Eczema is an itchy skin condition that can impact the area of skin behind the ears, as well as most areas of the ear itself. Prep area with betadine or chlorhexadine using circular motion moving away from joint x 3. Standard maxi drip sets between 10-20 ggt/ml. 05units/kg/hr IV OR give subQ 0. Hydrochlorothiazide 12. Penetrating trauma to the lower third of the face frequently requires intubation or a surgical airway [1] Place a protective shield over an eye suspected to have a ruptured globe. α-2 agonist, BP effects within 30-60 min after PO dose. The arteries that supply Kiesselbach's plexus (responsible for anterior nosebleeds). [1] The term "intertrigo" commonly refers to a secondary infection with bacteria (such as Corynebacterium minutissimum ), fungi (such as Candida albicans ), or viruses. It can be regarded as a special sort of dermatosis that occurs within a skin fold (also known as an intertrigo). Vaginal bleeding definitions. Retract upper lip anteriorly and superiorly. [1] : 309 See also [ edit ]Balanitis describes inflammation of the glans penis and posthitis means inflammation of the prepuce. Intertrigo is a superficial inflammatory dermatitis occurring on two closely opposed skin surfaces as a result of moisture, friction, and lack of ventilation. Breast abscesses develop most commonly when mastitis or cellulitis does not respond to antibiotic treatment, but an abscess can also be the first presentation of breast infection. Nonbullous. Randomized trial of the addition of ipratropium bromide to albuterol and corticosteroid therapy in children hospitalized because of an acute asthma exacerbation. [4] When it affects the mouth, in some countries it is commonly called thrush. Diagnostic of portal hypertension with 97% accuracy [7] SBP rarely develops in patients without portal hypertension. Intertrigo is due to genetic and environmental factors. Diagnosis is by clinical appearance and by potassium hydroxide wet mount. Generally, the infection occurs as a follicular inflammation, or as a cutaneous granulomatous. Griseofulvin 500-1000mg (20mg/kg) PO daily for 2-4 weeks. NOTE: it takes time to set up nitroglycerin drip, so consider SL nitroglycerin in interim. [ in″ter-tri´go] an erythematous skin eruption occurring on apposed surfaces of the skin, as the creases of the neck, folds of the groin and armpit, and beneath pendulous breasts. Patients should remain upright or reverse. Not considered an STI although it can be transmitted by. >3 bm per day or < 3 bm per week. 2001;155 (12):1329-1334. These include: Moisture. Pyelonephritis: Fluconazole 200 to 400 mg/d x 14d. It reduces itching that leads to skin irritation and infection. Contents. Intertrigo results from constant moisture within the skin folds and skin-on-skin friction. Symptoms of intertrigo include: flushed skin; itchiness; stinging; a burning. Staphylococcal scalded skin syndrome. It is caused by an enterovirus, primarily coxsackievirus A6. Definition: GCS 14-15. Noninvasive AGE Species Onset Symptoms Transmission Preformed Toxin Viral (norovirus, adenovirus, rotavirus) : 11-72 hrs Nausea, vomiting, watery diarrhea; Mild abdominal cramps, myalgiaBackground. Anterior Superior Alveolar. As rupture release yellow fluid which dries to form stratified golden crust. Associated injuries. Candidal intertrigo is an infection of the skin by Candida albicans, more specifically located between intertriginous folds of adjacent skin. 3 Differential Diagnosis. Procedure. WikEM, The Global Emergency Medicine Wiki, is the world's largest and most popular emergency medicine open-access reference resource. Asymptomatic periods between episodes where patient has no pain. Coconut oil has anti-inflammatory and skin protective properties. Hailey-Hailey disease (HHD; MIM #169600), also called benign familial pemphigus or benign chronic pemphigus, is a rare, autosomal dominant disorder that affects the adhesion of epidermal keratinocytes. Consult hand surgery regarding possible reimplantation vs revision amputation. 6 mg/dL or RR ≥ 30/min or age ≥ 65 or SBP < 90 mmHg or DBP ≤Funds go solely to hosting and development costs that allow medical practitioners around the globe to freely access WikEM. Management. Use catheter to instill pancreatic enzymes and allow 30-60 minutes to dissolve obstruction, then flush with water [1] Crush 1 pancrelipase tab (lipase, amylase, protease) to fine powder. This skin infection may cause rashes, scaling, itching, and swelling. Must distinguish from Herpes gingivostomatitis. General Fracture Management. Specific diseases separated into ones with known causes and idiopathic. These may include sore throat, fever, aches, nausea, and fatigue. Ensure adequate urine output first. Metrorrhagia: irregular vaginal bleeding outside the normal cycle. Keep the area clean, wash it gently with mild soap, and pat it dry. Anti-Fungal Powder. Antibiotics: Ancef 2 grams. Risk factors (prevalence can reach up to 50% in these populations): Age under 18. + suprapubic tenderness. 