Question

21-year-old man seeks care at his family physician’s office for a painful, draining lesion that’s been on his left thigh for 5 days. He reports that he was bitten by a spider during one of his weekly football games with his fraternity brothers, but doesn’t recall seeing a spider. He has been applying an over-the-counter topical antibiotic without any improvement, and reports that the area of redness has tripled in size within the last 24 hours. His past medical history is unremarkable except for an allergy to sulfa drugs that was discovered during treatment for a skin infection 2 years ago. He takes no regular medications. The patient is afebrile and in no distress. The skin overlying his left thigh has a 1cm oozing lesion with pus evident and surrounding erythema. The wound is warm and tender to the touch. Based on the patient’s history, the doctor suspects MRSA and obtains a swab for bacterial culture and sensitivities.

          21-year-old man seeks care at his family physician’s office for a painful, draining lesion that’s been on his left thigh for 5 days.  He reports that he was bitten by a spider during one of his weekly football games with his fraternity brothers, but doesn’t recall seeing a spider.  He has been applying an over-the-counter topical antibiotic without any improvement, and reports that the area of redness has tripled in size within the last 24 hours. His past medical history is unremarkable except for an allergy to sulfa drugs that was discovered during treatment for a skin infection 2 years ago.  He takes no regular medications. The patient is afebrile and in no distress.  The skin overlying his left thigh has a 1cm oozing lesion with pus evident and surrounding erythema. The wound is warm and tender to the touch. Based on the patient’s history, the doctor suspects MRSA and obtains a swab for bacterial culture and sensitivities.

Added by Kristin H.

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