Infectious Skin Diseases - Impetigo - Erysipelas and Cellulitis

16 important questions on Infectious Skin Diseases - Impetigo - Erysipelas and Cellulitis

What are the methods used for diagnosis?

  • Clinical presentation
  • CT or MRI
  • Skin biopsy for pathology, Gram stain, and tissue culture
  • Culture of fluid from bullae or fluctuant plaques
  • Blood cultures

What is the first-line treatment for erysipelas with penicillin?

  • Penicillin: 500 mg PO qid for 10 days
  • Dicloxacillin: 500 mg PO qid for 5-7 days
  • Warm compresses: tid

How is diagnosis confirmed according to the information?

Diagnosis is by clinical presentation and confirmation by culture if clinically indicated, such as bullae or abscess formation.
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What is the dosing for dicloxacillin in cellulitis treatment?

Dicloxacillin is dosed at 250-500 mg PO qid for 5-7 days in cellulitis treatment.

What is the most common pathogen responsible for erysipelas?

Group A β-hemolytic streptococcus is the most common pathogen responsible for erysipelas.

What is the treatment of choice for erysipelas?

Penicillin is the treatment of choice for erysipelas; parenteral therapy may be necessary for extensive or facial disease.

How is methicillin-resistant Staphylococcus aureus treated with linezolid?

Linezolid is dosed at 600 mg PO bid for 7-14 days for methicillin-resistant Staphylococcus aureus.

What systemic manifestations can S. pyogenes cause?

S. pyogenes produces enzymes that promote infection with systemic manifestations, such as fever and chills, tachycardia, and hypotension.

What is the recommended treatment for cellulitis?

An oral antistaphylococcal antibiotic is the treatment of choice for cellulitis; parenteral therapy is warranted for patients with extensive disease or systemic symptoms as well as for immunocompromised patients.

What is the treatment for penicillin allergy in erysipelas?

Clindamycin is dosed at 15 mg/kg/day PO tid for 10 days for penicillin allergy in erysipelas.

Which pathogen is most commonly associated with cellulitis?

Cellulitis: S. aureus is by far the most common pathogen for cellulitis. Left untreated, cellulitic skin can become bullous and necrotic, and an abscess or fasciitis, or both, can occur.

What supportive measures help expedite healing?

Good hygiene, warm compresses three or four times a day for 15 to 20 minutes, and elevation of the affected limb help to expedite healing.

What is the dosing for vancomycin in cellulitis treatment?

Vancomycin is dosed at 1-2 g IV daily in divided doses for 7 days in cellulitis treatment.

Describe the characteristics of erysipelas.

Erysipelas is a tender, well-defined, erythematous, indurated plaque on the face or legs.

How is azithromycin dosed for penicillin allergy in cellulitis?

Azithromycin is dosed at 500 mg PO × 1, then 250 mg PO daily for 4 days for penicillin allergy in cellulitis.

What symptoms often accompany cellulitis?

Cellulitis is often accompanied by constitutional symptoms, regional lymphadenopathy, and occasionally bacteremia.

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