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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.

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For additional information on MSRA Infection see the links below.
WebMD

http://www.webmd.com/skin-problems-and-treatments/understanding-mrsa-methicillin-resistant-staphylococcus-aureus

medicine net

http://www.medicinenet.com/mrsa_infection/article.htm

CDC

http://www.cdc.gov/mrsa/

NIAID


http://www.niaid.nih.gov/topics/antimicrobialresistance/
examples/mrsa/pages/default.aspx

Mayo Clinic

http://www.mayoclinic.org/diseases-conditions/mrsa/basics/definition/con-20024479

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