Folliculitis wikem. This patient presents with symptoms concerning for acute CVA versus TIA. Folliculitis wikem

 
This patient presents with symptoms concerning for acute CVA versus TIAFolliculitis wikem  It is one of the causes of folliculitis

Comparison to opposite CC joint space is more important. Dose (Ketamine): Start with 0. Neonates (up to 1 month of age) MRSA is uncommon in the neonate. 5437 or 800. Painful. 70% of patients with diverticulosis remain asymptomatic. Folliculitis has been traditionally divided into superficial and deep forms; however, most superficial forms can evolve into the deep form. Anorectal abscess; Bartholin gland abscess; Pilonidal abscess; Scrotal abscess; Necrotizing soft tissue infections. However, along with pain, folliculitis tends to involve more “itch,” while acne is less commonly described as “itchy”. Also occurs due to bacteremia with hematogenous seeding (Staph) Emphysematous pyelonephritis. PTA will have echo-free cavity with irregular border. Left untreated, severe infections can cause permanent hair loss and scarring. 5mg/kg IV q8hrs. Inflammation of deep dermal/subdermal lymphatic channels. Dependent upon the infected organ; PCR or culture on Thayer-Martin agar (most common) Management Presumed GC/chlamydia of cervix, urethra, or rectum (uncomplicated). Wet a clean washcloth with warm water and apply it to the infected skin area to help decrease pain and swelling. Cardiac. Necrotizing fasciitis; Necrotizing myositis; Necrotizing cellulitis; Fournier's gangrene; Mycobacterium marinum; Look-A-Likes. Folliculitis; Hidradenitis suppurativa; Skin abscess. Folliculitis refers to inflammation of the superficial or deep portion of the hair follicle. Symptoms usually include red or purple skin in the affected area, severe pain, fever, and vomiting. 80% of lower GI bleeding will resolve spontaneously [citation needed] Cause of bleeding found in <50% of cases [citation needed] Diverticulosis cause majority, other conditions include colitis, polyps, colorectal cancer, hemorrhoids, anal fissures. Causes of non-infective folliculitis. 1. Topical Antibiotics. 0 2. Select probe. The main goal is to determine superficial vs. After 2yr of age, UTI remains common in girls (but associated with symptoms)Labeled vulva, showing external and internal views. Most commonly, radiation-induced dermatitis is caused by radiotherapy for underlying malignancies. Echinacea is a herb which contains antibiotic properties and can be used for curing folliculitis. 1 Dermatoses, steroid-responsive; 3 Pediatric. [2] [3] This can lead to ingrown hairs, scarring, and skin discoloration. Pus-filled blisters around hair follicles. Ceftriaxone 1g (50mg/kg) IV once daily x 10 days OR. Chlamydia. Follicular occlusion may be a key pathogenic event in the. In men 40 and older: 2mm elevation in V2 and V3. Background. Other items on the differential include dissection, AMI, hypoglycemia or other metabolic derangement such as hepatic/uremic encephalopathy, medication side effect, or post-ictal Todd’s paralysis. Submandibular ultrasound may be superior to intraoral ultrasound when limited by trismus or pain. Pus-filled blisters that break open, ooze, and crust over. Both acne and folliculitis can be. Anorectal abscess;. Evaluate for tenderness, fluctuance. coli is responsible for ~80% of UTIs. Oblique (mortise) Best for evaluating for unstable fracture or soft tissue injury. Anorectal abscess; Bartholin gland abscess; Pilonidal abscess; Scrotal abscess; Necrotizing soft tissue infections. Technique. Be sure to palpate for the spermatic cord, urethra, and ipsilateral testicle. Levofloxacin 500mg PO/IV daily x 10 days OR. Tender inguinal lymphadenopathy may be. Fever. Pruritus or mild discomfort. Ceftriaxone 50mg/kg IV once daily OR Cefotaxime 50mg/kg IV three times daily, PLUS. Specialty. About WikEM; Disclaimers; This page was last edited 19:51, 27 January 2017 by Daniel. Use oral steroid for 3wks until skin turns over. String of pearls sign (small pockets of gas along the small bowel that are trapped between the valvulae conniventes) is virtually diagnostic [5] Small bowel diameter ≥3cm is associated with obstruction. Various interventions have been suggested for treating folliculitis (Craft 2012; O'Dell 1998), including local application of moist heat, phototherapy, antiseptic agents, antibiotics alone, or combination therapy. Your hair grows out of the follicle. At a point 1 cm proximal to tibial plafond space between tib/fib should be ≤6mm. After 1yr of age, occult UTI with normal UA extremely rare. Primarily in elderly, nursing home or young patients with neurological impairment, chronic opioid use. You can have folliculitis on your face, arms, back and legs. A mix of bacteria, oil, and cells can cause a pimple with or. 2. CO damage at cellular level due to reactive oxygen species, lipid peroxidation, and cellular apoptosis. Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score. Plus/minus local anesthesia skin wheal. [1] : 252 [2] The irritation is caused by a deep infection of hair follicles, often by species of Staphylococcus or Propionibacterium bacteria. Worsening pain around bowel movement, with decreased pain post rectal evacuation. Most types of folliculitis do not spread from person to person, but it can be contagious in certain forms. Do not over-reduce a lateral compression fracture (places increased strain on post pelvis) Placing pelvic binder in vertical shear injury (fall from height) may worsen fracture. Clinical Features. Hypotension. Also helpful for extremities, sole of foot. Breakouts. Signs and symptoms. Warm compresses may also help drain pus and improve healing. The role of anticholinergics in acute asthma treatment: an evidence-based evaluation. Be sure to palpate for the spermatic cord, urethra, and ipsilateral testicle. Clinical Features. Stevens-Johnson syndrome and toxic epidermal necrolysis. 1. The classic clinical findings of superficial folliculitis are folliculocentric, inflamed papules and/or pustules on hair-bearing skin ( picture 1A-C ). 3 Problems. aureus is the most common. Contents. Funds go solely to hosting and development costs that allow medical practitioners around the globe to freely access WikEM. Folliculitis is a type of small skin abscess that involves the hair follicle. It is also known as "sweat rash," "prickly heat," or "heat rash. What does skin cancer look like? Learn more about how to spot it and begin getting treatment early on. The number of lesions can vary; usually 300 or less but can be more than 2,000 [1]Outpatient. What is folliculitis barbae? Hairs are formed within the skin in tiny structures known as hair follicles. At first it may look like small pimples. Initial infusion 0. At first it may look like smalMethod 3: Apple Cider Vinegar. Superficial bacterial folliculitis – The most common form of folliculitis, this particular condition is usually caused by the bacteria Staphylococcus aureus. 454. Boils (also referred to as furuncles ) are pus-filled lesions that are painful and usually firm. Mental status changes. Augmentin 500mg PO BID x 10 days (generally reserved for failure of first line therapy) Boils, also known as furuncles, involve adjacent tissue and may progress to cellulitis or lymphadenitis. A common skin condition, folliculitis happens when a hair follicle becomes infected or inflamed. ; Sometimes folliculitis is due to an auto-inflammatory. Typically affects chest/face. 1. The main difference is that acne is a clogged or infected pore, while a folliculitis bump is actually an infected hair follicle. Signs of folliculitis are a superficial pustule or inflammatory nodule surrounding a hair follicle. However, presentation most concerning for a CVA. 7% of patients <2 years old with fever have pneumonia, however the etiology (viral/bacterial) or even the presence of pneumonia has low inter-observer reliability even among pediatric radiologists [1] 4% Prevalence of UTI with common other sources of fever ( OM, viral URI, etc) [2] 0. Folliculitis; Hidradenitis suppurativa; Skin abscess. hot tub folliculitis - pseudomonas folliculitis is a benign, self-limited disorder (2) Showering after exposure to contaminated water does not seem to prevent the disease hot water, a high pH, and low chlorine levels all predispose to infection - pseudomonas folliculitis can be prevented by proper maintenance and chlorination of pools, hot tubs. ABSTRACT: Pseudofolliculitis barbae (PFB), also known informally as razor bumps, is a common, chronic, inflammatory skin condition that occurs as a result of shaving, mainly in men of African descent. Perioral dermatitis (POD), also known as periorificial dermatitis, is a skin disorder that typically presents with multiple small, inflammatory papules around the mouth, nose, or eyes ( picture 1A-L ). You can have folliculitis on any part of your body that has hair. [1] Continuum of disease - Plugged ducts → engorgement → non-infectious inflammation → infectious inflammation → abscess. Folliculitis is a common skin condition that can impact men and women. If possible, sweep these structures out of the way. Folliculitis is a clinical diagnosis so diagnosis is usually based on history and physical examination. The condition can be itchy, sore and embarrassing. 