4 Pedi Quick Weight. More extensive persistent mucous membrane infections occur in. >3 bm per day or < 3 bm per week. Pass hemostat through both incisions and pull penrose through. Crusting (day 5–8): A honey/golden crust starts to. Contents. Intertrigo's Latin translation,. Doctors examine the affected areas and view skin samples under a microscope or in a culture. Most commonly caused by Tinea rubrum. Anatomy of the posterior pharynx. Friction between skin folds. Preparation: skin prepped with 2% chlorhexidine. Odontogenic Infections. Non-toxic. Clinical Features. The rash has a scaly raised red border that spreads asymmetrically down the inner thighs from the inguinal folds or. The mechanisms of injury, such as penetrating chest trauma or blunt force trauma to the chest, may signal impending respiratory failure. Severe Bullous disease. Signs of middle ear inflammation. Not considered an STI although it can be transmitted by. naloxone) or partial agonist (e. mentagrophytes. 25% [8] Epinephine (1:1,000): 0. Gejala awal penyakit kulit ini adalah ruam merah atau kecokelatan yang muncul pada lipatan kulit. The most benign infections are characterized by local overgrowth on mucous membranes (oropharyngeal involvement, vaginitis) as a result of changes in the normal microbiota. Adduct the affected arm and flex the elbow to 90 degrees. Clamp the prox end of the chest tube and pass it along the tract into the pleural cavity. Nursemaid's elbow involves the head of radius slipping out from the anular ligament of radius. Deviated trachea, flail chest, sucking chest wounds, asymmetric breath sounds, chest wall crepitus, etc. Mechanism. Most commonly seen in females in high estrogen states: pregnancy, oral contraceptive use, obesity, diabetes mellitus. By definition, balanoposthitis cannot occur in a circumcised male, although balanitis (inflammation of the glans. Intertrigo, a common skin condition that can occur in the folds of the skin, is characterized by red, inflamed skin that may be itchy or painful. Vascular injury that reduces cerebral blood flow to specific region of brain causing neuro impairment. Open lesion (day 4): Vesicles break open and merge to create one big, open, weeping ulcer. Cardiovert. Adrenal Insufficiency. ”. At a point 1 cm proximal to tibial plafond space between tib/fib should be ≤6mm. Tinea cruris is usually itchy. For 500 mcg/ml, take 0. Potentially infectious body fluids are blood and CSF. Intertrigo, one of the most common intertriginous skin disorders, is reviewed in detail separately. If you have time sedate with etomidate or ketamine before defibrillation. Hematochezia originates from briskly bleeding upper GI source in 10-15% of cases [citation needed]excessive exercise. Anti-Fungal Powder. Acute onset (<48hr) AND. Hematochezia originates from briskly bleeding upper GI source in 10-15% of cases [citation needed]Intertrigo (intertriginous dermatitis) is a clinical inflammatory condition that develops in opposing skin surfaces in response to friction, humidity, maceration, or reduced air circulation. intertrigo. 1 Administration; 2 Adult Dosing. ; The sterile matrix is deep to the nail, adheres to it and is distal to the lunule. Chloramphenicol 0. 500 mg, if weight <150 kg. Localizes to epigastric area, around waist, RUQ, or occasionally LUQ. It is often associated with. Less likely Intussusception given reassuring ultrasound, no hx of bloody stool, no asymptomatic periods between episodes, no lethargy or palpable mass. Risk factors (prevalence can reach up to 50% in these populations): Age under 18. Given history, exam and workup I have low suspicion for fracture, dislocation, significant ligamentous injury, septic arthritis, gout flare, new autoimmune arthropathy, or gonococcal arthropathy. 