Bacterial Infection

Question 1

Impetigo

Answer 1

1.Good hygiene
2. Remove crust
3. Topical (mild) : mupiracin
: fusidic acid
4. Systemic (sever, multi-lesion)
.cloxacillin⏰️
.Erythromycin 🐞
.amox + clavulanic🫖
.cephalexin🚦
5. MRSA
. oral clindamycine
. Tmp/smx

Question 2

Carbuncle

Answer 2

1. 1st line
   ●folliculitis: antibacterial wash(chlorhexidine, triclosan)
   :Topical mupirocin
   :clindamycin
   ●furuncle &carbuncle: incision and drainage
2. 2nd line
   ● folliculitis: oral dicloxacillin
   : tmp/smx
   : cephalexin(recalcitrant or sever case)
   ●furuncle &carbuncle: I & D
   : systemic abx with MRSA coverage (clinda or tmp/smx) for complicated case

Question 3

Cellulitis

Answer 3

• Treatment and Prognosis of Cellulitis and Erysipelas are similar
1.Supportive
• rest, immobilization, elevation, & analgesia.
2. Dressings
• Cool sterile saline dressings for removal of purulent exudates and necrotic tissue
3.Systemic treatment with appropriate antibiotics should be given for at least 10 days
3.Admission and parentral antibiotics are indicated in infants and severely ill adults
4.Local extension and systemic complications may follow inappropriate treatment

Question 4

Necrotising fascitis

Answer 4

Treatment
1. Surgical debridement of the infected tissue and the immediate surrounding area is immediately indicated
2.Antibiotics should be started as soon as this condition is suspected : combination of IV antibiotics including
piperacillin/tazobactam, vancomycin, and clindamycin
3. Cultures help determine the appropriate antibiotics, and antibiotics may be changed when culture results are obtained
4. Hyperbaric oxygen therapy may be helpful for anaerobes

Question 5

SSSS

Answer 5

Treatment
1. Supportive care
Eradication of the primary infection, Rehydration, antipyretics, management of thermal bums, and stabilization are important
2. Severe, generalized forms of SSSS: hospitalization and parenteral antibiotics
3. Milder cases: oral treatment with a (B-lactamase-resistant antibiotic (e.g. dicloxacillin, cephalexin) for a minimum of 1 week is usually sufficient.
Note:
Identification and decolonization of S. aureus earners are important, especially in hospital-acquired cases

Question 6

TSH

Answer 6

1.First line: Elimination of foreign body + IV fluids and vasopressors + IV clindamycin and oxacillin, nafcillin or cefazolin
2. Second line: IV vancomycin, linezolid, daptomycin, tigecycline or ceftaroline for recalcitrant disease

Question 7

Erythrasma

Answer 7

Topical or systemic:
Erythromycin , Clindamycin

Question 8

Trichomycosis axillaris AKA T.nodularis

Answer 8

1.First line: Clipping the affected hairs and the application of Topical
erythromycin or clindamycin
2. Second line: Oral erythromycin or tetracycline for severe disease

Question 9

Pitted keratolysis

Answer 9

1. Antiseptic foot powder, benzoyl peroxide soap, topical antibiotics are all helpful
2. Keeping the feet as dry as possible and treating hyperhydrosis with 5 to 10% Formaline Solution or 20% Aluminium chloride hexahydrate in absolute alcohol brings rapid improvement and prevents recurrence