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infection > 1.2 Diseases > Flashcards

1.2 Diseases Flashcards

1
Q

What types of tissues are affected by bacterial infections in SSTIs?

A

skin, muscles, and connective tissues such as ligaments and tendons

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2
Q

What percentage of hospitalized patients are affected by SSTIs?

A

approx 7% to 10%

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3
Q

Why are SSTIs particularly common in the emergency care setting?

A

rapid onset and potential severity , requiring immediate medical attention

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4
Q

Describe the two-step process involved in the clinical manifestations of SSTIs.

A
  1. Invasion of bacteria into the tissues.
  2. Interaction of the bacteria with the host’s defenses, leading to symptoms and clinical signs.
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5
Q

What is the range of severity for SSTIs?

A

mild infections to serious life-threatening infections such as necrotising fasciitis

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6
Q

What’s the principle barrier against invasion & a portal of entry for pathogens ?

A

the skin

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7
Q

What inhibits growth of pathogens in skin ?

A

low pH, sebum, fatty acids

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8
Q

What deters pathogenic organisms in humans = the own natural….. ?

A

flora

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9
Q

What is the most common route of infection of the skin ? give 6 examples

A

break in the barrier of the skin
* skin conditions
* wounds
* burns
* surgery
* needles
* bites

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10
Q

Development of an SSTI depends on 3 steps which are what ?

A
  • bacterial adherence to host cells
  • invasion of tissue with evasion of host defences
  • elaboration of toxins
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11
Q

Virulence factors such as exotoxins can cause what ?

A
  • pore formation
  • enzymatic reactions
  • tissue damage
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12
Q

Staphylococcus aureus bacteria features ?

A

Gram positive & opportunistic

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13
Q

Staphylococcus aureus notorious for causing ?

A

Skin and soft tissue infections

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14
Q

Examples of skin and soft tissue infections caused by staph A

A
  • cellulitis
  • osteomyelitis
  • mastitis
  • folliculitis
  • impetigo
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15
Q

Virulence factors of S. aureus ?
ACE

A
  • Adherence factors (adhesins)
  • exotoxins and enxymes
  • Coagulase
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16
Q

Adhesins (adherence factors) allows S. aurues to do what ?

A

attach onto the host cell surface

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17
Q

S. aureus virulence factor Exotoxins and enzymes are ….1…. they can spread the organism during …2..

A
  1. cytolytic, exofoliative
  2. infection and deep invasion
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18
Q

Coagulase as a virulence factor for S. aureus does what ?

A

prevents phagocytosis from the immune system by forming a clot around the bacteria

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19
Q

Conditions caused by S.aureus list them

A
  • staphylococcal scalded skin syndrome
  • staphylococcal toxic shock syndrome
  • Osteomylitis
  • Mastitis
  • Folliculitis
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20
Q

Action of enzymes in staphylococcal scalded skin syndrome ?

A

protease enzymes break down proteins in the skin

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21
Q

SSSS affects age ?

A

children under 5 yrs

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22
Q

SSSS presentation
BP LIFE / BE FLIP

A

Bullae (fluid filled blisters)
Erythema on skin
Fever
Lethargy
Irritability
Positive nikolsky sign (sign of blistering skin , where top layer sheers off)

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23
Q

How can generlaised staphylococcal scalded skin syndrome in immunodefiicent states happen ?

A

exfoliative toxin in patients with bullous impetigo may disseminate

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24
Q

Rupture of bullae can lead to what ?

A

rapid desquamation with impairment of thermo-regulation , and fluids and electrolyte balance

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25
Q

Mortality in children with SSSS is 4% despite what ?

A
  • fluids
  • correction of electrolyte imbalances
  • antibiotics
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26
Q

STSS (staphylococcal toxic shock syndrome) is an …1… illness where toxins produced by …2… activate …3… resulting in …4.. of cytokines and …5… cells

A
  1. acute onset
  2. S. aureus
  3. T-lymphocytes
  4. over-activation
  5. inflammatory
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27
Q

STSS is most often seen in ?

A
  • use of tampons
  • post-surgical infections
  • burns
  • post partum vaginal and caesarean wound infections
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28
Q

Presentation of STSS ?
RM N V RMHH

A
  • Rapid onset fever
  • Multi-organ failure
  • Nausea
  • Vomiting
  • Rash
  • Myalgia
  • Headache
  • Hypotension
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29
Q

Multi-organ failure is a presenation of STSS what does this involve ?

A
  • renal impairment
  • acute respiratory distress
  • soft tissue necrosis
  • liver involvement
  • coagulopathy
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30
Q

Risk factors for TSS ?

A
  • diabetes mellitus
  • alcoholism
  • vaginal , caesarean deliveries
  • single tampon use for several days of the menses cycle
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31
Q

Management for S.aureus infection in TSS ….1… plus ..2… is recommended ?

A
  1. clindamycin
  2. oxacillin
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32
Q

What is recommended as first-line therapy for patients with complicated soft tissue infections (MRSA identified or penicillin allergy) ?

A

vancomycin

33
Q

Apart from antibiotics like clindamycin , oxacillin , vancomycin what else should be considered for the management of S. aureus infections ?

A
  • surgical debridement
  • supportive therapy
34
Q

Difference between S. aureus and other staphylococcal species in what they can be referred to as ?

A

S.aureus - coagulase positive
others - coagulase negative (grape like cluster, gram positive)

35
Q

Where are coagulase-negative staphylococci (CoNS) primarily found on ?

A
  • skin and mucous membranes
  • scalp
  • ears
  • axilla
36
Q

CoNS can form biofilm -
1. which is what ?
2. e.g. where ?

