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  • Image not available. Folliculitis, furuncles (boils), and carbuncles begin around hair follicles and are caused most often by Staphylococcus aureus. Folliculitis and small furuncles are generally treated with warm, moist heat to promote drainage; large furuncles and carbuncles require incision and drainage. A penicillinase-resistant penicillin such as dicloxacillin is commonly used for extensive or serious infections (e.g., fever).
  • Image not available.Erysipelas, a superficial skin infection with extensive lymphatic involvement, is caused by Streptococcus pyogenes. The treatment of choice is penicillin, administered orally or parenterally, depending on the severity of the infection.
  • Image not available.Impetigo is a superficial skin infection that occurs most commonly in children. It is characterized by fluid-filled vesicles that develop rapidly into pus-filled blisters that rupture to form golden-yellow crusts. Effective therapy includes penicillinase-resistant penicillins (dicloxacillin), first-generation cephalosporins (cephalexin), and topical mupirocin. S. aureus is the primary cause of impetigo, with infections caused by community-associated methicillin-resistant S. aureus (CA-MRSA) emerging in recent years.
  • Image not available.Lymphangitis, an infection of the subcutaneous lymphatic channels, is generally caused by S. pyogenes. Acute lymphangitis is characterized by the rapid development of fine, red, linear streaks extending from the initial infection site toward the regional lymph nodes, which are usually enlarged and tender. Penicillin is the drug of choice.
  • Image not available.Cellulitis is an infection of the epidermis, dermis, and superficial fascia most commonly caused by S. pyogenes and S. aureus. Lesions generally are hot, painful, and erythematous, with nonelevated, poorly defined margins. Treatment generally consists of a penicillinase-resistant penicillin (dicloxacillin) or first-generation cephalosporin (cephalexin) for 5 to 10 days. Trimethoprim-sulfamethoxazole, with or without a β-lactam agent, or doxycycline should be considered for treatment of suspected staphylococcal infections in areas with a high prevalence of CA-MRSA.
  • Image not available.Necrotizing fasciitis is a rare but life-threatening infection of subcutaneous tissue that results in progressive destruction of superficial fascia and subcutaneous fat. Early and aggressive surgical debridement is an essential part of therapy for treatment of necrotizing fasciitis. Infections caused by S. pyogenes or Clostridium species should be treated with the combination of penicillin and clindamycin.
  • Image not available. Diabetic foot infections are managed with a comprehensive treatment approach that includes both proper wound care and antimicrobial therapy. Antimicrobial regimens for diabetic foot infections should include broad-spectrum coverage of staphylococci, streptococci, enteric gram-negative bacilli, and anaerobes. Outpatient therapy with oral antimicrobials should be used whenever possible for less severe infections.
  • Image not available. Prevention is the single most important aspect in the management of pressure sores. After a sore develops, successful local care includes a comprehensive approach consisting of relief of pressure, proper cleaning (debridement), disinfection, and appropriate antimicrobial therapy if an infection is present. Good wound care is crucial to successful management.
  • Image not available. All bite wounds (either animal or human) should be irrigated thoroughly with large volumes of sterile normal saline, and the injured area should be immobilized and elevated. Depending on the severity of the bite wound, amoxicillin-clavulanic acid or ampicillin-sulbactam are often used for treatment of animal bites because of their coverage of Pasteurella multocida, S. ...

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