Page 149 - Athletic Health Handbook
P. 149
MRSA infection. Return-to-play less virulent forms of community- clothing and equipment with
guidelines are the same as for acquired MRSA.2 More serious an infected individual can lead
impetigo.6 infections necessitate the use of to transmission.
Education: Cosmetic body vancomycin, which requires IV Treatment: Although molluscum
shaving should be avoided administration. Another option is lesions will self-resolve over
as it increases the risk for linezolid, which has been shown months to years, athletes should
these infections. to be as effective as vancomycin see a dermatologist to have the
Treatment: For smaller lesions, and can be taken orally.10 Incision lesions removed by curettage.
a warm compress can be used and drainage or debridement of Medication has not proven to be
to promote drainage. More necrotic tissue may be necessary effective at curing these lesions.4
serious lesions, such as furuncles for some of these skin lesions.
and carbuncles, may require Herpes Simplex
incision and drainage as well MRSA infection Identification: After a three- to
as systemic antibiotics.9 ten-day incubation period of the
Viral Infections herpes simplex virus (HSV) there
MRSA is a prodromal phase that can vary
Molluscum Contagiosum from mild to flu-like. Following
Identification: This highly Identification: Molluscum the prodrome, clusters of vesicles
antibiotic-resistant strain of manifests as small (a few appear on an erythematous base,
Staphylococcus aureus can present millimeters in diameter), flesh and eventually evolve into dry,
as a skin infection with 2–3 cm colored lesions that have a dimpled crusted lesions. The head, neck
erythematous lesions with a center and an otherwise glossy and upper extremities are the
purulent center. Cellulitis can also appearance. They can be solitary most common sites of infection.7
be present or these lesions can or clustered. Lesions are typically Recurrent outbreaks within an
grow into abscesses. MRSA skin found on the trunk or extremities.4 individual tend to be less
infections are usually seen on the Containment: Molluscum is widespread. If the clinical diagnosis
extremities or at the site of an spread by direct contact or via is unclear, a Tzanck smear can be
abrasion or laceration.5 Cultures fomites. All possible fomites performed to look for giant cells
of the lesion, along with antibiotic from an affected athlete should or a culture can be obtained.
sensitivities, should be obtained. be cleaned. Once the lesions
Containment: Any equipment are removed, a covering should Molluscum Contagiousm
that was exposed should be be applied to the site of the
thoroughly cleaned and lesion and return to sport is Containment: It is important not
disinfected. As long as there are permissible.4 Frequent checks to simply cover active lesions and
no systemic symptoms (fever, for more lesions should be allow a return to sport. Resumption
malaise) return-to-play guidelines performed since the lesions do of activities can be allowed when
are the same as for impetigo.4-6 not all arise at the same time. there are no new vesicles for at
It may be helpful to have Education: Molluscum is caused least three days, all lesions have
teammates of an infected athlete by the molluscum contagiosum crusted over, and antivirals have
shower with chlorhexidine to virus, a poxvirus. It is a self-limited, been used for at least five days.4,6
decrease asymptomatic carriage.5 superficial viral infection. In Education: Wrestlers seem to be
Education: Excellent hygiene addition to direct skin-to-skin at a particularly high risk for
practices and avoidance of transmission, sharing of towels, HSV infection.1,11 The infection
draining lesions is imperative lies latent in dorsal root ganglia
to prevent the spread of MRSA. and can reactivate leading to
Isolating infected athletes
from the rest of the team and
disinfecting possible fomites are
other important precautions.3
Treatment: Empiric oral therapy
with ciprofloxacin, clindamycin,
rifampin, tetracyclines, or Bactrim
can be used for the treatment of

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