13% of diverticulitis is found in patients <40 yrs of age [1]Cefotaxime 50mg/kg IV q6hrs OR Gentamicin 2. Tetracycline 1. Folliculitis is characterised by inflammation of the hair follicle. Rarely, in the anogenital area, these two processes develop from. Menorrhagia: >7 day (prolonged) or >80 mL/day (excessive) uterine bleeding at regular intervals. Odontogenic Infections. 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]Necrotizing fasciitis (NF), also known as flesh-eating disease, is a bacterial infection that results in the death of parts of the body's soft tissue. Pseudofolliculitis barbae (PFB) is a common inflammatory reaction of the hair follicle, most often on the face as a result of shaving. Lesions in various stages of development. An infant with Staphylococcal scalded skin syndrome. Bacterial folliculitis is usually due to Staphylococcus aureus. While the redness often turns white when. [2]To decrease pain of injection: Buffer lidocaine with bicarbonate (1mL bicarb:9mL lidocaine) Consider nerve blocks to avoid tissue distortion for cosmetic areas such as vermillion border. About WikEM; Disclaimers; This page was last edited 06:46, 26 November 2019 by Ross. Contact dermatitis. This condition may look like acne, often starting out as small red bumps. 1 General; 2. Malassezia adalah salah satu jenis jamur yang biasanya ditemukan di kulit. Prodrome: Headache, malaise, photophobia. Phytophotodermatitis caused by lime. Initial infusion 0. Common skin infections include cellulitis, erysipelas, impetigo, folliculitis, and furuncles and. Dental Numbering. 0. 05% cream. WE NEED YOU! Please fill out this brief <5 minute survey to guide WikEM's development of pediatric emergency resources:. It varies in size and may occur at different levels within the epidermis: subcorneal, intraepidermal, or basement membrane zones. Staphylococcal scalded skin syndrome. Clinical Features. It should be noted that both the methicillin-sensitive and methicillin-resistant forms of this bacteria can cause folliculitis. While this is a non. Anorectal abscess; Bartholin gland abscess; Pilonidal abscess; Scrotal abscess; Necrotizing soft tissue infections. The infection is caused by the bacteria Pseudomonas aeruginosa which lives in wet, warm areas including hot tubs, whirlpools, and waterslides. Continuous >12 mo in duration. The condition can be itchy, sore and embarrassing. Necrotizing fasciitis; Necrotizing myositis; Necrotizing cellulitis; Fournier's gangrene; Mycobacterium marinum; Look-A-Likes. Rarely needed but if so, use tube that is one half size smaller than normal for age/size of patient. A common skin condition, folliculitis happens when a hair follicle becomes infected or inflamed. Gluten-free diet; Dapsone; Disposition. 1. Antibiotic or antifungal. Children (non-permanent) teeth identified by letters. Then apply the paste on the affected or infected part of the skin. If microperfs become infected/inflamed, can lead to diverticulitis. CO binds to myoglobin and alters its function. This honeycomb is a painful. Within 24hr rash becomes vesicular (on erythematous base) Often referred to as "dew drop on a rose petal" [1] Palms/soles spared. 9. 1 General; 2 Adult Dosing. Vesiculobullous rashes. Type 2 is characterized by deep nodular or cystic lesions. ; Pseudomonas spp. Typically affects younger men and adolescents who have just begun to shave. Clinical diagnosis, based on history and physical examination; Management. High-potency topical corticosteroids: e. If you feel unable to isolate the above structures from the abscess site, it. Infectious disease. Other people who used the hot tub may have the same rash. Primary bacterial infection of skeletal muscle. Contact dermatitis from poison oak exposure (Day 4). Scan from midline to the midclavicular line at the right 11th/12th intercostal spaces. Do not shave the area. Perirectal abscesses often accompanied by fever, leukocytosis. Anal chancres appear ~2-6 weeks after intercourse, are often painful. Folliculitis. Oral corticosteroids such as prednisone 50mg PO daily. If possible, sweep these structures out of the way. Catheter should remain in place for 4-6wk to avoid recurrence. Most cases of folliculitis go away without treatment. Levofloxacin 500mg PO/IV daily x 10 days OR. 2. Clindamycin 10mg/kg IV PO four times daily OR. Comments. Also known as "Rose gardener's disease" [1] Caused by the fungus Sporothrix schenckii [2] found on rose thorns. 