By Steven Myint; et al
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Erythromycin may reduce spread, but it is rarely possible to give the antibiotic sufficiently early for this to be worthwhile; vaccination is more helpful. Influenza may be complicated by super-infection with bacteria, especially pneumococcal and staphylococcal pneumonia. Influenza vaccine should be given to all ' at risk' persons in the autumn, and the drug amantidine may be useful if given early in infection. RSV causes a severe bronchiolitis in those aged less than 2 (and the elderly), which may either be fatal or produce sufficient lung damage to bring about asthma later in life.
The patient is usually systemically unwell and febrile. 'Scalded skin syndrome' is an acute infection of babies and young children. Staphylococcal toxin causes splitting within the epidermis, leading to large areas of skin loss. Death of tissue leads to gangrene. Synergistic gangrene generally affects the groin and genitals and is confined to the skin. Widespread necrosis of deeper tissues is seen in necrotizing fasciitis caused by 'flesh-eating bugs'. Both conditions require extensive debridement to avoid a fatal outcome.
The condition is extremely difficult to treat and may result in blindness. Diagnosis and treatment Laboratory investigations are essential in the diagnosis and management of eye infections. This not only allows an accurate diagnosis but also, in the case of bacterial and fungal infections, provides a clinical isolate on which antibiotic sensitivity studies can be performed, enabling the appropriate choice of treatment. g. chloramphenicol) Parenteral antibiotics; topical chloramphenicol (newborn) Trachoma; conjunctivitis and keratitis Common in tropics; person to person transmission from contaminated flies, fingers, towels, etc.