MRSA

We had a young guy (avid Aussie Rules Football player - promised to teach me a bit about the sport if I show up for one of his games) with a "spider bite." Of course, hadn't seen the spider. In Denver it would have been a no-brainer diagnosis: patch of black necrotic skin overlying a palpable abscess and some surrounding cellulitis. But, MRSA hasn't yet arrived in Tassie in a big way, so there were a lot of house officers scratching their heads in confusion when I first saw the guy. (BTW, I suspect that the largest source of importation of MRSA is colonized locum tenens ER Docs from the US.)

So, a quick talk about characteristics of MRSA and antibiotic choice or non-choice, and on to the I&D. Some things are the same around the world: After the first 13 swipes of the scalpel, the intern had finally made it through the epidermis and was ready to start on the dermis and eventually had a full 5 mm incision and started to work downwards into the gloom with a hemostat. When I finally "helped him a little" and extended the incision to a reasonable size and buried the hemostat the hilt, his eyes got a little big, but was reassured when only pus and not arterial blood gushed forth.