1. In fact, an inflamed hair follicle ( folliculitis ) is the most common cause of red, inflamed pimples on your butt. 4 Pedi Quick Weight. Soreness is less frequent. ↑ Quirke M et al. The borders of the area of redness are generally not sharp and the skin may be swollen. Folliculitis develops when the hair follicle is clogged, an ingrown hair causes blockage and irritation, or the hair follicle is infected by bacteria, fungi. Keratosis pilaris (KP; also follicular keratosis, lichen pilaris, or colloquially chicken skin) is a common, autosomal-dominant, genetic condition of the skin's hair follicles characterized by the appearance of possibly itchy, small, gooseflesh-like bumps, with varying degrees of reddening or inflammation. Background. Is a superficial infection of the hair follicle, usually caused by staphylococcus aureus. Redness, swelling, and pustule formation centered around the hair follicle opening commonly occur with folliculitis. No specific therapy for most; self-limited;. 80% of lower GI bleeding will resolve spontaneously [citation needed] Cause of bleeding found in <50% of cases [citation needed] Diverticulosis cause majority, other conditions include colitis, polyps, colorectal cancer, hemorrhoids, anal fissures. Community acquired-MRSA (CA-MRSA) Tends to be resistant to beta-lactams, most commonly seen in Skin and Soft Tissue Infections and rarely in necrotizing. 1 The exact incidence of folliculitis is unknown as most patients do not seek medical attention. Patients should remain upright or reverse. Kingae (common in daycare population) DM or vascular insufficiency. S+ synergistic with cell wall antibiotics. For almost one quarter of PE patients, the initial clinical presentation is sudden death. Folliculitis; Evaluation Management. Manually express contents. Labs. Levofloxacin 500 mg orally once daily for 10 days. Small vessel. Folliculitis; Hidradenitis suppurativa; Skin abscess. ; The sterile matrix is deep to the nail, adheres to it and is distal to the lunule. Cephalexin 500mg (6. Gejalanya bisa memburuk ketika muncul. Reduced CNS sympathetic flow, decreasing SVR, HR, BP; no renal blood flow changes; tolerance/tachyphylaxis develop quickly. It is characterized by tender, swollen areas that form around hair follicles, often on the neck, breasts, buttocks, and face. We need you! See something you could improve? Make an edit and help make WikEM better for everyone. ; The lunula is that white semi-moon shaped proximal portion of the nail. I+D. Also, use hot water and detergent to wash any clothing. 1 mm of ST elevation in any two contiguous leads except V2 and V3. Being the panacea for a number of health issues, apple cider vinegar is also an effective remedy to treat folliculitis. This is so common that there’s a condition called “hot tub folliculitis. Aim of insulin regime is to correct the acidosis, not merely the hyperglycemia. Penyakit Folikulitis adalah suatu peradangan pada Folikel. When it affects the vagina, it may be. Sweet's syndrome. Herpes Zoster. 5mg/kg IV q8hrs. 2. e. Only 10% of stroke survivors will recover completely. In a small number of cases, it can cause: boils to form under your skin. Morel-Lavallee lesion is a closed traumatic soft-tissue degloving injury, caused by separation of the hypodermis from the underlying fascia. If med adherence is an issue [2]Inject 1-2mL of lidocaine with epinephrine into mucosa of anterior tonsillar pillar using 25 gauge needle. Characterized by slowly expanding indolent ulceration that is confined to superficial fascia. Advance depth until abscess cavity entered. Used when the patient and clinician make a joint decision to stop further attempts to restore and/or maintain sinus rhythm. Neutrogena's Body Clear Body Wash ($9) comes highly recommended by Zalka, who says it "may help prevent oils, dead skin cells, and bacteria from infiltrating your pores. Each hair on your body grows