Audia Skin and Muscle Infections II Flashcards by Madeline Wing

caused by bacteria in the pores

skin abscesses

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presence of inflammatory cells within the hair follicle

folliculitis

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presence of pus and raised red surface

boil (furuncle)

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cluster of boils(furuncles)

carbuncle

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non-infectious folliculitis

acne

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infectious folliculitis

furuncles and carbuncles

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holocrine secretion of sebaceous glands

sebum

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microbe that causes infectious folliculitis

Stap. aureus

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first line of treatment for skin abscesses

clean and drain

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to treat minor skin infections

topical bactroban (mupirocin)

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to treat moderate skin infections

Clindamycin

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to treat serious skin infections

Vancomycin

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injury to knee DDx; erythema and edema

cellulitis or arthritis

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inflammation of the dermis caused by infection; no necrosis

cellulitis

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most common cause of cellulitis;( gram +, beta hemolytic, catalase - )

Group A Strep

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if you see purple bullae involved in cellulitis, what 2 organisms are involved

Vibrio vulnificus
S. pneumoniae

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to diagnose cellulitis

presentation

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to treat mild cellulitis

Amoxicillin (penicillin b/c group A strep)

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to treat penicillin sensitive cellulitis

Clindamycin

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spreading infection of dermis that has facial rash that is itchy and tender

Erysipelas

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microbe that causes Erysipelas

Group A Strep

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caused by SPE superantigen and has rash like sandpaper and strawberry tongue

Scarlet Fever

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sequellae group A strep

scarlet fever

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caused by exfoliation toxin of S. aureus that cleaves desmoglein-1 (toxin disseminates)

Scalded Skin Syndrome

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Connecticut resident myalgia and arthralgia erythematous bull's eye skin lesion

Lyme Disease

this spirochete causes Lyme Disease

Borrelia burgdorferi

reservoir for lyme disease

mouse, deer

vector for lyme disease

deer tick

primary stage of lyme disease

70% of patients with distinct rash

secondary stage of lyme disease

knee complaints (contain spirochetes)

tertiary stage of lyme disease

crippling arthritis; neurologic complications

to diagnose lyme disease:

clinical presentation serology for late stage

to treat early lyme disease

doxycycline or amoxicillin

to treat secondary and tertiary lyme disease stages

cephalosporins

complication to Lyme disease where there is a cytokine storm and systemic response

Jarisch-Herxheimer Reaction

NUMB rash, takes a very long time to develop symptoms after first exposure; armadillos

Leprosy

stain used for Mycobacteria

Acid Fast stain

causes chronic granulomatous disease of peripheral nerves and superficial tissues; skin lesions

Mycobacterium leprae

milder form of leprosy

Tuberculoid

more severe form of leprosy and is most infectious

Lepromatous

most common in CA, LA, and Texas; armadillos transmit

Mycobacterium leprae

obligate intracellular bacterial species that multiply very slowly and immunity to it is T cell mediated

M. leprae

strong intracellular reaction, relatively few bacteria (less severe)

tuberculoid leprosy

strong Ab response; but defect in specific cellular response (pathogen able to multiply---> more severe)

lepromatous leprosy

tuberculoid on left and lepromatous on the right

To diagnose M. leprae:

acid fast stain skin reactivity test PCR

To treat Leprosy: tuberculoid form

rifampicin + dapsone

to treat Leprosy: lepromatous form

rifampicin + dapsone + clofazimine

complications from using vasopressors for a while

gangrene on extremities

starts with minimal trauma (micro-abrasion) and organism spreads through subcutaneous tissue and deep fascia; extremely painful; can start as cellulitis

Necrotizing Fasciitis

this can develop from necrotizing fasciitis and is death of muscle tissue

myonecrosis

Necrotizing Fasciitis vs. Gas Gangrene

NF starts w/ minimal trauma

organism that most often causes necrotizing fasciitis

Group A Strep

Group A Strep produces what 3 things that help illicit NF

superantigen streptodornase streptokinase

a score of >6 on LRINEC means what

type I NF

polymicrobial

microbes that make up type I NF

stap, strep, enterococci

Type II NF

monomicrobial

microbe that makes up type II NF

Group A Strep

marine injuries are associated with what microbe that can cause NF

Vibrio vulnificus

bacterial virulence factors for NF

exotoxins, endotoxins(LPS), and superantigens

predisposing factor to NF

diabetes

To treat NF:

Vancomycin + piperacillin/tazobactam

CC: lumpy jaw and suppuration/tenderness

Actinomycosis

gram + rod, filamentous, NOT acid fast

Actinomyces

infection by this anaerobic microbe is by minor dental trauma and endogenous source; slowly developing infections

Actinomyces

forms "molar tooth" colonies on blood agar

Actinomyces

colonies of this infection are sulfur granules and appear yellow/orange; cervicofacial infections and draining sinus tracts

Actinomyces

To Treat Actinomycosis

Penicillin G