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54 year old man presents with a 4 day history of a rapidly, enlarging, painful, draining, nodulo-pustule on the side of his finger. Was unsure, but said he might have cut it at work. On blood pressure medication but otherwise healthy.

What is your diagnosis?

Diagnosis: MRSA infection

A culture confirmed Methicillin-resistant Staphylococcus aureus (MRSA) sensitive to Trimethoprim/Sulfa antibiotics. The patient was initially started, empirically on a Z pack, but when results came back day 2 it was discovered that the bacteria was resistant to erythromycin he was switched to Bactrim DS, 1 PO BID x 14 days. He was also sent to an orthopedic hand specialist to rule out any osseous involvement (there was not) . He noticed remarkable improvement after starting the Bactrim. Here is a pictuire of the finger 21 days after initiating treatment.

For additional information on MSRA Infection see the links below.


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