spine. The patient was found to be bacteremic with P. multocida, although she had no apparent injury related to animal contact. Repeated evaluation by MRI with gadolinium-contrast established the diagnosis of spinal epidural abscess. The patient was cured by the rapid initiation of antimicrobial therapy without surgery.We describe the successful treatment of an individual with a spinal epidural

2019 BMC Infectious Diseases

50. Comparison of Minimally Invasive Loop Drainage and Standard Incision and Drainage of Cutaneous Abscesses in Children Presenting to a Pediatric Emergency Department: A Prospective, Randomized, Noninferiority Trial. (Abstract)

Comparison of Minimally Invasive Loop Drainage and Standard Incision and Drainage of Cutaneous Abscesses in Children Presenting to a Pediatric Emergency Department: A Prospective, Randomized, Noninferiority Trial. This study aimed to determine whether the treatment of skin abscesses with vessel loop drainage is noninferior to standard incision and drainage (I&D) regarding treatment failure in pediatric patients in the emergency department (ED).This study was a prospective, randomized controlled (...) trial in a pediatric ED of an urban tertiary pediatric hospital. Patients with a skin abscess were enrolled. Subjects were assigned to the control arm of I&D or the study arm of vessel loop drainage. Study end points (failure rates, satisfaction scores, wound appearance, visit frequency) were assessed before discharge from the ED, at 24- to 48-hour follow-up, and at 14-day follow-up. Treatment failure was declared if the abscess required reinstrumentation or admission for intravenous antibiotics

2019 Pediatric Emergency Care Controlled trial quality: predicted high

51. [Application of closed negative pressure irrigation and suction device in the treatment of high perianal abscess]. (Abstract)

method, the patients were randomly divided into negative pressure irrigation and suction group and routine drainage group. All patients were clearly diagnosed and the location and size of the perianal abscess were marked before surgery. These two groups were treated as follows: (1) Negative pressure irrigation and suction group: the skin was incised at a diameter of 1-2 cm at the site where the abscess fluctuated most obviously. After the abscess was removed, a closed negative pressure irrigation (...) and suction device was installed and the pressure of -200 to -100 mmHg (1 mmHg=0.133 kPa) was maintained to keep the abscess cavity collapsed. Generally, the irrigation was stopped 5 days later or when the drainage was clear. The closed vacuum suction was maintained for 2 additional days, before the wound was sutured. (2) Conventional drainage group: conventional incision and drainage was carried out. The skin was cut at a diameter of 8 to 10 cm at the site of abscess with most obvious fluctuation. After

2019 Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery Controlled trial quality: uncertain

52. A Novel Silicon Device for the Packing of Cutaneous Abscesses. (Abstract)

A Novel Silicon Device for the Packing of Cutaneous Abscesses. Superficial skin abscesses are commonly encountered in emergency medicine practice. Standard treatment includes incision, drainage, and often packing with a gauze strip. The packing component of the procedure has several negative potential outcomes, is painful, and necessitates a return visit for removal.Here we report the first case in which a novel silicon packing device was utilized. The patient presented with a facial abscess

2019 Journal of Emergency Medicine

53. Pilot Study to Evaluate the Adjunct Use of a Povidone-Iodine Topical Antiseptic in Patients with Soft Tissue Abscesses. (Abstract)

Pilot Study to Evaluate the Adjunct Use of a Povidone-Iodine Topical Antiseptic in Patients with Soft Tissue Abscesses. Povidone-iodine (PVP-I) antiseptic solutions have been shown to be effective against methicillin-resistant Staphylococcal aureus, a common cause of superficial skin abscesses.Our objective was to study the feasibility of using PVP-I as a treatment adjunct in patients with superficial skin abscesses and determine if it confers any benefit over incision and drainage (I&D (...) ) alone.This was a randomized controlled pilot study of adult patients with an uncomplicated skin abscess. Patients were randomized to PVP-I or standard treatment. All patients had I&D and abscess packing. Patients randomized to PVP-I were instructed on daily application of the agent to hands, wound, and surrounding skin with dressing changes. Subjects returned at 48-72 h and 7-10 days and followed-up by phone at 30 days. The primary outcome was clinical cure 7-10 days after I&D. The secondary outcomes

2019 Journal of Emergency Medicine

54. Uncomplicated Skin Abscess

Uncomplicated Skin Abscess Rotation Prep | NEJM Resident 360 Social Login Email Login Log in via Email Create Your Account We will not share your email with anyone. Password must be at least 8 characters. Show or Hide the password you are typing. Request to Join has invited you to join this group Your browser does not support video tags Welcome! NEJM Resident 360 helps you prepare for your next rotation quickly and efficiently, provides support for coping with the pressures of resident life