A
  1. adherence to medical device
  2. vascular catheter infection , prosthetic valve endocarditis, device-related bone and joint infection, foreign body related bloodstream infection
37
Q

Can the presence of Coagulase-negative Staphylococci (CoNS) always indicate an infection?

A

No,
They can be commensals or contaminants.

38
Q

Who are more at risk of infections caused by Coagulase-negative Staphylococci (CoNS)?

A

Immunocompromised individuals and preterm babies

39
Q

Infective endocarditis is an infection involving what ?

A

endocardial of the heart

40
Q

Bacteria causing endocarditis / infective endocarditis ?

A
  • streptococcus viridans (found in mouth causes dental caries)
  • S. aureus CoNS
41
Q

Risk factors of endocarditis ?

A
  • heart disease
  • congenital heart defect
  • valve replacement or pacemaker
  • IV drug use
  • vascular access e.g. central venous catheter
42
Q

Endocarditis presentation ?
My Cat was fat know has fever is SoB and lost weight

A

Myalgia, Fatigue, Weight loss
Cardia murmur
Fever
Shortness of breath

43
Q

Explain why the ‘normal’ heart is relatively resistant to infection

A
  • bacteria + fungi don’t easily adhere to the endocardial surface
  • constant blood flow helps prevent them from settling on endocardial structures
44
Q

What 2 factors are typically required for endocarditis ?

A
  • predisposing abnormality of the endocardium
  • microorganisms in the bloodstream (bacteraemia)
45
Q

What cause endocarditis on normal valves ?

A

massive bacteraemia or particularly virulent microorganisms (e.g. staph A)

46
Q

How do microorganisms adhere to the endocardial surface?

A

by attaching to abnormal or damaged endothelium via surface adhesions.

47
Q

What happens after microorganisms adhere to the endocardial surface?

A

hey proliferate, leading to the colonization of the endocardial structures

48
Q

Why should blood cultures be taken before starting empirical antibiotic therapy in suspected endocarditis?

A

prior antibiotic treatment can lead to culture-negative endocarditis, making it difficult to identify the causative organism.

49
Q

What is a common cause of culture-negative endocarditis?

A

antibiotic therapy administered before blood cultures are taken

50
Q

Why is it important to identify the causative organism in endocarditis?

A

it guides the selection of appropriate antibiotic therapy, ensuring effective treatment of the infection

51
Q

How does Staphylococcus aureus endocarditis typically progress

A

it is often rapidly progressive, meaning it advances quickly and aggressively

52
Q

What is the mortality rate associated with Staphylococcus aureus endocarditis infections?

A

greater than 45%

53
Q

Streptococcys pyogenes :
bacteria staining , usually what ?

A

gram positive
pathogenic

54
Q

What aids in identification of S. pyogenes ?

A

Lancefield group A antigen on it’s surface

55
Q

Why is streptococcus pyogenes often referred to as Group A streptococcus ?

A

Presence of Lancefield group A antigen on surface

56
Q

Examples of conditions caused by streptococcus pyogenes ?

A
  • Cellulitis
  • Impetigo
  • Toxic Shock syndrome
  • Pharyngitis
  • Rheumatic fever
57
Q

Virulence factors of S. pyogenes ?

A
  • Streptolysins & haemolysins
  • superantigens
  • hyaluonidase
  • streptokinases
  • M protein
58
Q

Action of streptolysisns & haemolysis

A
59
Q

Action of sueprantigens

A
60
Q

Action of hyaluronidase

A
61
Q

Action of streptokinases

A
62
Q

Action of M protein

A
63
Q

Scarlet fever most commonly infects what people and age group ?

A

children between 5-15 years old

64
Q

What induces inflammation in scarlet fever and are pyrogenic ?

A

exotoxins and superantigens

65
Q

Scarlet fever presentation ?
a FEW Mischevious StrawberriesS

A

Fever
Enlarged lymph nodes
Widespread rash
malaise
Sore throat
Strawberry tongue

66
Q

Diagnosis of scarlet fever ?

A

usually clinically due to rash , fever, sore throat

67
Q

management of scarlet fever ?

A
  • treating GAS infection to prevent rheumatic fever, sepsis
  • typically self-resolving
  • oral phenoxymethylpenicillin
  • supportive care, analgesics, antipyretics
68
Q

Impetigo is a ..1.. infection of the …2… caused by either …3…

A
  1. bacterial
  2. superficial skin
  3. Staph aureus or Strep pyogenes
69
Q

Risk factors for impetigo ?

A
  • diabetes
  • compromised skin barrier e.g. eczema
70
Q

Impetigo presentation ?
PRY

A

Pus or fluid
Red, itchy sores
Yellow scabs

71
Q

Cellulitis is an infection of where ?

A

deep dermis and subcutaneous tissue

72
Q

Most causative bacteria of cellulitis are?

A

Strep pyogenes
Staph aureus

73
Q

Infections of cellulitis can occur when what happens ?

A

bacteria breach skin surface, where there is fragile skin or decreased local host defences e.g. diabetes, eczema, oedema, obestiy

74
Q

Presentation of cellulitis ?
FOAM

A

Fever
Orange-peel appearance
Acute onset of red, painful, hot , swollen skin
Malaise

75
Q

Treatment of S. pyogenes infections ?

A

recommend combination therapy with benzylpenicillin plus clindamycin

76
Q

In patients who are allergic to penicillin what may be used in place of benzylpenicilln ?

A

vancomycin

77
Q

Appart from antibioitcs what is included in treatment of S. pyogenes infections ?

A

ICU support e.g. fluid resuscitation , surgical debridement

78
Q

Candida albicans ….

A

infection (33 decks)

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