What lab values should be monitored in cases of ecthyma?

From the Guidelines

In cases of ecthyma, monitoring of complete blood count (CBC) with differential, blood cultures, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), wound cultures, and renal function tests including BUN and creatinine is crucial to assess for bacterial infection, guide antibiotic therapy, and identify potential complications. According to the practice guidelines for the diagnosis and management of skin and soft tissue infections, Gram stain and culture of the pus or exudates from skin lesions of ecthyma are recommended to help identify the causative organism, such as Staphylococcus aureus and/or β-hemolytic Streptococcus 1.

Key Lab Values to Monitor

• Complete blood count (CBC) with differential to assess for leukocytosis and neutrophilia
• Blood cultures if systemic infection is suspected, particularly in immunocompromised patients
• C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) as markers of inflammation
• Wound cultures to identify the causative organism and guide appropriate antibiotic therapy
• Renal function tests including BUN and creatinine to monitor for potential complications such as post-streptococcal glomerulonephritis In patients with extensive disease or those who are immunocompromised, additional lab tests such as blood glucose levels, immunoglobulin levels, and HIV testing may be warranted to rule out underlying conditions that may be contributing to the infection 1.

Rationale for Lab Tests

• Monitoring for bacterial infection and guiding antibiotic therapy
• Identifying potential complications such as post-streptococcal glomerulonephritis
• Ruling out underlying conditions that may be contributing to the infection
• Establishing diagnosis and monitoring treatment response It is essential to note that the choice of lab tests may vary depending on the individual patient's circumstances, such as the presence of underlying medical conditions or the severity of the infection. However, the lab values mentioned above are the most critical to monitor in cases of ecthyma.

From the Research

Lab Values for Ecthyma

Ecthyma is a type of skin infection that can be caused by bacteria such as Staphylococcus aureus or Streptococcus pyogenes. When monitoring lab values for ecthyma, the following should be considered:

• White blood cell count (WBC): An elevated WBC count can indicate the presence of a bacterial infection, including ecthyma 2, 3.
• C-reactive protein (CRP): CRP is a protein that increases in response to inflammation and infection. Elevated CRP levels can indicate the presence of a bacterial infection, including ecthyma 3.
• Erythrocyte sedimentation rate (ESR): ESR is a blood test that measures how quickly erythrocytes (red blood cells) settle in a test tube. It can be elevated in response to inflammation and infection, including ecthyma.
• Blood cultures: Blood cultures can help identify the presence of bacteria in the blood, including those that cause ecthyma 3.
• Complete blood count (CBC): A CBC can help identify any abnormalities in the blood, including anemia, which can be a complication of ecthyma.

Specific Lab Values to Monitor

The following lab values should be monitored in cases of ecthyma:

• WBC count: >10,000 cells/μL can indicate the presence of a bacterial infection 2, 3.
• CRP: >10 mg/L can indicate the presence of a bacterial infection 3.
• ESR: >20 mm/h can indicate the presence of inflammation and infection.
• Blood cultures: Positive blood cultures can indicate the presence of bacteria in the blood 3.
• CBC: Abnormalities in the CBC can indicate the presence of anemia or other complications of ecthyma.

Limitations of Current Evidence

There are limited studies that specifically address the lab values that should be monitored in cases of ecthyma. Most of the current evidence is based on studies of other types of skin infections, such as impetigo and cellulitis 4, 5. Therefore, the lab values that should be monitored in cases of ecthyma are based on general principles of infectious disease diagnosis and treatment, rather than specific evidence-based guidelines.