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Skin Abscess

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41. Primary Care Corner with Geoffrey Modest MD: TMP/SMX For Uncomplicated Skin Abscesses

Primary Care Corner with Geoffrey Modest MD: TMP/SMX For Uncomplicated Skin Abscesses Primary Care Corner with Geoffrey Modest MD: TMP/SMX For Uncomplicated Skin Abscesses | BMJ EBM Spotlight by By Dr. Geoffrey Modest NEJM just a published a study looking at trimethoprim-sulfamethoxazole (TMP/SMX) vs placebo in patients with uncomplicated skin abscesses (see N Engl J Med 2016;374:823). Details: Study done in 5 US ERs, assessing TMP/SMX at dose of 320mg/1600mg (i.e., two DS tablets) twice daily (...) (n=630) for 7 days vs placebo (n=617). Patients had to have the abscess for at least 1 week, and it had to be at least 2cm in diameter, including the induration. Mean age 35; 58% male; 4.0 days of symptoms; 18% with fever; 11% diabetic; 4% with chronic skin conditions; site: 13% head/neck, 21% trunk/abdomen/back, 21% groin/buttocks, 23% arms/hands, 21% legs/feet; mean abscess size 2.5 cm x 2.0 cm x 5cm deep; erythema 7.0×5.0cm; wound culture: 45% MRSA, 16% methicillin-sensitive S. aureus, 12

2016 Evidence-Based Medicine blog

42. Trichosporon inkin causing invasive infection with multiple skin abscesses in a renal transplant patient successfully treated with voriconazole (PubMed)

Trichosporon inkin causing invasive infection with multiple skin abscesses in a renal transplant patient successfully treated with voriconazole 29296646 2019 02 26 2352-5126 4 1 2018 Jan JAAD case reports JAAD Case Rep Trichosporon inkin causing invasive infection with multiple skin abscesses in a renal transplant patient successfully treated with voriconazole. 27-29 10.1016/j.jdcr.2017.10.008 Jannic Arnaud A Department of Dermatology, Saint-Louis Hospital, Paris, France. Université Paris

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2017 JAAD Case Reports

43. A Case of Recurrent Skin Abscesses: A Conundrum Solved after Obtaining a Thorough Sexual History (PubMed)

A Case of Recurrent Skin Abscesses: A Conundrum Solved after Obtaining a Thorough Sexual History Background. Despite the improvement in patient-physician communication techniques, sexuality and sexual health continue to be challenging areas for discussion during a clinical encounter. Most people are not prepared to discuss sexual matters openly as it can be perceived as negative or inappropriate. Consequently, an incomplete health assessment can result in delayed diagnosis or misdiagnosis. Case (...) Report. We present a 33-year-old woman who developed recurrent left breast abscesses. She required multiple incision and drainage procedures in the operating room followed by antimicrobial therapy. Although she always had an initial improvement with this approach, she continued to have recurrences and development of new abscesses in other body areas. The polymicrobial nature of her recurrences prompted an extensive and costly workup to determine the nature of her condition. The cause was finally

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2017 Case reports in infectious diseases

44. Multiple Liver Abscesses with a Skin Pustule due to Chromobacterium violaceum (PubMed)

Multiple Liver Abscesses with a Skin Pustule due to Chromobacterium violaceum A 69-year-old woman was admitted to our hospital with the chief complaints of fever and fatigue. We initially treated the patient for a tick-borne disease after noticing a pustule on her leg; however, abdominal computed tomography (CT) showed multiple low-density areas in the liver and Chromobacterium violaceum was isolated from a blood culture. We diagnosed her with multiple liver abscesses secondary

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2017 Internal Medicine

45. Sulfamethoxazole-Trimethoprim (Cotrimoxazole) for Skin and Soft Tissue Infections Including Impetigo, Cellulitis, and Abscess (PubMed)

Sulfamethoxazole-Trimethoprim (Cotrimoxazole) for Skin and Soft Tissue Infections Including Impetigo, Cellulitis, and Abscess Skin and soft tissue infections (SSTI) affect millions of people globally, which represents a significant burden on ambulatory care and hospital settings. The role of sulfamethoxazole-trimethoprim (SXT) in SSTI treatment, particularly when group A Streptococcus (GAS) is involved, is controversial. We conducted a systematic review of clinical trials and observational (...) support SXT use for treatment of impetigo and purulent cellulitis (without an additional β-lactam agent) and abscess and wound infection. For nonpurulent cellulitis, β-lactams remain the treatment of choice.

