Audia Skin and Muscle Infections II Flashcards
caused by bacteria in the pores
skin abscesses
presence of inflammatory cells within the hair follicle
folliculitis
presence of pus and raised red surface
boil (furuncle)
cluster of boils(furuncles)
carbuncle
non-infectious folliculitis
acne
infectious folliculitis
furuncles and carbuncles
holocrine secretion of sebaceous glands
sebum
microbe that causes infectious folliculitis
Stap. aureus
first line of treatment for skin abscesses
clean and drain
to treat minor skin infections
topical bactroban (mupirocin)
to treat moderate skin infections
Clindamycin
to treat serious skin infections
Vancomycin
injury to knee DDx; erythema and edema
cellulitis or arthritis
inflammation of the dermis caused by infection; no necrosis
cellulitis
most common cause of cellulitis;( gram +, beta hemolytic, catalase - )
Group A Strep
if you see purple bullae involved in cellulitis, what 2 organisms are involved
Vibrio vulnificus
S. pneumoniae
to diagnose cellulitis
presentation
to treat mild cellulitis
Amoxicillin (penicillin b/c group A strep)
to treat penicillin sensitive cellulitis
Clindamycin
spreading infection of dermis that has facial rash that is itchy and tender
Erysipelas
microbe that causes Erysipelas
Group A Strep
caused by SPE superantigen and has rash like sandpaper and strawberry tongue
Scarlet Fever
sequellae group A strep
scarlet fever
caused by exfoliation toxin of S. aureus that cleaves desmoglein-1 (toxin disseminates)
Scalded Skin Syndrome
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
NF
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