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Symptoms And Treatment Of Patients

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Patient A
Paronychia is an infection of the nail that occurs when bacteria enter the tissue surrounding the nail following trauma to the surrounding skin or cuticle. (Rigopoulos et al, 2008)
S. aureus forms part of the nasal flora of approximately 30% - 40% of the population, and can also be found transiently on the skin and in other areas e.g. mucous membranes, vagina. S. aureus produce lipases and glycerol ester hydrolases which break down lipids in the skin and can also grow in high salt concentrations. These factors facilitate colonisation of the skin.
When the skin barrier is broken, S. aureus is able to penetrate the tissue below. S. aureus produces microbial surface components recognising adhesive matrix molecules (MSCRAMMs) …show more content…

This results in a massive influx of leukocytes especially neutrophils to the site of infection.
S. aureus produces haemolysins and leukocidins that are able to lyse host blood cells. When leukocytes, especially neutrophils, are lysed, they release lysosomal enzymes that damage the surrounding tissue. The host response to this tissue damage is to deposit a fibrin capsule around the damage containing it to the site of the infection. This fibrin capsule also protects the bacteria inside from the host’s immune cells.
S. aureus produces catalase which destroys neutrophils ability to produce oxygen free radicals used to kill phagocytised bacteria, and coagulases which convert fibrin to fibrinogen, proteases, and DNases. S. aureus also produces hyaluronidase which breaks down hyaluronic acid which is part of the matrix in-between cells. This facilitates the spreading of the bacterium through the tissues and may account for the cellulitis seen in this patient. (Engleburg et al, 2013a) (Cheng et al, 2011) (Bauman, 2012a) (Greenwood et al, 2007a)
Treatment for Staphylococcal abscesses initially involves the lancing of the abscess and drainage of the pus which consists of the infectious organism and dead white blood cells. (Goering et al, 2013a)
Antibiotic sensitivity testing revealed that this strain of S. aureus is resistant to Oxacillin, and therefore, the initial antibiotic therapy of

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