Tags: Skin infections


Essentials of Diagnosis Characteristic pattern of inflammation on glabrous skin surfaces. The active border of infection is scaly, red, and slightly elevated. Wet mount preparation with potassium hydroxide (10-20%). Skin scraping of the active border shows branching, translucent, rod-shaped filaments (hyphae) in keratinized material under low-power microscopy (10-40×). Hyphae are uniformly wide and regularly septated. Wood's light examination (UV light at 365 nm) shows blue-green fluorescence for Microsporum canis and Microsporum audouinii. Trichophyton schoenleinii is pale green, and tinea versicolor shows white-yellow fluorescence. Culture should be performed with hair, nail, and skin specimens from particularly inflammatory lesions, to make a definitive mycologic diagnosis. General Considerations Dermatophytes are molds that infect keratinized […]

Candida Dermatitis (Candida rash)

Clinical Findings Signs and Symptoms Skin infections with Candida are common and may manifest in a variety of forms. Intertrigo occurs in warm, moist areas of skin, such as under the breast, in the groin, and in the axilla. Initially pustular or vesicular, lesions eventually become confluent to form an erythematous, macerated area of skin with a scalloped border and satellite lesions (Box 1). Erosio interdigitalis blastomycetica is similar to intertrigo but involves the areas between the fingers and toes. Paronychia is infection of the nail bed, seen more commonly in diabetics and people who frequently immerse their hands in water. Candida spp. may cause onychomycosis, particularly in HIV-infected patients. Candida […]

Pseudomonas Aeruginosa

Essentials of Diagnosis Nosocomial acquisition. Predisposing factors include immunosuppression (neutropenia, cystic fibrosis [CF], AIDS, corticosteroid use, diabetes mellitus); presence of a foreign body, prosthesis, or instrumentation; prolonged hospitalization and antibiotic use; intravenous drug use. Most common infections include pneumonia, bacteremia, urinary tract infection, otitis media, skin and skin structure infections, including ecthyma gangrenosa. Gram stain shows gram-negative bacilli; recovery of microorganism from culture of blood or other tissue. General Considerations Epidemiology The genus Pseudomonas consists of a number of human pathogens, the most important of which is Pseudomonas aeruginosa. P aeruginosa is an opportunistic pathogen found widely in soil, water, and organic material, reflecting its limited nutritional requirements. A moist environment […]

Gram-Positive Aerobic Bacilli

LISTERIA MONOCYTOGENES Essentials of Diagnosis Incriminated foods include unpasteurized milk, soft cheeses, undercooked poultry, and unwashed raw vegetables. Asymptomatic fecal and vaginal carriage can result in sporadic neonatal disease from transplacental and ascending routes of infection. Incubation period for foodborne transmission is 21 days. Organism causes disease especially in neonates, pregnant women, immunocompromised hosts, and elderly. Organism is grown from blood, cerebrospinal fluid (CSF), meconium, gastric washings, placenta, amniotic fluid, and other infected sites. General Considerations Epidemiology L monocytogenes is found in soil, fertilizer, sewage, and stream water; on plants; and in the intestinal tracts of many mammals. It is a foodborne pathogen that causes bacteremic illness and meningoencephalitis, with few […]


STAPHYLOCOCCUS AUREUS Essentials of Diagnosis Large gram-positive cocci (0.7-1.5 um in size). Colonies surrounded by zone of hemolysis on blood agar. Colonies pigmented pale yellow to deep orange macroscopically. Cluster in grapelike bunches microscopically. Biochemically differentiated from streptococci by presence of the enzyme catalase. Biochemically differentiated from other staphylococci by presence of the enzyme coagulase. Analysis of chromosomal DNA can identify clonal isolates (useful in epidemiologic studies). General Considerations Epidemiology Staphylococcus aureus colonizes the human skin, vagina, nasopharynx, and gastrointestinal tract. Colonization occurs shortly after birth and may be either transient or persistent. Published studies differ widely in estimates of the prevalence of S aureus carriage. Between 10% and 35% of […]

Nonpyogenic Skin Infections

Clinical Findings Signs and Symptoms Impetigo and staphylococcal scalded skin syndrome (SSSS) are primarily childhood diseases. More than 70% of cases of impetigo are caused by S aureus, with the remainder attributed to pyogenic streptococci or mixed infection. Impetigo begins as a scarlatiniform eruption in a previously traumatized area that blisters then ruptures to form a wet, honey-colored crust. Common sites for infection are the face and trunk. The primary symptom in impetigo is localized pain; fever and constitutional symptoms are rarely seen (Box 1). Physical exam often reveals regional lymphadenopathy. Staphylococcal scalded skin syndrome encompasses three distinct clinical scenarios: bullous impetigo, staphylococcal scarlet fever, and generalized scalded skin syndrome. The […]

Pyogenic Cutaneous Infections

Clinical Findings Signs and Symptoms S aureus is the leading bacterial cause of pyogenic skin lesions (Box 46-1). Folliculitis, infection of the hair follicles, is a local suppurative process causing indurated papules or pustules, often with a hair exiting from the center of the lesion. There is local erythema and tenderness, but the patient is not systemically ill. A furuncle ("boil") begins as a hair follicle infection and extends locally to form an abscess, characterized by liquefaction of necrotic tissue. Clinically, this presents as a well-circumscribed, fluctuant, tender, erythematous collection. Infection on occasion spreads to the surrounding epidermis, causing cellulitis. Common sites for furuncles include the face, neck, axilla, back and […]

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Erymax 250mg Gastro-resistant Hard Capsules (Erythromycin) What Erymax is and what it is used for Read indications for use if you want to order Erythromycin online The name of this medicine is Erymax 250 mg gastro-resistant hard capsules. The active ingredient in them is erythromycin, which belongs to a group of medicines called antibiotics. Erymax is used to treat ear, nose, throat and chest infections. It can also be used to treat skin infections. Before you take Erymax Before buy Erythromycin online, read information about the drug Do not take Erymax if you: Are allergic (hypersensitive) to erythromycin or any of the other ingredients of Erymax. Are taking antihistamines (for allergies) called terfenadine or […]

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Fluconazole [US: Diflucan 50mg, 100mg, 150mg, 200mg] Synonyms: Fluconazol; Fluconazolum; Flukonatsoli; Flukonazol; UK-49858  BAN: Fluconazole USAN: Fluconazole INN: Fluconazole [rINN (en)] INN: Fluconazol [rINN (es)] INN: Fluconazole [rINN (fr)] INN: Fluconazolum [rINN (la)] INN: Флуконазол [rINN (ru)] Chemical name: 2-(2,4-Difluorophenyl)-1,3-bis(1H-1,2,4-triazol-1-yl)propan-2-ol Molecular formula: C13H12F2N6O =306.3 CAS: 86386-73-4 ATC code: D01AC15; J02AC01 Read code: y02Ug Pharmacopoeias European Pharmacopoeia, 6th ed. (Fluconazole). A white or almost white, hygroscopic, crystalline powder. It exhibits polymorphism. Slightly soluble in water freely soluble in methyl alcohol soluble in acetone. Store in airtight containers. The United States Pharmacopeia 31, 2008, and Supplements 1 and 2 (Fluconazole). A white or almost white, crystalline powder. Slightly soluble in water soluble in […]