Skin Infection

A 10-year old male complained to his mother about right shoulder pain. When she looked at the shoulder, she noticed what she described as some “areas of blistering,” with a few that appeared to have opened, leaving some redundant skin. She took him to an urgent care clinic, where he was diagnosed with a skin infection (presumably Staphylococcus aureus) and prescribed trimethoprim/sulfamethoxazole (TMP/SMX). The lesions seemed to quickly improve, but when asked, he still complained about some pain, so she took him to his primary care clinic. The mother relayed to the triage person that the child had an episode of severe Salmonella osteomyelitis in his right shoulder when he was an infant, almost 10 years earlier. With that information, the child was sent directly to radiology for plain radiographs of the right shoulder (Figure 1), which were preliminarily read as a fracture at the old infection site. With that report, the patient was urgently sent to the local orthopedic clinic without being examined.

The use of statins for as little as 91 days is associated with an increased risk for skin infections via diabetogenic and nondiabetogenic mechanisms, according to findings published in the British Journal of Pharmacology.

Numerous barriers prevent the common use of fungal preparations in the dermatology setting, such as the belief that clinical diagnosis is sufficient and the lack of a required Clinical Laboratory Improvement Amendment certification, along with the notion that it is difficult to obtain, according to recent survey findings.