Skin abscess: Difference between revisions

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==Diagnosis==
==Diagnosis==
===Work-up===
*[[Ultrasound: Soft tissue|Ultrasound]] can be helpful
===Evaluation===
*Generally clinical diagnosis, may be assisted by ultrasound (above)


==Management==
==Management==

Revision as of 11:58, 28 April 2016

Background

Methicillin-resistant Staphylococcus aureus (MRSA) is a well known cause of many abscesses in the ED being the most common cause of purulent skin and soft-tissue infections.[1][2][3] Treatment for cutaneous abscesses has been incision and drainage with antibiotics generally reserved for those that also had associated cellulitis. This multicenter, double-blind, randomized Controlled Trial of 5 US EDs with >1200 patients challenges the traditional dogma of no antibiotics for simple small uncomplicated abscesses that can be drained. For abscess of median size, 2.5 x 2.0 x 1.5cm that underwent I&D and co-administration of 5 days of TMP/SMX, cure rates were 80.5% vs 73.6% with placebo and I&D.[4]

Clinical Features

Differential Diagnosis

Skin and Soft Tissue Infection

Look-A-Likes

Diagnosis

Work-up

Evaluation

  • Generally clinical diagnosis, may be assisted by ultrasound (above)

Management

Disposition

See Also

Incision and drainage

External Links

References

  1. Maligner D et al. The prevalence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) in skin abscesses presenting to the pediatric emergency department. N C Med J. 2008 Sep-Oct;69(5):351-4.
  2. Pickett A et al. Changing incidence of methicillin-resistant staphylococcus aureus skin abscesses in a pediatric emergency department. Pediatr Emerg Care. 2009 Dec;25(12):831-4.
  3. Bradley W. Frazee et al. High Prevalence of Methicillin-Resistant Staphylococcus aureus in Emergency Department Skin and Soft Tissue Infections http://dx.doi.org/10.1016/j.annemergmed.2004.10.011
  4. Talan DA et al.. "Trimethoprim–Sulfamethoxazole versus Placebo for Uncomplicated Skin Abscess". NEJM. 2016. 374(9):823-832. [EBQ:TMP-SMX vs Placebo for Uncomplicated Skin Abscess|Bactrim and I&D NEJM]]