Bacterial Derm Flashcards
1
Q
CELLULITIS
- Definition
- Etiology
A
- acute inflammation of dermis and subQ tissue
2. group A beta-hemolytic strep (2/3), Staph aureus (1/3), Pseudomonas, H. influenzae
2
Q
CELLULITIS
- Predisposing conditions
- Clinical features
A
- DM, IV drug use, cirrhosis, renal failure, tinea pedis, immunosuppression, surgical wounds, chronic edema, bite, alcoholism, obesity, chronic lymphedema
- unilateral, erythematous, warm, tender, patch or plaque with irregular, ill-defined margins; fever; malaise; anorexia; chills; lymphadenopathy; systemic toxicity; common on lower extremities
3
Q
CELLULITIS
- Diagnosis
- Differential diagnosis
A
- clinical presentation; cultures; occasional biopsy
2. stasis/contact dermatitis; superficial thrombophlebitis; deep venous clot; inflammatory breast cancer
4
Q
CELLULITIS
- Treatment
- Complications
- Prevention
A
- PO antibiotics, elevation, supportive measures; occasionally IV antibiotics if systemic illness
- sepsis, gangrene, lymphangitis, recurrence, chronic edema, endocarditis, necrotizing fasciitis
- support stockings, proper skin hygiene, early tinea pedis treatment in DM patients
5
Q
ERYSIPELAS
- Definition
- Etiology
A
- acute superficial infection of the dermis (superficial subset of cellulitis)
- group A beta-hemo strep; rarely Staph aureus
6
Q
ERYSIPELAS
- Predisposing conditions
- Clinical features
A
- malnutrition, EtOH, IV drug use, stasis dermatitis, lymphedema, DM
- “acute illness” phase with fever, chills; unilateral, erythematous, raised, indurated, tender, warm, peau d’orange appearance; sharp elevated margins with predisposition for scalp, face, legs, abdomen; lymphangitis common
7
Q
ERYSIPELAS
- Diagnosis
- Differential diagnosis
A
- clinical presentation; cultures; neutrophilic leukocytosis
- contact dermatitis, thrombophlebitis, drug reaction, erythema migrans
8
Q
ERYSIPELAS
- Treatment
- Complications
A
- aggressive antibiotics, supportive/symptomatic, treat other skin conditions
- sepsis, desquamation (skin sloughs off as infection resolves), chronic edema, lymphatic damage, distant infections
9
Q
IMPETIGO
- Definition
- Etiology
A
- acute, contagious, superficial bacterial skin infection; typically > beta-hemo strep
10
Q
IMPETIGO
- Predisposing conditions
- Clinical features
A
- preexisting skin disease/minor breaks, insect bites, head lice, trauma, burns, poor hygiene, staphylococcal colonization, incisional sites, warm/moist climate
- initial vesicle/pustule; ruptures and dries; forms honey colored crust with characteristic stuck-on appearance; clustered or polycystic; occur anywhere; various stages seen (eg bullous impetigo)
11
Q
IMPETIGO
- Diagnosis
- Differential diagnosis
A
- appearance, cultures
2. varicella, herpes simplex, tinea corporis
12
Q
IMPETIGO
- Treatment
- Complications
- Prevention
A
- local: topical cream/ointment (mupirocin) or vinegar wet dressings; widespread: PO antibiotics; recurrent: swab/treat for colonization; nasal/fingernail regimen
- post-strep glomerulonephritis; 2ary infection; guttate psoriasis; rheumatic fever?
- adequate hygiene
13
Q
TOXIC SHOCK SYNDROME
- Definition
- Etiology
A
- acute toxin-mediated illness, medical emergency!
2. Staph aureus (tampon use), Strep pyogenes
14
Q
TOXIC SHOCK
- Predisposing conditions
- Clinical features
A
- tampon use, wounds, cellulitis, other infection, foreign body, more often in females 20-50 y.o and Caucasian
- RAPID ONSET acute fever, hypotension, myalgias, rash and mucous membranes, organ failure, desquamation, sepsis, seizure, tingling hands and feet
15
Q
TOXIC SHOCK
- Diagnosis
- Differential diagnosis
A
- clinical findings, blood culture, gram stain, biopsy, CDC criteria
- scarlet fever, pelvic infection, septic abortion, rubeola, rheumatic fever, gastroenteritis
