A 50-year-old woman presents to ER with a well-demarcated, raised rapidly progressive red area in her left arm. She has chronic lymphedema of this arm following axillary dissection. Which of the following intravenous antibiotic is indicated?
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الإجابة: A. Penicillin G
A well-demarcated, raised, rapidly spreading red area on a lymphoedematous arm after axillary dissection is erysipelas, caused mainly by group A Streptococcus. Treatment is the same as for cellulitis, and the IV drug of choice is penicillin G. Metronidazole has no streptococcal cover, ciprofloxacin is poor against strep, and clindamycin or a macrolide are alternatives for penicillin allergy.
ليش كل خيار صح أو غلط
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A
ليش صح
The lesion is erysipelas: an acute superficial cellulitis with a sharply demarcated, raised border, caused predominantly by Streptococcus and treated like cellulitis. IV penicillin G, the anti-streptococcal penicillin, fits.
✓ Common Surgical Skin Conditions - Afnan.pdf · p. 11 -
B
ليش غلط
Metronidazole is the antibiotic of choice for anaerobes (and some protozoa). Erysipelas is a streptococcal skin infection.
✓ Antibiotic-1 (3).pdf · p. 31 -
C
ليش غلط
Ciprofloxacin is not one of the fluoroquinolones with gram-positive activity (only moxifloxacin and levofloxacin have some), so it is a poor choice for streptococcal erysipelas.
✓ Antibiotic-1 (3).pdf · p. 23 -
D
ليش غلط
Clindamycin is listed for anaerobic abdominal or genital infection and staphylococcal infection of joint, bone, teeth and diabetic foot. For streptococcal erysipelas the drug of choice is penicillin G.
✓ Antibiotics.pdf · p. 3 -
E
ليش غلط
Erythromycin is a macrolide, an alternative to penicillin in allergic patients. She has no allergy mentioned, so penicillin G stays the choice.
✓ Antibiotics.pdf · p. 3
- المصدر
- Common Surgical Skin Conditions - Afnan.pdf · p. 11
Surgical Principles 💉.pdf · p. 99 - المحاضرة
- Antimicrobials · Infectious Diseases · Module B
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