Question

"This sample was obtained from tissue and fluid aspirated from a skin pustule of a patient complaining of skin redness and irritation."

I need to identify the type of bacteria and recommendation to the treating physician in regards to which antimicrobial drugs to prescribe to your shared patient.

Answer 1

Skin infections may be either primary or secondary. Primary infections have characteristic morphologies and courses are initiated by single organisms and usually occurs in normal skin.They are more frequently caused by Staphylococcus aureus, Streptococcus pyogened,and coryneform bacteria. Impetigo, folliculitis,boils and erythrasma are common examples. Systemic infections may also have skin manifestations. Secondary infections originate in diseased skin as a superimposed condition.Intertrigo and toe web infections are example of secondary infections.

To identify the type of bacteria, Specimens are collected with a blade or by swabbing the involved areas of skin.When pustules or vesicles are present the roof or crust are removed with a sterile surgical blade. The pus is spread as thinly as possible on a clear glass slide for Gram staining. For actinomycetes,pus is collected from closed lesions by aspirations with a sterile needle or syringe. Material is collected from draining sinuses by holding a sterile test tube. Granules are aggregates of inflammatory cells, debris, proteinaceous material and delicate branching filaments. Pus and other exudates are examined microscopically for the presence of granules.

Prevention and treatment done by cleansing and degerming the skin with a soap or detergent containing an antimicrobial agent may be useful. Drying agents such as topical salicylate are also helpful. Topical antimicrobial agents can be used for some infections,but systemic therapy may be necessary for patients with extensive disease. Systemic treatment with antibiotics is mandatory for extensive pyoderma. It can be done orally or parenterally. Pencillin is prescribed for treating various bacterial infections. Common signs and symptoms of pencillin allergy include hives rash and itching.