out of a tiny pouch called a follicle. LOOP Technique. Tinea barbae is due to a dermatophytic infection around the bearded area of men. 1 Background; 2 Clinical Features; 3 Differential Diagnosis. It is typically due to an infection and results in irritated pimple-like spots or pustules. Nafcillin 50 mg/kg IV four times daily to cover K. 5atm: 24min. Folliculitis barbae is an itchy and sometimes tender papulopustular eruption of hair follicles in skin areas prone to shaving, such as the beard-line in men. Some patients may feel ill or have a. Tense and clear vesicles/bullae on head, trunk, mucosa. In a small number of cases, it can cause: boils to form under your skin. Sometimes folliculitis looks like acne, but follicultis tends to arise suddenly, with larger and more. Ear anatomy. Phased array probe used by many providers as well. Folliculitis is an infection of the hair follicles. 2 Distal Leg Fracture Types;Bullous impetigo. Certain types of folliculitis are known as hot tub rash and barber's itch. a chronic inflammatory reaction. If you feel unable to isolate the above structures from the abscess site, it may be safest to consult urology. Folliculitis commonly occurs in areas with terminal hair growth, such as the head. 2 iOS. Anda mungkin tidak merasakan apapun atau terkadang infeksi ini menyebabkan gatal pada kulit. It helps to have your finger in the tract and pass the tube along your finger, particularly in obese patients. Symptoms include: Itchy, red, and bumpy rash. Gallstones are classified as cholesterol stones and pigmented stones (black and brown), and are present in approx 20% of females and 8% of males in the United States. 2017 Aug;177(2):382-394. Perianal abscess. Many have been documented in the past. Funds go solely to hosting and development costs that allow medical practitioners around the globe to freely access WikEM. U sensitive for UTI only (non systemic infection) X1 no data. 2 Dermatology Nomenclature. At first it may look like small pimples around the tiny pockets from where each hair grows (hair follicles). You can have folliculitis on your face, arms, back and legs. Folliculitis manifests clinically as erythematous papules or pustules around hair follicles. 5437 or email us. Vesiculobullous rashes. 95% recover completely after 3-4wk. About WikEM; Disclaimers; This page. Cut distal tip off of needle sheath and place over 18ga needle to expose 1 cm of needle to prevent accidentally plunging deeper than desired. Soreness. CRP (mg/L) ≥150: 4 points. Diseases of cutaneous appendages. Dapsone 50mg daily. Starts on trunk or scalp as pruritic, red macules, spreads to extremities. ; Pseudomonas spp. Flucloxacillin is used for both staphylococcal and streptococcal skin infections. Vancomycin 15mg/kg IV four times daily OR. For example, oil and dead skin cells lead to blackheads and whiteheads. Pass hemostat through both incisions and pull penrose through. Antihistamine for pruritus. 7. Necrotizing fasciitis; Necrotizing myositis;. Anorectal abscess; Bartholin gland abscess; Pilonidal abscess; Scrotal abscess; Necrotizing soft tissue infections. Tinea barbae is a dermatophytosis that manifests in the beard area as superficial annular lesions, but deeper infection similar to folliculitis may occur. Children tend to be affected more often than. Barber’s itch (pseudofolliculitis barbae or razor bumps). 1 Rash Red Flags [1] 2 Petechial. Furuncles and Carbuncles. Funds go solely to hosting and development costs that allow medical practitioners around the globe to freely access WikEM. Morel-Lavallee lesion is a closed traumatic soft-tissue degloving injury, caused by separation of the hypodermis from the underlying fascia. Tipe folikulitis yang satu ini umumnya menyerang di bagian dada bagian atas dan punggung. [ 1, 2] In superficial. Histopathology. Herpes has more systemic signs, less bleeding, lack of interdental papilla involvement. Characterized by slowly expanding indolent ulceration that is confined to superficial fascia. If unsure, see pediatric fever; Diagnosis. One can also have Folliculitis on buttocks. 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. A systematic review of the best evidence on the available treatments was needed. g. Add TMP/SMX DS 1 tab PO BID [3] if MRSA is. 5-2 g/day. [3]Background. Paracentesis results supporting a diagnosis of SBP: Absolute neutrophil count (PMNs) ≥250, pH <7. Redness and Irritation. 