2 Causes; 1. Can be treated within 24hr by angiographic clot removal or angioplasty. Initiate nutrition at a maximum of 40%–50% goal, but usually starting the glucose infusion rate around 4–6 mg/kg/min and advancing by 1–2 mg/kg/min daily as blood glucose levels allow until you reach a max of 14–18 mg/kg/min. In children, give 1/2 of total volume as FFP and 1/2 as LR throughout 24 hrs. Background. Place a wick if the ear canal is fully obstructed. Blockage or congestion of nose. Intertrigo frequently is worsened by infection, which most commonly is with Candida species. Clin Toxicol. Need labs before starting, does not work in people with CKD. 1 Pediatric signs of dehydration. The wisdom tooth (3rd molar). The affected area is red, irritated, itchy, or a combination. Erysipelas. Highest inflammatory response - wood, copper, iron, steel. Tinea barbae is due to a dermatophytic infection around the bearded area of men. These areas tend to. When it affects the mouth, in some countries it is commonly called thrush. Whiff Test. Time out: Immediately prior to procedure a "time out" was called to verify the correct patient, procedure, equipment, support staff and site/side marked as required. Place in plastic bag and put bag in ice water (do not put finger directly on ice!) Tetanus Prophylaxis if > 5 years since last vaccination. : inflammation produced by chafing of adjacent areas of skin. Defined as an infection of the endocardial surface of the heart, affecting native (or prosthetic) heart valves as well as in-dwelling cardiac devices. Touch the skin with a gloved hand to determine if the lesions are flat or raised. Perforation can be due to multiple mechanisms but is generally either mechanical (e. Intertrigo is a skin condition that causes a rash in skin folds, such as under the breasts, in the groin, or in stomach folds. Open lesion (day 4): Vesicles break open and merge to create one big, open, weeping ulcer. 5mg, max 25mg. Night pain and unrelenting pain are worrisome symptoms. 1mg/kg IV; repeat if needed. Karo syrup, add 1 tsp to 4 oz cooled, boiled water; give 1 oz of solution to baby just before feeds twice a day until stool softens. UA /Urine cultures. [7] How to use: Apply coconut oil on the affected area and leave it overnight. Missed. Abdominal pain or bleeding; < 20 weeks gestation. Intertrigo in babies requires special care because the affected skin area is so delicate. -CVA tenderness. Pseudogout = Positively birefringent, rhomboid-shaped, calcium pyrophosphate crystals. By definition, balanoposthitis cannot occur in a circumcised male, although balanitis (inflammation of the glans. Acute tinea cruris may present as a moist and exudative rash. Consider octreotide (50 mcg IV bolus, then 50 mcg/hr continuous, maintained at 2-5 days in patients with concern for variceal bleeding) [12] Consider vasopressin. Consider other reasons for intertrigo especially:. 5gm q6h + cipro 400mg q8h + vanco 15mg/kg q12. Clinical Features. Background. “Germ-tube positive yeast” is identified as. 1. Fetal Effects in pregnancy. The most common cause is infection of residual bladder urine with urea-splitting organisms ( Proteus, Pseudomonas,. Radiates to back. Counsel patient/family on importance of hand hygiene/avoiding touching face to prevent spread! Apply warm or cool compresses (for comfort and cleansing) every 4 hours, followed by instillation of ophthalmic antibiotic solutions. D-dimer testing still effective and a negative test decreases post-test probability disease to <1%. The main goal is to determine superficial vs. Hyposmia (diminished ability to smell) Anterior or posterior nasal discharge lasting <12wk. Urolithiasis comprises 3 similar clinical entities: Nephrolithiasis. Intertrigo is skin maceration in intertriginous areas caused by moisture and/or infection. Funds go solely to hosting and development costs that allow medical practitioners around the globe to freely access WikEM. A "one-part" fracture is one in which fragment is displaced <1cm or not angulated >45deg. Hypotension. Dashboard impact, fall from height, sports injury. Peak in 5-15yr old [1] Rare in <2yr of age [1] Accounts for only 15-30% of pharyngitis [1] Caused by S. Technique. 33% are associated with ocular trauma. Heals in 4-6 weeks. Typically presents acutely (i. Also known as "trench mouth". Candida is considered part of the normal flora in the gastrointestinal tract, the mouth and the vagina. Defined as a reduction of blood to the small and/or large intestines. Tinea Cruris (Jock Itch) Tinea cruris is a dermatophyte infection of the groin. General group of diseases that involve the scarring of lung parenchyma. 1 mm of ST elevation in any two contiguous leads except V2 and V3. 