User login
PHOENIX – When a child presents with what looks like a spider bite, but the family can't find a spider, Dr. Lawrence F. Eichenfield considers community-acquired methicillin-resistant Staphylococcus aureus.
“Most pediatric cases we see are not in wrestlers or football players. They are in families that have problems with MRSA, so the epidemiology has changed,” he told clinicians at a clinical dermatology conference sponsored by Medicis.
Spider bite-appearing lesions are a classic presentation of MRSA, according to Dr. Eichenfield, chief of pediatric and adolescent dermatology at Rady Children's Hospital-San Diego and professor of pediatrics and medicine at the University of California, San Diego. If the child's lesion looks like a spider bite, he recommended asking whether anyone in the family has a history of abscesses or recurrent folliculitis.
Draining abscesses is usually more effective than using antibiotics when patients have community-acquired MRSA, Dr. Eichenfield said. He cited a recent study that found 57% of emergency department patients received the wrong antibiotics for skin and soft-tissue infections caused by community-acquired MRSA (N. Engl. J. Med. 2006;355:666-74). Many busy physicians don't want to take the time to drain an abscess, he said, but “study after study shows it [drainage] is way more effective.”
Warm soaks and drainage often are sufficient, he said, but warned that lesions greater than 5 cm present a higher risk. “Many times we use antibiotics concurrently, but drainage is really the key,” he said.
The lesion always should be cultured, Dr. Eichenfield said. Community-acquired MRSA has different patterns of susceptibility to antibiotics than does hospital-acquired MRSA.
Community-acquired MRSA skin infections are being seen in neonates, though less frequently than in older children. He cited a study of 89 infants, mostly boys, who were less than 30 days old and had S. aureus infections. Among these, 77 infections involved skin and soft tissue, and 61 were methicillin resistant. Mothers of 13 infants with MRSA had a history of skin infections (Pediatrics 2006;118:874-81).
'Many times we use antibiotics concurrently, but drainage is really the key.' DR. EICHENFIELD
A MRSA abscess, like this one on a patient's hip, often can resemble a spider bite. CDC/Bruno Coignard M.D/Jeff Hageman, M.H.S.
PHOENIX – When a child presents with what looks like a spider bite, but the family can't find a spider, Dr. Lawrence F. Eichenfield considers community-acquired methicillin-resistant Staphylococcus aureus.
“Most pediatric cases we see are not in wrestlers or football players. They are in families that have problems with MRSA, so the epidemiology has changed,” he told clinicians at a clinical dermatology conference sponsored by Medicis.
Spider bite-appearing lesions are a classic presentation of MRSA, according to Dr. Eichenfield, chief of pediatric and adolescent dermatology at Rady Children's Hospital-San Diego and professor of pediatrics and medicine at the University of California, San Diego. If the child's lesion looks like a spider bite, he recommended asking whether anyone in the family has a history of abscesses or recurrent folliculitis.
Draining abscesses is usually more effective than using antibiotics when patients have community-acquired MRSA, Dr. Eichenfield said. He cited a recent study that found 57% of emergency department patients received the wrong antibiotics for skin and soft-tissue infections caused by community-acquired MRSA (N. Engl. J. Med. 2006;355:666-74). Many busy physicians don't want to take the time to drain an abscess, he said, but “study after study shows it [drainage] is way more effective.”
Warm soaks and drainage often are sufficient, he said, but warned that lesions greater than 5 cm present a higher risk. “Many times we use antibiotics concurrently, but drainage is really the key,” he said.
The lesion always should be cultured, Dr. Eichenfield said. Community-acquired MRSA has different patterns of susceptibility to antibiotics than does hospital-acquired MRSA.
Community-acquired MRSA skin infections are being seen in neonates, though less frequently than in older children. He cited a study of 89 infants, mostly boys, who were less than 30 days old and had S. aureus infections. Among these, 77 infections involved skin and soft tissue, and 61 were methicillin resistant. Mothers of 13 infants with MRSA had a history of skin infections (Pediatrics 2006;118:874-81).
'Many times we use antibiotics concurrently, but drainage is really the key.' DR. EICHENFIELD
A MRSA abscess, like this one on a patient's hip, often can resemble a spider bite. CDC/Bruno Coignard M.D/Jeff Hageman, M.H.S.
PHOENIX – When a child presents with what looks like a spider bite, but the family can't find a spider, Dr. Lawrence F. Eichenfield considers community-acquired methicillin-resistant Staphylococcus aureus.
“Most pediatric cases we see are not in wrestlers or football players. They are in families that have problems with MRSA, so the epidemiology has changed,” he told clinicians at a clinical dermatology conference sponsored by Medicis.
Spider bite-appearing lesions are a classic presentation of MRSA, according to Dr. Eichenfield, chief of pediatric and adolescent dermatology at Rady Children's Hospital-San Diego and professor of pediatrics and medicine at the University of California, San Diego. If the child's lesion looks like a spider bite, he recommended asking whether anyone in the family has a history of abscesses or recurrent folliculitis.
Draining abscesses is usually more effective than using antibiotics when patients have community-acquired MRSA, Dr. Eichenfield said. He cited a recent study that found 57% of emergency department patients received the wrong antibiotics for skin and soft-tissue infections caused by community-acquired MRSA (N. Engl. J. Med. 2006;355:666-74). Many busy physicians don't want to take the time to drain an abscess, he said, but “study after study shows it [drainage] is way more effective.”
Warm soaks and drainage often are sufficient, he said, but warned that lesions greater than 5 cm present a higher risk. “Many times we use antibiotics concurrently, but drainage is really the key,” he said.
The lesion always should be cultured, Dr. Eichenfield said. Community-acquired MRSA has different patterns of susceptibility to antibiotics than does hospital-acquired MRSA.
Community-acquired MRSA skin infections are being seen in neonates, though less frequently than in older children. He cited a study of 89 infants, mostly boys, who were less than 30 days old and had S. aureus infections. Among these, 77 infections involved skin and soft tissue, and 61 were methicillin resistant. Mothers of 13 infants with MRSA had a history of skin infections (Pediatrics 2006;118:874-81).
'Many times we use antibiotics concurrently, but drainage is really the key.' DR. EICHENFIELD
A MRSA abscess, like this one on a patient's hip, often can resemble a spider bite. CDC/Bruno Coignard M.D/Jeff Hageman, M.H.S.