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2017 Open forum infectious diseases

46. The Massachusetts abscess rule: a clinical decision rule using ultrasound to identify methicillin-resistant Staphylococcus aureus in skin abscesses (PubMed)

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

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2014 EvidenceUpdates

47. There?s Pus About, So Are Antibiotics In or Out? Adding antibiotics for abscess management

research. www.acfp.ca January 21, 2019 There’s Pus About, So Are Antibiotics In or Out? Adding antibiotics for abscess management Clinical Question: Does the addition of antibiotics to incision and drainage improve cure rates in single, uncomplicated skin abscesses? Bottom Line: Adding antibiotics that cover MRSA during incision and drainage for a small abscess increases the cure rate from 85% to 92%, meaning an additional one in 15 patients will be cured compared to placebo at one month. Approximately (...) There?s Pus About, So Are Antibiotics In or Out? Adding antibiotics for abscess management Tools for Practice is proudly sponsored by the Alberta College of Family Physicians (ACFP). ACFP is a provincial, professional voluntary organization, representing more than 5,000 family physicians, family medicine residents, and medical students in Alberta. Established over sixty years ago, the ACFP strives for excellence in family practice through advocacy, continuing medical education and primary care

2019 Tools for Practice

48. Is Loop Drainage Technique More Effective for Treatment of Soft Tissue Abscess Compared With Conventional Incision and Drainage?

Is Loop Drainage Technique More Effective for Treatment of Soft Tissue Abscess Compared With Conventional Incision and Drainage? TAKE-HOME MESSAGE Loop drainage technique may be associated with lower failure rate than conventional incision and drainage in treatment of skin and soft tissue abscesses, but data are limited. Further randomized controlled trial data are required. Is Loop Drainage Technique More Effective for Treatment of Soft Tissue Abscess Compared With Conventional Incision (...) in children. J Pediatr Surg. 2011;46:502-506. 3. Ladde JG, Baker S, Rodgers CN, et al. The LOOP technique: a novel incision and drainage technique in the treatment of skin abscesses in a pediatric ED. Am J Emerg Med. 2015;33:271-276. 4. Gaszynski R, Punch G, Verschuer K. Loop and drain technique for subcutaneous abscess: a safe minimally invasive procedure in an adult population. ANZ J Surg. 2018;88:87-90. 5. Özturan _ IU, Do gan NÖ, Karakayali O, et al. Comparison of loop and primary incision

2018 Annals of Emergency Medicine Systematic Review Snapshots

49. Internal dressings for healing perianal abscess cavities. (PubMed)

Internal dressings for healing perianal abscess cavities. A perianal abscess is a collection of pus under the skin, around the anus. It usually occurs due to an infection of an anal gland. In the UK, the annual incidence is 40 per 100,000 of the adult population, and the standard treatment is admission to hospital for incision and drainage under general anaesthetic. Following drainage of the pus, an internal dressing (pack) is placed into the cavity to stop bleeding. Common practice (...) , or study setting.Published or unpublished randomised controlled trials (RCTs) comparing any type of internal dressing (packing) used in the post-operative management of perianal abscess cavities with alternative treatments or different types of internal dressing.Two review authors independently performed study selection, risk of bias assessment, and data extraction.We included two studies, with a total of 64 randomised participants (50 and 14 participants) aged 18 years or over, with a perianal abscess

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2016 Cochrane

50. Community-Assoc. S. Aureus Colonization and Recurrent Infection in Pts With Uncomplicated S. Aureus Skin Abscesses

Community-Assoc. S. Aureus Colonization and Recurrent Infection in Pts With Uncomplicated S. Aureus Skin Abscesses Community-Assoc. S. Aureus Colonization and Recurrent Infection in Pts With Uncomplicated S. Aureus Skin Abscesses - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number (...) of saved studies (100). Please remove one or more studies before adding more. Community-Assoc. S. Aureus Colonization and Recurrent Infection in Pts With Uncomplicated S. Aureus Skin Abscesses (CIRCUS) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02690415 Recruitment Status : Enrolling by invitation