2016 Now@NEJM

55. New Clinical Decisions article: Skin Abscess

New Clinical Decisions article: Skin Abscess Rotation Prep | NEJM Resident 360 Social Login Email Login Log in via Email Create Your Account We will not share your email with anyone. Password must be at least 8 characters. Show or Hide the password you are typing. Request to Join has invited you to join this group Your browser does not support video tags Welcome! NEJM Resident 360 helps you prepare for your next rotation quickly and efficiently, provides support for coping with the pressures

2016 Now@NEJM

56. Scleredema Diabeticorum with Superimposed Cellulitis and Abscess Formation Full Text available with Trip Pro

Scleredema Diabeticorum with Superimposed Cellulitis and Abscess Formation Scleredema diabeticorum is a rare cutaneous manifestation of diabetes mellitus. We present a case of an obese male with poorly controlled diabetes who came to the hospital with upper back pain and subsequently developed sepsis due to a small deep-seated abscess in his back that was drained and treated with antibiotics. He was also found to have extensive induration of the skin over his back and neck. Skin biopsy

2018 Case reports in endocrinology

57. Staphylococcus pseudintermedius Surface Protein L (SpsL) Is Required for Abscess Formation in a Murine Model of Cutaneous Infection Full Text available with Trip Pro

Staphylococcus pseudintermedius Surface Protein L (SpsL) Is Required for Abscess Formation in a Murine Model of Cutaneous Infection Staphylococcus pseudintermedius is the leading cause of pyoderma in dogs and is often associated with recurrent skin infections that require prolonged antibiotic therapy. High levels of antibiotic use have led to multidrug resistance, including the emergence of epidemic methicillin-resistant clones. Our understanding of the pathogenesis of S. pseudintermedius skin (...) deficient in expression of SpsD led to a focal accumulation of neutrophils and necrotic debris in the dermis and deeper tissues of the skin characteristic of a classical cutaneous abscess. In contrast, mice infected with mutants deficient in SpsL or both SpsD and SpsL developed larger cutaneous lesions with distinct histopathological features of regionally extensive cellulitis rather than focal abscessation. Furthermore, comparison of the bacterial loads in S. pseudintermedius-induced cutaneous lesions

2018 Infection and immunity

58. Staphylococcus lugdunensis from gluteal abscess to destructive native triple valve endocarditis Full Text available with Trip Pro

Staphylococcus lugdunensis from gluteal abscess to destructive native triple valve endocarditis We herein present the case of a 43-year-old male diabetic patient who presented with an aggressive form of infective endocarditis involving the tricuspid, mitral and aortic valves following a gluteal abscess due to infection with Staphylococcus lugdunensis. This coagulase-negative organism which is generally considered a component of the normal flora of the skin has however recently emerged

2018 Saudi medical journal

59. Methicillin-resistant Staphylococcus aureus prostatic abscess after traumatic rectal injury Full Text available with Trip Pro

Methicillin-resistant Staphylococcus aureus prostatic abscess after traumatic rectal injury Methicillin-resistant Staphylococcus aureus (MRSA) commonly causes infection of the skin, soft tissue, bones and heart. MRSA is a rarely reported organism of prostatic abscess (PA). We present a case of an intravenous drug user who presented with dyspareunia, dysuria and dyschezia after a traumatic injury to the rectum. He was diagnosed with PA, which was treated with transurethral resection (...) of the prostate drainage and intravenous antibiotics. MRSA PA carries a low case fatality rate on early diagnosis and treatment with proper antibiotics with or without drainage of the abscess.

2018 Oxford Medical Case Reports

60. Spontaneous subconjunctival abscess in congenital lamellar ichthyosis Full Text available with Trip Pro

Spontaneous subconjunctival abscess in congenital lamellar ichthyosis Congenital lamellar ichthyosis is an autosomal recessive, heterogeneous disorder presenting at birth with generalized skin involvement. The most common ophthalmic manifestation noted is bilateral ectropion of the lower eyelids. A 1-month-old female neonate, the second born of a nonconsanguineous marriage, presented with 4 days' history of redness, discharge, and swelling in the right eye. There was severe right upper eyelid (...) ectropion, conjunctival injection, chemosis, a subconjunctival mass on the temporal bulbar conjunctiva spontaneously draining pus and corneal haze. The anterior chamber, iris, lens and fundus appeared normal. Congenital lamellar ichthyosis was suspected because of scaling and excessive dryness of the entire body. The occurrence of a spontaneous subconjunctival abscess is not known in lamellar ichthyosis. We thus report the management of a rare case of unilateral upper eyelid ectropion, subconjunctival

2018 Indian journal of ophthalmology

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