Pediatric emergency medicine trisk 2377 2377

puncture wound Pseudomonas Crepitance, subcutaneous air on XR, or gangrene Clostridium species or other anaerobes Immunocompromised hosts Pseudomonas, other GNRs, anaerobes Pseudomonas accounts for up to 70–90% of plantar puncture– associated osteomyelitis; the benefit of postpuncture prophylactic antibiotics is unclear Broad-spectrum antibiotics covering anaerobes and aerobes + early surgical consultation if concern exists for necrotizing fasciitis If neutropenic, a child may not have redness, induration, or pus, but will have tenderness; examination findings may not correlate with the extent of disease GAS, group A streptococcus (S pyogenes ); Hib, Haemophilus influenzae type b; PCN, Penicillin; GNRs, gram-negative rods; XR, radiograph