1. ingested bones) or via chemical corrosion (e. Symptoms can appear from several hours to 5 days after contact with the bacteria. 4mg tab during 5 min = ~80 mcg/min (2 tabs = ~160 mcg/min, etc. extended use of antibiotics (which can cause gram negative folliculitis. Penyakit ini sering sekali terjadi pada hampir semua orang. You have hair follicles just about everywhere except your lips. The condition can be itchy, sore and embarrassing. Ensure that inner tract/incision can fit your finger and tube. Apply a warm compress. Ottawa Ankle Rules (sen 96-99% for excluding fracture) 3 views: AP: Best for isolated lateral and medial malleolar fractures. Become flaccid and turbid 2-3 days later. Rare condition. The end result depends on the materials that plug up the pore. Fever and flulike symptoms. Primary lesions. A bulging tympanic membrane which is typical in a case of acute otitis media. 1989 Mar;3 (1):53-64. 12,43 Furuncles can originate from a preceding folliculitis and manifest as tender, deep-seated, erythematous, perifollicular. Hot tub rash can affect people of all ages. Allergic Reactions. A score > 6 has PPV of 92% and NPV of 96% for necrotizing fasciitis. Treatment. Presenting complaint in 50% of cases. Boils, also known as furuncles, involve adjacent tissue and may progress to cellulitis or. Not caused by extension of periorbital cellulitis. ↑ Gunderson CG, Martinello RA. e. Type 1 lesions are seen in 80% of the cases and appear as superficial pustules without the presence of comedonal lesions. Insert Word catheter and inflate balloon with 2-4mL of water. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Catheter should remain in place for 4-6wk to avoid recurrence. The bumps can also be filled with fluid ( pus) and can form around hair follicles. Smoking. About WikEM; Disclaimers; This page was last edited 19:51, 27 January 2017 by Daniel. 6 mg total. Use a shaving soap, gel or foam to lubricate the blades across the skin to help prevent nicks and cuts. Hot tub folliculitis ( pseudomonal folliculitis) is a common type of folliculitis, a condition which causes inflammation of hair follicles. , boil) is an infection of the hair follicle, but unlike folliculitis in which the infection remains in the epidermis, the inflammation in furuncles extends deep into the dermis. 2. Diagnostic of portal hypertension with 97% accuracy [7] SBP rarely develops in patients without portal hypertension. Risk factors include obesity, family history, prolonged sitting, greater amounts of hair, and not enough exercise. A common skin condition, folliculitis happens when a hair follicle becomes infected or inflamed. The diverticula appear on either side of the longitudinal muscle bundle (taenium) which runs horizontally across the specimen in an arc. Most often due to ethmoid sinusitis. Effects will typically be seen within 6 hours of ingestion with the exception of sotalol which can have a delayed and prolonged toxicity. Depending on the etiology and chronicity of the condition, histologic examination reveals various populations of inflammatory cells around the pilosebaceous unit. 1 to 0. Atrial flutter - start at 50 J. Generally, the infection occurs as a follicular inflammation, or as a cutaneous granulomatous lesion, i. [1] [2] [3] Standard skin abscess are not typically due to spider bites and should not be diagnosed as such. Rich in antibacterial, antiseptic, and antifungal properties, neem can effectively cure folliculitis infection as well as soothe the follicles. 1. Symptoms of folliculitis will vary based on the exact type of folliculitis and its severity. 1 U/kg q2hr and switch IV fluids to Dextrose 5% at 150cc/hr. Aim of insulin regime is to correct the acidosis, not merely the hyperglycemia. Hand and sole of foot lesions. Oral antihistamines. Wash the area periodically with antibacterial soap. Apart from folliculitis and infections associated with pilonidal cysts and piercing of the umbilical area, the clinician should consider the possibility of infected remnants of the allantois. One of the most popular resolutions for desktop wallpaper is 1280x1024. 454. After receiving two doses of paclitaxel, the patient developed follicular papules and pustules on the forehead, cheeks, chin, and upper chest; bacterial. There may also be drainage of fluid, but rarely a fever. Enters skin through small cuts and abrasions, and inhalation for pulmonary disease.