Treatment of Superficial Bacterial Folliculitis

Chapter 101


Treatment of Superficial Bacterial Folliculitis



Superficial bacterial folliculitis (SBF) is diagnosed frequently in dogs and can develop secondary to almost any primary skin disease. SBF is most commonly encountered as a complication of primary allergic, parasitic, or metabolic disease. Staphylococci, and in particular Staphylococcus pseudintermedius, are the most important pathogens causing SBF (see Chapter 100).



Diagnosis




Cytologic Analysis


Cytologic demonstration of cocci is helpful if there is any doubt that lesions represent SBF. However, if classic lesions of SBF are present and if similar lesions have responded to antimicrobial drug (AMD) therapy in the past, then cytologic examination is unnecessary. Cytologic analysis for cocci is never a poor diagnostic test and is mandatory in the following circumstances:



The absence of bacteria on cytologic analysis does not rule out SBF, and the absence of inflammatory cells does not rule out infection (these cells may be absent in the presence of immunosuppressive diseases or in patients treated with immunosuppressive drugs).



Bacterial Culture and Susceptibility Testing




What to Culture


Pustules are the preferred lesion because they have the highest reported rate for positive growth. Performing a diligent search, clipping hair with scissors to obtain “windows of the skin,” and using a magnifying lens are encouraged. Do NOT disinfect the pustule surface. Lance the lesion with a sterile needle and apply a culturette to the purulent exudate.


Crusts, especially if fresh with pus on the underneath surface, are also suitable lesions to culture. Do NOT disinfect the surface; lift the edge of the crust with a sterile needle or forceps and touch a culturette to the exposed skin surface.


Epidermal collarettes may be cultured, but this is not as sensitive a technique as pustule culture. Do NOT disinfect; rub a culturette across the center of the lesion and under the leading edge of the collarettes.


Finally, papules also may be cultured; however, the technique is more invasive, time consuming, and expensive. After subcutaneous injection of local anesthesia, wipe the lesion once with 70% alcohol, then collect a tissue sample with a 3-mm sterile punch and submit the sample in a sterile container. Suture the biopsy site.


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Jul 18, 2016 | Posted by in PHARMACOLOGY, TOXICOLOGY & THERAPEUTICS | Comments Off on Treatment of Superficial Bacterial Folliculitis

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