The most recent AHA guidelines (2007) have limited antibiotic prophylaxis to those patients at highest-risk for developing endocarditis and who are undergoing high-risk invasive procedures.
In the past few years, a hypervirulent strain of C. difficile, called NAP-1, has caused hospital outbreaks that have been unusually severe and recurrent.
A 32 year old woman, otherwise healthy, presented with a “spider-bite”. On exam, she had a tender abscess on her buttock. It was associated with some surrounding cellulitis but no fever or other systemic features.
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