Recurrent Skin Sepsis Pathway - Recurrence
Recurrence is defined by the clinical context i.e. several episodes may be required to lead to action if minior clinical problem, however two episodes may be acted on if there is significant consequence or co-morbidity. The issue is recurrent seeding of the skin with Staphylococcus aureus secondary to carriage, most commonly in the nose but also in other sites (throat, axilla, groin etc).
Underlying carriage is the issue:
- Deprived households more at risk (generally due to overcrowding) and consequently eradication of carriage must be affordable.
- Certain ages are more susceptible due to their close skin to skin societal contact.
- Close contact due overcrowding or susceptible age. (Who lives in your house?-Genogram may assist).
- Compromised skin integrity (provides portal of entry)-eczema, insect bites, abrasions, devices e.g. PEG.
- Nutritional factors notably iron deficiency. Consider dietary history and growth chart.
- Co-morbidities e.g. diabetes and more uncommonly renal or immune deficiency disease.(self and others).
- Hidradenitis suppurativa see dermnet for in depth information.
- Inflammatory skin diseases notably eczema and psoriasis.
- Chronic granulomatous disease.
- Persistent/resistant/recurrent candida (thrush).
- Herpes zoster (Shingles).
- Clinical Treatment Failure is defined as new lesion(s) after full treatment completed.
- Partial Treatment Failure - history or diary indicates some improvement consider repeating last treatment regimen again before preceding to next step.
Last updated : Friday, August 21, 2015
Next review date : Saturday, August 20,2016
Disclaimer: This site is intended to be flexible and frequently updated. While every effort has been made to ensure accuracy, all information should be verified.