Abstract
Three family members attended their general practice and emergency department over a 3-month period with recurrent skin and soft tissue infections (SSTIs) such as paronychia, submandibular carbuncle and groin and gluteal abscess requiring surgical drainage. Only when two family members were concurrently admitted with abscesses requiring drainage under general anaesthetic was the definitive diagnosis reached. The wound swabs identified methicillin-resistantStaphylococcus aureus(MRSA) and subsequent identification of the exotoxin Panton-Valentine leukocidin (PVL). Following MRSA decolonisation therapy with mupirocin and octenidine, only one family member has had one recurrence of an SSTI with MRSA isolated from the wound. When patients present with a history of recurrent SSTIs or a family all have had similar presentations, the clinician should consider MRSA with PVL exotoxin infection. Then patients must be referred for confirmation to ensure management is effective for the SSTI and prescribe MRSA decolonisation therapy concurrently to reduce recurrence.
Reference22 articles.
1. Prevention of Recurrent Staphylococcal Skin Infections
2. Incidence and recurrence of boils and abscesses within the first year: a cohort study in UK primary care
3. NHS Digital . Appointments in general practice, February 2024. 2024. Available: https://digital.nhs.uk/data-and-information/publications/statistical/appointments-in-general-practice/february-2024 [Accessed 04 Apr 2024].
4. NHS Digital . A&E attendances and emergency admissions. 2024. Available: https://www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting-times-and-activity/ [Accessed 04 Apr 2024].
5. Methicillin-resistant Staphylococcus aureus (MRSA): antibiotic-resistance and the biofilm phenotype