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Revista Clínica de Medicina de Familia

On-line version ISSN 2386-8201Print version ISSN 1699-695X

Abstract

GOMEZ GONZALEZ, Carlos; GONZALEZ CARRERAS, Christian  and  ZAMBRANO CENTENO, Luz Belén. Polymicrobial skin infections requiring a multidisciplinary approach. Rev Clin Med Fam [online]. 2014, vol.7, n.1, pp.59-62. ISSN 2386-8201.  http://dx.doi.org/10.4321/S1699-695X2014000100010.

A male patient aged 52 visits the outpatient clinic referring intense itching in his right foot over 15 days. Personal history: hypercholesterolemia, hypertriglyceridemia and urethral stenosis under dilatation therapy. Hip replacement surgery due to fracture and multiple surgical interventions in both feet due to fractures occurred in a traffic accident. At present he is on permanent therapy with simvastatin plus omega-3 fatty-acid. He is independent for daily life activities and lives in a small town 35 km away from the closest hospital center. Physical examination: Redness in the dorsal area and interdigital area from the third to fifth toe in his right foot accompanied by maceration with no presence of toenail onychomycosis. Complementary tests: skin samples of ulcerous lesions were obtained for culture, showing infection with Pseudomonas aeruginosa, Methicillin resistant Staphylococcus aureus and Enterococcus faecalis. Differential diagnosis: Intertrigo, tinea pedis, inverse psoriasis, erytharsma, candidiasis. Discussion: Skin infections are very frequent in primary care and a correct differential diagnosis is necessary and the pertinent complementary tests should be carried out before starting therapy. The use of ambulatory intravenous antibiotic therapy can be an appropriate option in these cases.

Keywords : Skin Diseases; Infectious; Intertrigo; Primary Health Care.

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