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Medicine I > Bacterial Skin Diseases > Flashcards

Bacterial Skin Diseases Flashcards

1
Q

Resident bacteria vs transient bacteria?

A
  • Resident - live/multiply on normal skin and hair shafts
  • Transients - grow on/in damaged, unhealthy skin and can become pathologic
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2
Q

Where does Staphylococcus pseudointermedius live on the body normally?

A
  • Normal Flora of:
    • mouth
    • nares
    • inguinal areas
    • perianal areas
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3
Q

What is the most common bacterial pathogen of canine skin?

A

Staphylococcus pseudointermedius

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4
Q

How do staphylococcal bacteria become methicillin-resistant

A
  • Acquire mecA gene - encodes for a low affinity penicillin-binding protein (PBP2a) that results in impaired binding of beta-lactam antibiotics
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5
Q

What diagnostic tests can be ran to determine skin disease cause?

A
  • Cytology (impression smears - bacteria)
  • Bacterial culture and sensitivity (species ID)
  • Skin scraping (ectoparasites)
  • Fungal cultures (fungal infection)
  • tests for endocrinopathies (hypothyroidism/hyperadrenocorticism)
  • Allergy tests (secondary pyoderma)
    • Diet trial (food allergy)
  • Skin biopsy
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6
Q

When should bacterial skin disease have culture & sensitivity completed?

A
  • Deep infections
  • Infections that are poorly responsive to antibiotics
  • When rods are seen in impression smears
  • History of methicillin-resistant Staphylococcus
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7
Q

What antibiotic is commonly used for systemic therapy for skin diseases?

A
  • 1st gen cephalosporins (initially/empirically)
  • Amoxi-clav (some cases)
  • Fluoroquinolones
  • Lincosamides
  • Potentiated slfonamides
  • Chloramphenicol, Doxy, Minocycline, rifampin
    • for MRSA based on C&S
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8
Q

What topical therapies exist for bacterial skin infections? how do they work

A
  • Shampoos, conditioners, sprays, ointments,….
  • Active ingredients:
    • chlorhexidine
    • benzoyl peroxide
    • ethyl lactate
    • triclosan
    • bleach
  • Shampoos need 10-15mins contact time
    • Bathe at leat 2x weekly initially
    • massage helps remove scale, exudate, debris and trapped bacteria
    • after rinsing, dry thoroughly
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9
Q

What is “glycotechnology”

A
  • Microbial lectins are on the surfaces of yeast and bacteria
    • Lectins recognize sugars on the keratinocyte surface leading to adherence
  • Exogenous sugars/carbs (in the shampoo) saturate fungal/bacterial lectin binding sites
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10
Q

What are the effects of Benzoyl Peroxide?

A
  • Antibacterial
  • “follicular flushing”
  • Keratolytic
  • Degreasing
  • Drying
  • Irritating
  • Bleaching effect
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11
Q

What are the effects of Chlorhexidine?

A
  • antibacterial
  • Antifungal
  • Non-drying
  • Nonirritating (usually)
  • Best for methicillin-resistant Staphylococcus
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12
Q

What is Pyoderma

A
  • Bacterial skin infection
  • can be primary or secondary
  • classified by location on skin
    • surface
    • superficial
    • deep
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13
Q

What are the common underlying causes of secondary pyoderma

A
  • Allergic dermatitis
  • seborrhea
  • endocrinopathies
  • ectoparasitism
  • autoimmune conditions
  • other skin conditions
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14
Q

What are the common Surface bacterial skin infections?

A
  • Pyotraumatic dermatitis
  • Intertriginous pyoderma
    • between skin folds
  • Bacterial overgrowth syndrome (surface to superficial)
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15
Q

What is Bacterial overgrowth syndrome?

A
  • Surface to superficial bacterial skin infection
  • Typical features of pyoderma (papules, collarettes, pustules, crusts) are lacking
  • May only have erythema and pruritus
  • Topical therapy alone may be effective
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16
Q

What are common superficial pyodermas?

A
  • Superficial bacterial folliculitis
  • Mucocutaneous pyoderma
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17
Q

What are the signs/symptoms of Superficial Bacterial Folliculitis

A
  • Follicular papules
    • less commonly pusules
  • Crusts
  • epidermal collarettes
  • hyperpigmentation
  • erythema
  • patchy “moth eaten” alopecia in short-coated dogs
  • Generalized or localized (abdomen, inguinal areas, axillae, caudal thighs)
  • some are very pruritic
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18
Q

What is the treatment for Superficial Bacterial Folliculitis?

A
  • Topical antibacterials
    • Shampoos
    • Rinses, sprays
    • Creams, gels
    • topical therapy alone may be effective
  • Systemic anibiotics may be needed
    • 3 week course (or longer)
  • Evaluate for underlying causes in recurrent cases
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19
Q

What are the signs/symptoms of Mucocutaneous Pyoderma

A
  • Lips become swollen, erythematous, and crusted
    • Commissures of the lips may especially be affected
  • May involve eyelids, nares, anus
  • May resemble autoimmune conditions (especially DLE)
  • Systemic antibiotic therapy may be needed
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20
Q

What are types of Deep Pyodermas?