2016 Clinical Trials

51. Primary Care Management of Skin Abscesses Guided by Ultrasound. (PubMed)

Primary Care Management of Skin Abscesses Guided by Ultrasound. Primary care providers often manage skin abscesses in the outpatient setting. Estimating the size and depth of an abscess, and distinguishing abscess from cellulitis by clinical examination can be challenging due to surrounding firm tissue induration. Definitive treatment of abscess requires incision and drainage, and the approach chosen may be altered by abscess size, depth, and surrounding neurovascular structures.For 31 (...) consecutive patients seen in the primary care outpatient clinic, we prospectively compared the estimated size of skin abscesses by clinical examination with that determined by ultrasound. Prior to incision and drainage, a limited point-of-care ultrasound examination was performed and the abscess dimensions were measured, the depth was determined, and adjacent vascular structures were noted. Based on ultrasound findings, physicians reported whether the decision to perform the procedure or the techniques

2016 American Journal of Medicine

52. Comparison of trimethoprim-sulfamethoxazole versus placebo for uncomplicated skin abscesses. (PubMed)

Comparison of trimethoprim-sulfamethoxazole versus placebo for uncomplicated skin abscesses. Clinical question In patients with uncomplicated abscesses receiving incision and drainage, does the addition of trimethoprim-sulfamethoxazole result in improved clinical resolution at 7 to 14 days after treatment when compared with placebo? Article chosen Talan DA, Mower WR, Krishnadasan A, et al. Trimethoprim-sulfamethoxazole versus placebo for uncomplicated skin abscess. N Engl J Med 2016;374(9):823 (...) -32.The primary objective of this study was to compare the clinical cure rates at 7 to 14 days after the end of the treatment period among patients receiving either trimethoprim-sulfamethoxazole (TMP-SMX) or placebo. Secondary outcomes included composite cure; surgical drainage procedures; change in erythema size; presence of swelling, induration, or tenderness; invasive infections; skin infections at the same site and different sites; hospitalizations; similar infections in household contacts

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2016 CJEM

53. Trimethoprim-Sulfamethoxazole versus Placebo for Uncomplicated Skin Abscess. (PubMed)

Trimethoprim-Sulfamethoxazole versus Placebo for Uncomplicated Skin Abscess. U.S. emergency department visits for cutaneous abscess have increased with the emergence of methicillin-resistant Staphylococcus aureus (MRSA). The role of antibiotics for patients with a drained abscess is unclear.We conducted a randomized trial at five U.S. emergency departments to determine whether trimethoprim-sulfamethoxazole (at doses of 320 mg and 1600 mg, respectively, twice daily, for 7 days) would be superior (...) to placebo in outpatients older than 12 years of age who had an uncomplicated abscess that was being treated with drainage. The primary outcome was clinical cure of the abscess, assessed 7 to 14 days after the end of the treatment period.The median age of the participants was 35 years (range, 14 to 73); 45.3% of the participants had wound cultures that were positive for MRSA. In the modified intention-to-treat population, clinical cure of the abscess occurred in 507 of 630 participants (80.5

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2016 The New England journal of medicine

54. Skin Abscess

Skin Abscess Skin Abscess Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Skin Abscess Skin Abscess Aka: Skin Abscess , Furunculosis (...) , Furuncle , Carbuncle , Skin Boil , Recurrent Skin Abscess From Related Chapters II. Definitions Abscess Walled-off of purulent infection Firm wall with inner fluctuant core Carbuncle Coalition of Furuncles Deeper, more extensive involvement Require greater degree of debridement III. Pathophysiology infection that spreads to deeper tissue (often begins as ) IV. Risk Factors Impaired function use V. Causes (most common) species Mixed VI. Signs Tender, erythematous skin mass Often spontaneously opens

2018 FP Notebook

55. A Prescription for Resistance: Management of Staphylococcal Skin Abscesses by General Practitioners in Australia (PubMed)

A Prescription for Resistance: Management of Staphylococcal Skin Abscesses by General Practitioners in Australia We investigated the management of staphylococcal abscesses (boils) by general practitioners (GPs) in the context of rising antibiotic resistance in community strains of Staphylococcus aureus.We analyzed patient-reported management of 66 cases of uncomplicated skin abscesses from the frequency matched methicillin-resistant S. aureus (MRSA) and methicillin-sensitive S. aureus (MSSA (...) was performed in only 60.6% of 66 patients, and antibiotics were always prescribed. The prescribed antibiotics were frequently inactive and often changed, and did not appear to affect patient recovery. Our results show that community GPs can confidently reduce their use of antibiotics for patients with skin abscesses and should be aware that MRSA is a much more common in this type of infection.

