4. MTB Step 3 - Skin Infections Flashcards
IMPETIGO
What are the (2) Most Common bacterial causes of Impetigo?
- Streptococcus pyogenes
- Staphylococcus aureus
**Impetigo = Most Superficial bacterial cause = Epidermal layer of skin**
IMPETIGO
What are (2) Initial Medical Treatments for minor-moderate Impetigo caused by Strep pyogenes?
- Mupirocin (Topical)
- Retapamulin (Topical)
IMPETIGO
What are (2) Initial Medical Treatments for severe Impetigo caused by Strep pyogenes?
- Dicloxacillin (Oral)
- Cephalexin (Oral)
IMPETIGO
What are (2) Initial Medical Treatments for severe Impetigo caused by MRSA?
- TMP/SMX (Bactrim)
- Doxycycline
IMPETIGO
What is the Treatment for Severe Impetigo caused by Strep pyogenes in a patient with a Rash Allergy to Penicillin?
Cephalexin
IMPETIGO
What are the (7) possible Treatments for Severe Impetigo caused by Strep pyogenes in a patient with an Anaphylaxis Allergy to Penicillin?
Anaphylaxis Allergy = Vancomycin, Linezolid, Clindamycin, Doxycycline, Telavancin, TMP/SMX, Daptomycin
ERYSIPELAS
What is the Most Likely Bacterial Cause of Erysipelas?
Streptococcus pyogenes (Group A Strep)
ERYSIPELAS
What are (2) Clinical Manifestations of Erysipelas, and what is the MOA for these?
- Bright Red skin
- Hot skin
MOA = dilation of the capillaries of the Dermis due to locally released inflammatory mediators.
ERYSIPELAS
What are the (2) Best INITIAL (empiric) Treatments for Clinically (solely based on observation; empirically) Diagnosed Erysipelas?
- Dicloxacillin (Oral)
- Cephalexin (Oral)
ERYSIPELAS
What is the Treatment for culture diagnosed Streptococcus pyogenes (Group A Strep) Erysipelas?
Penicillin VK
CELLULITIS
What are the (2) Most Likely Bacterial Causes of Cellulitis?
- Staphylococcus aureus
- Streptococcus pyogenes
CELLULITIS
What are (4) Clinical Manifestations of Cellulitis?
- Warm
- Red
- Swollen
- Tender skin
**likely to present in the arm or leg but can present in any skin**
CELLULITIS
If presented with a possible case of Cellulitis in a Leg, what condition should be Ruled Out prior to treatment, and which diagnostic method should be used?
Lower Extremity Doppler to exclude DVT.
CELLULITIS
What are (3) Antibiotics used to treat Minor Cases of Cellulitis?
- Dicloxacillin (Oral)
- Cephalexin (Oral)
- Amoxicillin/Clavulanate (Oral)
CELLULITIS
What are (4) Antibiotics used to treat Severe Cases of Cellulitis?
- Oxacillin (IV)
- Nafcillin (IV)
- Cefazolin (IV)
- Ampicillin/Sulbactam (IV)
CELLULITIS
What are the (2) Medications which may be used to treat Cellulitis in a patient with a Rash Allergy to Penicillin?
Cephalosporins:
- Cefazolin
- Ceftaroline
CELLULITIS
What are the (2) Medications which may be used to treat Minor Cases of Cellulitis in a patient with an Anaphylaxis Allergy to Penicillin?
- TMP/SMX
- Clindamycin
CELLULITIS
What are the (3) Medications which may be used to treat Severe Cases of Cellulitis in a patient with an Anaphylaxis Allergy to Penicillin?
- Vancomycin
- Linezolid
- Daptomycin
FOLLICULITIS < FURUNCLES < CARBUNCLES < BOILS
What is the Most Likely Bacterial Cause for Folliculitis, Furuncles, Carbuncles, and Boils?
Staphylococcus aureus skin infections beginning in the Hair Follicle:
- Folliculitis = smallest, most minor
- Furuncles = small, minor
- Carbuncles = medium, moderate
- Boils = large, moderate-severe
- Abscess = largest, most severe
FOLLICULITIS < FURUNCLES < CARBUNCLES < BOILS
What are (3) Antibiotics used to treat Minor Cases of these Skin Infections?
- Dicloxacillin (Oral)
- Cephalexin (Oral)
- Amoxicillin/Clavulanate (Oral)
**Larger Infections** (eg, Boils, Abscess) **respond to drainage**
**Same Tx as for Cellulitis**
FOLLICULITIS < FURUNCLES < CARBUNCLES < BOILS
What are (4) Antibiotics used to treat Severe Cases of these Skin Infections related to pimples?
- O xacillin (IV)
- N afcillin (IV)
- C efazolin (IV)
- A mpicillin/Sulbactam (IV)
O.N.C.A.
**Same Abx’s as for Cellulitis**
FOLLICULITIS < FURUNCLES < CARBUNCLES < BOILS
What are the (2) Medications which may be used to treat these Skin Infections in a patient with a Rash Allergy to Penicillin?
Cephalosporins:
- Cefazolin
- Ceftaroline
FOLLICULITIS < FURUNCLES < CARBUNCLES < BOILS
What are the (2) Medications which may be used to treat Minor Cases of these Skin Infections in a patient with an Anaphylaxis Allergy to Penicillin?
- TMP/SMX
- Clindamycin
FOLLICULITIS < FURUNCLES < CARBUNCLES < BOILS
What are the (3) Medications which may be used to treat Severe Cases of these Skin Infections in a patient with an Anaphylaxis Allergy to Penicillin?
- Vancomycin
- Linezolid
- Daptomycin
FUNGAL INFECTIONS OF SKIN AND NAILS
What are (3) Common Manifestations of Fungal Infections on the SCALP?
- Severe Itching
- Dandruff
- Bald Patches
FUNGAL INFECTIONS OF SKIN AND NAILS
What are (4) Common Manifestations of Fungal Infections on the NAILS?
- Thickened
- Yellow
- Cloudy
- Fragile and/or Broken
FUNGAL INFECTIONS OF SKIN AND NAILS
What is the Best Test to Diagnose Fungal Infections of the Skin and Nails?
KOH Preparation
Procedure:
- Scrape the Skin/Nail
- Place scraping on slide with KOH + Acid
- Heat the slide
**Epithelial Cells will dissolve and leave the Fungal forms behind, visible on the slide, due to the Chitin in the Fungal Cell Wall**
FUNGAL INFECTIONS OF SKIN AND NAILS
What are (7) Medicinal Treatments for Fungal Infections of the Skin NOT involving the Hair or Nails?
- Clotrimazole (Topical)
- Miconazole (Topical)
- Ketoconazole (Topical)
- Econazole (Topical)
- Terconazole (Topical)
- Nystatin (Topical)
- Ciclopirox (Topical)
FUNGAL INFECTIONS OF SKIN AND NAILS
What are (3) Medicinal Treatments for Fungal Infections of the Skin Involving the Hair or Nails?
Oral Medications:
- Terbinafine: AEs = Increased LFTs
- Itraconazole
- Griseofulvin (for Tinea Capitis): Has Less Efficacy than either Terbinafine or Itraconazole.
