Reports of infections caused by unusual bacteria are becoming more common. Nonetheless, they are repeatedly misdiagnosed. It is the purpose of this paper to delineate the methods by which a correct diagnosis can be made of an unusual infection in the skin.
The problem of separating the pathogen from the contaminant can be difficult. A positive culture in pure growth from a cutaneous lesion is not always sufficient to implicate an organism as a pathogen. It is necessary to have a rising antibody titer or to culture a bacteria from several sources or from an unbroken lesion before it can be regarded as a proven pathogen. Because of this, many cases reported in the literature as lesions due to rare bacteria must be disregarded as probable coincidental eruptions in patients from whom carrier organisms were cultured on the skin.
Cutaneous manifestations of infections are of 2 types: primary or secondary.
BURNETT JW. Uncommon Bacterial Infections of the Skin. Arch Dermatol. 1962;86(5):597–607. doi:10.1001/archderm.1962.01590110033004
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