Question

Pt presents with uncomplicated cellulitis on his foot. He tells you that it came out of nowhere but confesses that he is an occasional IVDU and you find injection marks on his arm. Would you cover for S. aureus in this case?

a) Yes
b) No
c) Maybe
d) Not sure

Answer 1

Yes, it would be prudent to cover for S. aureus when treating a patient with uncomplicated cellulitis of the foot, especially if they have a history of intravenous drug use and visible injection marks.

Step-by-step explanation:

When treating a patient presenting with uncomplicated cellulitis of the foot, particularly when the patient is an occasional intravenous drug user (IVDU) with visible injection marks on their arm, it would be prudent to cover for S. aureus. This decision comes from the knowledge that Staphylococcus aureus is commonly associated with skin infections that can be purulent, such as cellulitis, and is frequently a concern with skin infections in IVDU due to possible pathogen introduction at the injection site. Moreover, S. aureus can produce leukocidins that lead to pus formation, and because patients such as those with IVDU histories are at higher risk for antibiotic-resistant strains, an antimicrobial susceptibility test (AST) should be conducted to ensure appropriate antibiotic therapy. Therefore, the answer would be 'a) Yes,' antibiotic coverage for S. aureus should be initiated.