TY - JOUR
T1 - Diagnosis and management of skin and soft tissue infections in the intensive care unit
T2 - a review
AU - Burnham, Jason P.
AU - Kirby, John P.
AU - Kollef, Marin H.
N1 - Publisher Copyright:
© 2016, Springer-Verlag Berlin Heidelberg and ESICM.
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Purpose: To review the salient features of the diagnosis and management of the most common skin and soft tissue infections (SSTI). This review focuses on severe SSTIs that require care in an intensive care unit (ICU), including toxic shock syndrome, myonecrosis/gas gangrene, and necrotizing fasciitis. Methods: Guidelines, expert opinion, and local institutional policies were reviewed. Results: Severe SSTIs are common and their management complex due to regional variation in predominant pathogens and antimicrobial resistance patterns, as well as variations in host immune responses. Unique aspects of care for SSTIs in the ICU are discussed, including the role of prosthetic devices, risk factors for bacteremia, and the need for surgical consultation. SSTI mimetics, the role of dermatologic consultation, and the unique features of SSTIs in immunocompromised hosts are also described. Conclusions: We provide recommendations for clinicians regarding optimal SSTI management in the ICU setting.
AB - Purpose: To review the salient features of the diagnosis and management of the most common skin and soft tissue infections (SSTI). This review focuses on severe SSTIs that require care in an intensive care unit (ICU), including toxic shock syndrome, myonecrosis/gas gangrene, and necrotizing fasciitis. Methods: Guidelines, expert opinion, and local institutional policies were reviewed. Results: Severe SSTIs are common and their management complex due to regional variation in predominant pathogens and antimicrobial resistance patterns, as well as variations in host immune responses. Unique aspects of care for SSTIs in the ICU are discussed, including the role of prosthetic devices, risk factors for bacteremia, and the need for surgical consultation. SSTI mimetics, the role of dermatologic consultation, and the unique features of SSTIs in immunocompromised hosts are also described. Conclusions: We provide recommendations for clinicians regarding optimal SSTI management in the ICU setting.
KW - Gas gangrene
KW - Necrotizing fasciitis
KW - Skin and soft tissue infections in the intensive care unit
UR - http://www.scopus.com/inward/record.url?scp=84989885401&partnerID=8YFLogxK
U2 - 10.1007/s00134-016-4576-0
DO - 10.1007/s00134-016-4576-0
M3 - Review article
C2 - 27699456
AN - SCOPUS:84989885401
SN - 0342-4642
VL - 42
SP - 1899
EP - 1911
JO - Intensive care medicine
JF - Intensive care medicine
IS - 12
ER -