Sepsis with Skin Findings

Meningococcemia----------------N. meningitidis ---------Penicillin

or

Ceftriaxone

Consider protein C replacement in fulminant meningococcemia.

Rocky Mountain spotted fever (RMSF--------------Rickettsia rickettsii

Doxycycline If both meningococcemia and RMSF are being considered, use ceftriaxone plus doxycycline or

chloramphenicol alone .If RMSF is diagnosed, doxycycline is the proven superior agent.

Purpura fulminans---------------------- S. pneumoniae, H. influenzae, N. meningitidis Ceftriaxone

Vancomycin
If a -lactam–sensitive strain is identified, vancomycin can be discontinued.

Erythroderma: toxic shock syndrome ---------Group A Streptococcus, Staphylococcus aureus