Staphylococcus aureus infection
Patient presentation:
E.S. is a 25 year old female. The patient is in overall good health with no significant past medical history other than an appendectomy in 1997. She is allergic to tomatoes resulting in hives. The patient presented to the ER with complaints of itchy bug bites or pimples to the left leg. Her vital signs were: BP 104/76, HR 68, RR 14, oxygen saturation 99% on room air, and temperature 97.0 oral. E.S. denied pain. Upon assessment the patient had a 24cm x 18cm abrasion on the outside of her left calf. Above and below the abrasion were reddened areas with pustules.
Differential list:
Bacterial infection: Staphylococcus aureus
Diagnosis:
The patient was asked further questions about the abrasion. Approximately 10 days prior she sustained a turf burn while playing soccer on a turf field. The patient continued to play the remainder of the game. She cleaned the wound when she arrived home that night and placed Neosporin®. She continued to work out daily and play soccer. The small pustules appeared a short time later. Her boyfriend recognized the infection and encouraged her to seek help.
While in the ER the nurse cultured her wound by swabbing the reddened area and placing the specimen in a sterile container. It was then sent to the lab. Results can take up to two days.
Treatment:
The patient was sent home with the instructions to keep the area clean, dry, and covered. She was not allowed to do physical activity that would evoke sweating for 2 weeks. E.S. was placed on broad-spectrum antibiotics. Two days later the lab confirmed the findings that the specimen was positive for S. aureus. The healthcare provider contacted E.S. to verify the findings and encouraged her to come back if the wound had not resolved in one week.
Outcome:
The patient took the full course of antibiotics. She cleaned the area and kept it dry and covered at all times. Within a week the wounds and abrasion healed.