A 10monthold infant has an erythematous, fluctuant, nondraining abscess on
the right buttock after 10 days of treatment with amoxicillin for impetigo. What is the next step in managing this infant's care?

Question

A 10­month­old infant has an erythematous, fluctuant, non­draining abscess on
the right buttock after 10 days of treatment with amoxicillin for impetigo. What is the next step in managing this infant's care?

Quizplus · Accepted Answer

The presentation of an erythematous, fluctuant, non-draining abscess on the right buttock suggests a bacterial skin infection that has not responded to the previous treatment with amoxicillin. The next step would be to perform incision and drainage of the abscess with culture to identify the causative organism and guide antibiotic therapy. This is the standard of care for the management of skin abscesses. Consultation with a pediatric infectious disease specialist may be considered if there are complications or if the culture results are concerning. Empiric treatment with clindamycin may be considered if there is a high suspicion for methicillin-resistant Staphylococcus aureus (MRSA) infection, but should not be the initial step without confirming the diagnosis. Culture of any superficial open surface wounds may also be helpful in identifying the causative organism, but incision and drainage of the abscess is the priority in this case.

A 10­month­old Infant Has an Erythematous, Fluctuant, Non­draining Abscess on

A 10monthold Infant Has an Erythematous, Fluctuant, Nondraining Abscess on