How should a skin infection be managed in an immunocompromised host?
—Efren A. Casanova, MD, Scottsdale, Ariz.
This is a very broad question. For an uncomplicated bacterial infection, I would use standard antimicrobial therapy and perhaps follow the patient a little more closely as an outpatient. A complicated bacterial infection in an immunocompromised patient would warrant a lower-than-usual threshold for hospitalization. Check bacterial cultures and sensitivities. Here again, I would use standard therapy, but I would also have a lower threshold for adding or changing therapies if the initial response was suboptimal.
—Jeffrey M. Weinberg, MD (112-11)