1 Colitis; 2 Differential Diagnosis. Measure SBP from both brachial arteries using cuff and handheld Doppler over the AC fossa. Perform a careful physical exam. Most commonly seen in females in high estrogen states: pregnancy, oral contraceptive use, obesity, diabetes mellitus. May also be called lumbago, referring to pain in the muscles and joints of the lower back. In-hospital mortality of 5-10% for ischemic stroke and 40-60% for hemorrhagic stroke. Intertrigo (intertriginous dermatitis) is an inflammatory condition of skin folds, induced or aggravated by heat, moisture, maceration, friction, and lack of air circulation. 2 Definitions; 1. Always consider possibility of multiple foreign bodies. Rub erythematous skin to see if it sloughs. 2015; 53(1):5-12. Fluconazole 150mg (6mg/kg) PO once a week x 2 weeks. Ceftriaxone 500 mg IM in a single dose PLUS. Rashes in in skin folds ( intertrigo ), such as under your breast, are generally caused by the following: viral or bacterial infections such as shingles (viral) or yeast (bacterial) skin friction. Pneumonia Pneumonia by imaging AND O2 sat 89−91% OR pneumonia severity index 71-90 OR two CURB-65 criterion (confusion or BUN > 19. 5cm) or long (>6cm) objects. Suppresses the reticular activating center in the brainstem and cerebral cortex, thereby causing sedation. Ocular foreign bodies are a high-risk chief complaint because of short and long-term threats to vision loss. WikEM Bureaucratic Portal. This page is for adult patients; see urinary tract infection (peds) for pediatric patients. ST depression ≥1 mm in lead V1, V2, or V3 - 3 points. 2. Mitral valve most commonly affected overall; tricuspid valve most common in IVDA. rubrum and E. ingested bones) or via chemical corrosion (e. Correct. Routes of Administration:. Occurs due to sudden change in direction with heel off the ground. 1 This common skin disorder may be localized in a small area or involve larger surfaces. Select probe. Stage I: GI toxicity: nausea, vomiting, diarrhea, GI bleeding from local corrosive effects of iron on the gastric and intestinal mucosa. Drug or alcohol intoxication. Type 1: Spontaneous Myocardial Infarction. May spread to perineum, perianally, onto buttocks, or into gluteal cleft. associated with change of stool freq. Funds go solely to hosting and development costs that allow medical practitioners around the globe to freely access WikEM. ; The lunula is that white semi-moon shaped proximal portion of the nail. Candidal intertrigo (Erythematous patches with satellite lesions) Inverse psoriasis; Testicular Diagnoses. This patient presents with symptoms concerning for acute CVA versus TIA. You need to shower every day (especially after excessive sweating or physical activity) and properly dry yourself with a clean towel by gently tapping it on your skin, rather than rubbing it forcefully. 1 Genitourinary infection; 1. Normal vaginal epithelial cells on wet mount: note clean borders. Named after. Gunshot, High energy trauma, Motor vehicle crash with rollover or ejection, Fall >10 ft or 3 m, Pedestrian hit by car. Respiratory: normal effort. Primary risk factors include history of prior miscarriage and advanced maternal age [1] Other risk factors include heavy alcohol use, uterine structure abnormalities, and systemic maternal disease. Perforation can be due to multiple mechanisms but is generally either mechanical (e. Note trabeculated wall, which is a sign of urinary retention. 2. Common materials based on inflammatory reactions. 3 Hand and finger infections. 2 Universal Web App. Cohabitation with infected individual. 1. NB: levofloxacin is preferred for contact lens wearers for coverage of pseudomonas. Intertrigo frequently is worsened or colonized by infection, which most commonly is candidal but also may be bacterial or viral or due to other fungal infection. Start 10 mg on alternate days for three doses and increase by 10 mg every three doses until symptoms improve. pyogenes (Group A strep) [1] Peak season is late winter / early spring [1] Transmission is respiratory secretions [1] Incubation period is 24-72 hours [1]Persistent unpleasant sensations attributable to the bladder, can include pressure, spasms, or discomfort. 1. Background. Lipohemarthrosis (presence of fat and blood from bone marrow in the joint space after an intraarticular fracture) seen on X-ray in a person with a subtle tibial plateau fracture. Bradycardia. Background. Major Points. Closed. Condition other than CAD contributes to an imbalance between myocardial oxygen supply and/or. Intubation. 