How are skin and soft-tissue infections (SSTIs) treated in patients with cell-mediated immunodeficiency?

Updated: Jun 14, 2019
  • Author: Thomas E Herchline, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Common or unusual bacteria (eg, Mycobacterium, Nocardia), viruses, protozoa, helminths, or fungi can cause SSTIs in patients with conditions such as Hodgkin disease, lymphoma, and human immunodeficiency virus (HIV) infection, as well as in patients who have had a bone marrow transplantation or have received long-term high-dose immunosuppressant therapy. [2] These patients require biopsy and early, aggressive management.

The IDSA guidelines provides a table of antibiotic selections based on the predisposing factor (eg, neutropenia, cellular immune deficiency) and pathogen (eg, bacteria, viruses, fungi). [2] Empiric treatment must be determined on the basis of local susceptibilities.

Readers are encouraged to check the IDSA Web site for the 2014 updated recommendations for the diagnosis and management of skin and soft-tissue infections.


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