Patient X is a 40 year old female reporting pain on the side of her right thigh. She ignored said pain, and 7 hours later, removed pus from an ingrown hair in the area. Cellulitis developed over the course of 8 hours in the same area approximately 6 cm x 11 cm. Pus is still extruding from the area. After 12 more hours, the area of cellulitis is now from hip to knee.
Patient X goes to the doctor. Her intake report has all normal vital signs. Area of cellulitis is warm and red. No swollen lymph nodes observed. No pus was removed at the ingrown hair site during the visit. Patient X is referred to surgery, given IM ceftriaxone and oral cephalexin.
After 48 hours, there is now fluctuance near the ingrown hair site and patient has a low grade fever. Pus is extracted for gram stain and culture. Incision and drainage of the site followed. Results showed a gram positive, coagulase positive, coccus microbe. Blood agar plates showed colonies with beta-hemolysin.
What microbe is causing her cellulitis? How did she become infected?
Why were incision and drainage necessary to treat this infection? Why would antibiotics not be used in this infection?
What other types of infections does this organism cause?
If this patient presented with fever, diffuse skin rash, low blood pressure, and diarrhea, what virulence factor might the organism causing his cellulitis be producing? Explain?
When the culture results returned, the physician changed his antimicrobial therapy. Why?