1 Serious; 6. Middle ear effusion AND. In men 40 and older: 2mm elevation in V2 and V3. read more that manifests in the beard area as superficial annular lesions, but deeper infection. Thrombosis of vascular access can be treated with direct. Diagnosis is typically by clinical appearance. This breakdown often leads to infection by yeast or bacteria. The arteries of the face and scalp. Structural imaging on MRI or CT might not. Pyelonephritis: Fluconazole 200 to 400 mg/d x 14d. Clindamycin 450mg (5mg/kg) PO q8hrs x 10 days (if PCN allergic) OR. Traumatic superficial thrombophlebitis - Associated with limb injury from blunt trauma, IV catheters or chemical treatment. Additionally, the affected area should. Perform infraorbital and supraorbital nerve block if needed. In men under 40: 2. Our highly acclaimed content is freely available via the internet and our dedicated mobile applications. ; The germinal portion is proximal. Gout = Negatively birefringent, needle-shaped monosodium urate crystals. Tunnel view may also be helpful. Dentoalveolar Injuries. Food and bacteria can accumulate between the erupting tooth and operculum (flap of gingiva) leading to infection and pain. Orthopedic emergency. Infection thrombophlebitis - Associated with prolonged IVs and is the only thrombophlebitis to require antibiotics. Atherosclerotic plaque rupture or intraluminal thrombus in one or more of the coronary arteries. At least 100,000 deaths per year may be directly or indirectly related to DVT and PE. Intertrigo is most commonly found in the groin, axillae, and inframammary folds. 3 Uncomplicated UTI; 2. Menorrhagia: >7 day (prolonged) or >80 mL/day (excessive) uterine bleeding at regular intervals. Ensure that inner tract/incision can fit your finger and tube. A breast abscess is a localized collection of inflammatory exudate (ie, pus) in the breast tissue. Colloquially known as Pinworm (United States), Treadworm (UK and Australia) or Seatworm. 5gm q6h + cipro 400mg q8h +. The reason for the higher incidence in these cancer patient populations is the higher radiation dose to the skin. Background. Candida are considered normal flora in the gastrointestinal and genitourinary tracts of humans but invade and cause disease when there is an imbalance in their ecologic niche. Weaker topical steroids are utilized for thin-skinned and sensitive areas, especially areas under occlusion, such as the armpit, groin, buttock crease, and breast folds. High-energy trauma is primary mechanism for native hip dislocation. Intertrigo is inflammation of skinfolds caused by skin-on-skin friction. Yes, complete expulsion of products. Develops over 1-3 days. Ocular myasthenia gravis. If microperfs become infected/inflamed, can lead to diverticulitis. Inject 1-2mL of lidocaine with epinephrine into mucosa of anterior tonsillar pillar using 25 gauge needle. Phosphate ≥ 4. Three months of abdominal pain : relieved by defecation. With impairment of consciousness at onset. Abrupt onset of lateral foot pain, with no prior history of pain at that site, suggests acute injury and helps distinguish from stress injury. If you are a medical practitioner, join our contributor community and share your important. doi. 4 - 1 unit/min [13] Give with IV nitroglycerin at 10 - 50 mcg/min to bolster portal hypotension and reduce vasopressin systemic. Other symptoms may include soreness and problems swallowing. 5 mL per kg (maximal dose: 5 mL) via nebulizer. Dosage Forms. Intertrigo's Latin translation, inter (between) and terere (to rub) helps explain the physiology of the condition. These fat folds can trap heat, moisture, bacteria and yeast inside, and combined with chafing, this leads to a condition called intertrigo. In rapid accumulating effusion (left curve), even a small effusion volume can exceed the limit of parietal pericardial stretch and finally causes a steep rise in pressure. TEN involves >30% of the skin body. In most cases, pityriasis rosea begins with cold-like symptoms. Intertrigo (intertriginous dermatitis) is an inflammatory condition of skin folds, induced or aggravated by heat, moisture, maceration, friction, and lack of air circulation. CO damage at cellular level due to reactive oxygen species, lipid peroxidation, and cellular apoptosis. Interpretations of Key Phrases. tend to cause more side effects (heavy/irregular menses. Ocular myasthenia gravis. WikEM is wiki-based medical website and point-of-care phone application for emergency medicine clinicians. Acute: less than 3 weeks in duration. ECG (ie. 3. Funds go solely to hosting and development costs that allow medical practitioners around the globe to freely access WikEM. As rupture release yellow fluid which dries to form stratified golden crust. Calamine lotion is a topical over-the-counter medication you can use for mild itchiness. 