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Revista Virtual de la Sociedad Paraguaya de Medicina Interna
On-line version ISSN 2312-3893
Abstract
PERALTA, Ruth and TORRES DE TABOADA, Estela. Skin and soft tissues infections. Rev. virtual Soc. Parag. Med. Int. [online]. 2017, vol.4, n.2, pp.19-26. ISSN 2312-3893. https://doi.org/10.18004/rvspmi/2312-3893/2017.04(02)19-026.
Introduction:
Skin and soft tissues infections (SSTI) are common reasons for consulting and the clinical spectrum ranges from trivial to lethal processes. In the last years, methicillin resistant Staphylococcus aureus has been the main causative agent.
Objectives:
To determine the clinical and microbiological characteristics of SSTI from the community and apply Shapiro rule to calculate the profitability of cultures.
Methodology:
Observational descriptive and prospective design that included 181 adult patients admitted in the Clinical Service of the National Hospital (Itauguá, Paraguay) during 2015 and 2016.
Results:
Mean age was 56 years and there was a predominance of male sex (57%). The most frequently diagnosed SSTI was cellulitis: 106 (59%) patients followed by 61 (34%) patients with necrotizing fasciitis. The most frequent comorbidity was type 2 diabetes mellitus. Staphylococcus aureus was the most frequently isolated bacteria. Relating patients according to the blood culture results and Shapiro rule, the patients who scored higher than 5 had more reports of positive blood cultures. Eighty five patients presented sepsis, 44% required surgical intervention and 5 died.
Conclusions:
Cellulitis was the most frequent SSTI and most infections were caused by Staphylococcus aureus. Diabetes mellitus was the most frquent comorbidity. The application of Shapiro rule for the selection of patients who should have blood cultures will improve their profitability.
Keywords : cellulitis; erysipelas; necrotizing fasciitis; methicillin resistant Staphylococcus aureus.