Reference no: EM132732837
A man comes to the Walk In clinic complaining of a golf-ball sized mass near his left groin. Upon physical examination, the mass is palpable, and warm to the touch, with a 5 cm radius of cellulitis. As the physician palpates the mass, a thick, purulent substance leaks out. The physician promptly collects the pus and sends it to the lab for testing. The physician then sends the man home with directions to apply heat to the area 3-4 times per day and to wait to hear what the lab results are before discussing a treatment plan. Below are the preliminary laboratory results:
Test Performed
Results
Catalase
+
Slide coagulase
+
Tube coagulase
+
The physician orders a lab technician to perform a Kirby Bauer disk diffusion assay and finds that the organism is resistant to the following antibiotics: 1) Penicillin, 2) Ampicillin, 3) Methicillin, and 4) Trimethoprim/Sulfamethoxazole.
The physician asks the man about any drug allergies and other predisposing factors that could impact anti-microbial therapy. The man is allergic to all of the beta-lactam antibiotics, all cephalosporins, and does not tolerate sulfa drugs well. The man also has a form of hepatitis from a botched blood transfusion several years prior.
After two weeks of antibiotic treatment, the mass has not retreated and is now very hard. What would be the next logical course of action?