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2016 Frontiers in microbiology

56. Contribution of Staphylococcus aureus Coagulases and Clumping Factor A to Abscess Formation in a Rabbit Model of Skin and Soft Tissue Infection (PubMed)

Contribution of Staphylococcus aureus Coagulases and Clumping Factor A to Abscess Formation in a Rabbit Model of Skin and Soft Tissue Infection Staphylococcus aureus produces numerous factors that facilitate survival in the human host. S. aureus coagulase (Coa) and von Willebrand factor-binding protein (vWbp) are known to clot plasma through activation of prothrombin and conversion of fibrinogen to fibrin. In addition, S. aureus clumping factor A (ClfA) binds fibrinogen and contributes (...) to platelet aggregation via a fibrinogen- or complement-dependent mechanism. Here, we evaluated the contribution of Coa, vWbp and ClfA to S. aureus pathogenesis in a rabbit model of skin and soft tissue infection. Compared to skin abscesses caused by the Newman wild-type strain, those caused by isogenic coa, vwb, or clfA deletion strains, or a strain deficient in coa and vwb, were significantly smaller following subcutaneous inoculation in rabbits. Unexpectedly, we found that fibrin deposition and abscess

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2016 PloS one

57. BET 1: Trimethoprim-sulfamethoxazole in uncomplicated skin abscess. (PubMed)

BET 1: Trimethoprim-sulfamethoxazole in uncomplicated skin abscess. A short cut review was carried out to establish whether incision and drainage followed by treatment with oral trimethoprim-sulfamethoxazole is better than incision and drainage alone at treating patients with uncomplicated skin abscesses. One hundred and ninety-seven papers were found using the reported searches, of which three presented the best evidence to answer the clinical question. The author, date and country (...) of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. It is concluded that trimethoprim-sulfamethoxazole may help with abscess cure, and will decrease abscess formation at new sites.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

2016 Emergency Medicine Journal

58. Point-of-Care Ultrasound for Diagnosis of Abscess in Skin and Soft Tissue Infections. (PubMed)

Point-of-Care Ultrasound for Diagnosis of Abscess in Skin and Soft Tissue Infections. Traditionally, emergency department (ED) physicians rely on their clinical examination to differentiate between cellulitis and abscess when evaluating skin and soft tissue infections (SSTI). Management of an abscess requires incision and drainage, whereas cellulitis generally requires a course of antibiotics. Misdiagnosis often results in unnecessary invasive procedures, sedations (for incision and drainage (...) in pediatric patients), or a return ED visit for failed antibiotic therapy.The objective was to describe the operating characteristics of point-of-care ultrasound (POCUS) compared to clinical examination in identifying abscesses in ED patients with SSTI.We systematically searched Medline, Web of Science, EMBASE, CINAHL, and Cochrane Library databases from inception until May 2015. Trials comparing POCUS with clinical examination to identify abscesses when evaluating SSTI in the ED were included. Trials

2016 Academic Emergency Medicine

59. Trimethoprim-Sulfamethoxazole Therapy Reduces Failure and Recurrence in Methicillin-Resistant Staphylococcus aureus Skin Abscesses after Surgical Drainage. (PubMed)

Trimethoprim-Sulfamethoxazole Therapy Reduces Failure and Recurrence in Methicillin-Resistant Staphylococcus aureus Skin Abscesses after Surgical Drainage. To determine whether a 3-day vs 10-day course of antibiotics after surgical drainage of skin abscesses is associated with different failure and recurrence rates.Patients age 3 months to 17 years seeking care at a pediatric emergency department with an uncomplicated skin abscess that required surgical drainage were randomized to receive 3 (...) difference 10.3%, 95% CI 0.8%-19.9%).Patients with MRSA skin abscesses are more likely to experience treatment failure and recurrent skin infection if given 3 rather than 10 days of trimethoprim-sulfamethoxazole after surgical drainage.ClinicalTrials.gov: NCT02024867.Copyright © 2016 Elsevier Inc. All rights reserved.

2016 Journal of Pediatrics

60. Management of Skin Abscesses

Management of Skin Abscesses 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

2014 Now@NEJM

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