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Abscess 681.00

   Abcess
  • 681.00 Cellulitis and abscess, unspedified
  • spreading, diffuse inflammation, erythema, swelling and pain with an area of fluctuance.
  • Most commonly pathogens: S aureus.
  • MRSA is becoming increaseingly prevalent, especially in hand infections. Consider Bactrim DS +/- rifampin. If group A streptococcus is strongly suspected add Keflex
  • Treatment: Incision and debridement. Get aerobic and anaerobic cultures and gram stain before starting antibiotics. IV antibiotics are started after cultures are taken and are adjusted based on culture results. Cefazolin 1 g IV q8h, or Ampicillin-sulbactam 1.5 mg IV q6h. Consider Nafcillin 1-2 g IV q4-6h plus gentamicin or Imipenem, 0.5-1.0 g IV q6h for IV drug abusers or diabetics with more severe abcesses.

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