Necrotizing fasciitis in vibrio septicemia
Antibiotic of choice for Vibrio vulnificus:
doxycycline + ceftazidime
NOTE: Add penicillin +/- clindamycin if group A beta-hemolytic streptococcus is also suspected. Clindamycin may be more effective in invasive infections (e.g. fasciitis or myonecrosis). Unlike with penicillin, the efficacy of clindamycin is unaffected by the size of the inoculum and the stage of bacterial growth. In addition, clindamycin inhibits the production of toxin by streptococci.
Post LP headache
This is relatively common. The most effective treatment is epidural blood patch.
Ways to reduce post LP headache:
1. Smaller needles.
2. Correct needle position.
3. Reinsertion of the stylet prior to removal.
Conveniently the Salter-Harris types can be remembered by the mnemonic SALTR.