5mg/kg IV can be given every two minutes. , appendicitis, diverticulitis, perforated peptic ulcer, penetrating trauma) and often requires immediate surgical intervention. Sweat, urine, and. It belongs to a group of medications called antifungals. I got a bad patch of Intertrigo in skin folds. 3 Complications; 2 Clinical Features. Make incisions along natural auricular crease for cosmesis. Trace - 10-30mg/dl. Muscle rigidity - generalized, "lead pipe" rigidity. First line for people with DM and/or proteinuria. Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are a spectrum of disease which ultimately results in blistering and peeling of the skin. Remove the guidewire and fascial dilator, leaving only the peel-away sheet. Most common presenting sign. (a) Fingernail avulsion; (b) polypropylene nail substitute; (c) clinical result at 12 months. If med adherence is an issue [2]Other Medications. Sodium bicarbonate (Redirected from Sodium Bicarbonate) Contents. 2 Posterior; 2. Azithromycin 1% ophthalmic solution 1 drop BID for 2 days THEN 1 drop daily for 5 days. LOOP Technique. Figure 2A of Edlow & Newman-Toker "Using the physical exam to diagnose patients with acute dizziness and vertigo" J Emerg Med 2016 I think would make a much more appropriate choice to replace this algorithm. Pericardial pressure-volume relationships in patients who have rapidly (left curve) and gradually (right curve) developed a pericardial effusion. Institutionalized. E. Replace nail into nailfold after. Non Blow-out Fracture. Microscopic hematuria generally defined as >3 RBCs per high-power field of an uncontaminated sample. It is a collection of disparate conditions with similar clinical presentation and varying etiologies affecting a particular anatomical site [ Table 1 ]. 5 ml of 10mg/ml phenylephrine, and dilute in 9. The most benign infections are characterized by local. Defined as a reduction of blood to the small and/or large intestines. Background. Blue - supply from inferior mesenteric artery (IMA) and its branches: left colic, sigmoid, superior rectal artery. Menorrhagia: >7 day (prolonged) or >80 mL/day (excessive) uterine bleeding at regular intervals. Most frequent symptom is increased discomfort with bladder filling and relief with voiding. Keeping the elbows adducted, ask the patient to slowly lean head back and allow shoulder to roll forward. If you are a medical practitioner, join our contributor community and share your important knowledge with. Evaluation should focus on determining whether. Proteins. Pick up the pre-lubricated catheter and insert it. Dermatophyte infection involving the crural fold. CNS. intraocular foreign bodies. In most cases, pityriasis rosea begins with cold-like symptoms. Intertrigo leads to an itchy rash that can. 1 General. These options do not cover gonococcal or chlamydial infections. Then, a single, large spot may appear on your chest, stomach, or back. Undressing the patient to fully examine the trunk and the extremities. The result can be a red, irritated, and inflamed skin rash that sometimes has a smell. Intertrigo is a common inflammatory skin disorder caused by skin-on-skin friction within skin folds, as a result of moisture becoming trapped because of poor air circulation. [9] ETIOLOGY. Delirium, coma. 3 mg PO q12 scheduled; For hypertensive emergency, 0. Intertrigo frequently is worsened or colonized by infection, which most commonly is candidal but also may be bacterial or viral or due to other fungal infection. ointments that may block the skin. It is a common skin condition affecting opposing cutaneous or muco-cutaneous surfaces. in· ter· tri· go -ˈtrī-ˌgō. Nausea/vomiting noted in most. 5mg/kg IV; repeat if needed. Back pain (red flags) (Redirected from Back Pain (Red Flags)) Contents. Intertrigo (intertriginous dermatitis) is an inflammatory condition of skin folds, induced or aggravated by heat, moisture, maceration, friction, and lack of air circulation. Once in the space, remove the clamp. Neutropenic patients: micafungin 100 mg/d IV or other echinocandin (anidulafungin, caspofungin) Patients with fluconazole resistant candida can be treated with amphotericin B. Type 5 (Crush) Salter-Harris IV fracture of the distal tibia with associated distal fibular fracture that does not involve the physis.