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Chapter 73. Skin and Soft Tissue Infections

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A 4-year-old child is brought into the clinic by his mother with complaints of blisters covering his forehead, nose, and cheeks, which have gradually worsened over the last week. His face is red, and many vesicular lesions are noted. Yellowish crusts are present where blisters have apparently ruptured. The child is diagnosed with impetigo. Which of the following statements regarding the treatment of this child’s impetigo is true?

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A. Topical antibiotics, like mupirocin, should be utilized first because of their enhanced efficacy.

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B. Macrolide antibiotics, such as erythromycin, are typically preferred first line because of their low rates of staphylococcal and GAS resistance.

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C. Because of the potential for severe complications associated even with mild impetigo, IV antibiotic therapy is the most appropriate treatment option.

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D. First-generation cephalosporins and penicillinase-stable penicillins are considered first-line treatment for this child since oral therapy is indicated.

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A 46 year-old man with diabetes presents with a very large and painful nodule on his neck. The nodule is draining pus from multiple hair follicles. The best management in this case is:

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A. Daily cleansing with soap and water, as it is most likely acne.

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B. Warm moist compresses, as it is most likely folliculitis.

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C. Application of a topical antibiotic, as it is most likely erysipelas.

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D. Incision and drainage, as it is most likely a carbuncle.

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SM is a 43 year-old quadriplegic man. His wife brings him into the clinic, stating that he hasn’t been feeling well lately. His appetite has been poor, and he has lost 20 lb (9 kg) in the last month. SM states that he has been feeling fatigued and “a bit dizzy” at times. His temperature at the clinic is 102.2°F (39.0°C), his blood pressure is 85/46 mm Hg, and physical examination reveals a large, stage 3 pressure sore on his sacrum, with surrounding cellulitis and necrotic debris. Which of the following risk factors for pressure ulcer development is not applicable to SM’s case?

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A. Age

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B. Malnutrition

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C. Limited mobility

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D. Loss of sensation

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Which of the following antibiotics is most appropriate for the treatment of SM’s condition (assume no drug allergies)?

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A. Silver sulfadiazine 1% cream applied three times daily ...

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