A
  • Deep folliculitis, furunculosis and cellulitis
  • Canine acne
  • Bacterial pododermatitis
  • German shepherd folliculitis, furunculosis and cellulitis
  • Abscess
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21
Q

What is the treatment for Deep Pyodermas?

A
  • Long course of systemic antibacterial therapy
    • 4-6 weeks or longer
  • Topical antibacterial therapy should be used adjunctively
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22
Q

What are abscesses commonly caused by?

A
  • Commonly caused by cat bites
  • Pasteurella multocida commonly isolated
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23
Q

What are some Nontuberculous Mycobacteriosis?

A
  • Feline Leprosy signs
  • Canine Leproid Granuloma Syndrome
  • Opportunist Mycobacterial Infections
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24
Q

What is canine leproid granuloma

A
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25
Q

How do dermal infections occur? (MOA)

A
  • Surface adhesion molecules bind host surface receptors on keratinocytes
    • ⇢ bacterial colonization of keratinocytes
      • ⇢ bacterial skin infection
  • form “biofilms” to help protect the bacteria
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26
Q

What bacteria are associated with TSS in dogs?

A
  • Staphylococcal spp.
  • Streptococcoal spp.
    • Streptococcus canis
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27
Q

Why is MRSA / MRSP a huge concern?

A
  • Interspecies transmission can occur
  • Animals/People can be carriers w/ no signs of illness
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28
Q

How is methicillin resistance tested for?

A

bacterial sensitivity to oxacillin

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29
Q

How does the skin protect itself?

A
  • Stratum corneum is a physical and chemical barrier
    • sebum, sweat, fatty acids
  • Epidermal cells secrete antimicrobial peptides (AMPs) ⇢ help maintain healthy skin
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30
Q

What factors predispose animals to bacterial skin infections?

A
  • Allergic dermatitis
  • Ectoparasites
  • endocrinopathies
  • environmental conditions (i.e humidity)
  • short hair coat
  • irritants
  • Seborrhea
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31
Q

Why is pyoderma common in dogs?

A
  • thin stratum corneum
  • less intercellular lipids
  • alkaline pH
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32
Q

Which drugs used for pyoderma are bactericidal?

A
  • Cephalexin and Cefadroxil (1st gen cehpalosporins)
  • Cefpodoxime (extended-spectrum cephalosporin)
  • Cefovecin (extended-spectrum cephalosporin)
  • Amoxicillin-clavulanic acid
  • Enrofloxacin
  • Orbifloxacin
  • Pradofloxacin
  • Marbofloxacin
  • Trimethoprim-sulfonamides (can be)
  • Chloramphenicol (high dose)
  • Rifampin
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33
Q

Which drugs commonly used for pyoderma are bacteriostatic?

A
  • Clindamycin
  • Lincomycin
  • Chloramphenicol
  • Doxycycline
  • Minocycline
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34
Q

What is astringent therapy?

A
  • Aluminum acetate (Domeboro’s solution)
  • Dry agent for certain moist lesions
    • e.g. ‘Hot spots’
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35
Q

How is primary pyoderma differentiated from secondary pyoderma?

A
  • No apparent underlying cause of pyoderma
  • Usually occurs in otherwise healthy skin
  • Can be cured with appropriate therapy
  • Less common
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36
Q

How is secondary pyoderma differentiated from primary pyoderma?

A
  • Underlying causes include allergic dermatitis, seborrhea, ectoparasitism
  • Affects already diseased/damaged skin
  • More than one species of bacteria may be isolated
  • Therapy may be less effective and treatment of the underlying cause is necessary
  • More common
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37
Q

What is surface pyoderma? examples?

A
  • On skin surface only
  • Ex:
    • Intertrigo (skin fold dermatitis)
    • pyotraumatic dermatitis ‘Hot spot’
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38
Q

What is superficial pyoderma?

A
  • Involves the epidermis and follicular epithelium
  • Usually heals without scarring
  • Usually doesn’t involve regional lymph nodes and rarely produces systemic signs
  • Very common in dogs
39
Q

What is Deep pyoderma

A
  • Involves the dermis and/or subcutaneous tissue
  • May heal with scarring
  • Often long, chronic course and may see systemic signs
40
Q

What are common surface bacterial infections?

A
  • Pyotraumatic Dermatitis
  • Intertriginous Pyoderma
  • Bacterial Overgrowth Syndrome
41
Q

What is Pyotraumatic dermatitis? Why does it happen?

A
  • Acute moist dermatitis ‘Hot Spot’
    • Intense inflammatory reaction
  • Surface bacterial colonization occurs
  • Predisposing factors:
    • scratching/chewing
      • ectoparasites, matted coat, allergies, trauma, foreign bodies, otitis, etc)
    • Increased moisture of skin
    • Thick-coated dogs in warm, humid weather
42
Q

What are the clinical signs of pyotraumatic dermatitis

A
  • Well-demarcated, erythematous, moist lesion
  • Very pruritic and often painful
  • Acute onset
    *
43
Q

How is Pyotraumatic Dermatitis diagnosed?

A
  • History
  • Clinical signs
  • Impression smear cytology to assess for concurrent pyoderma
44
Q

How is Pyotraumatic Dermatitis diagnosed?

A
  • Clip and Clean (chlorhexidine, weak providone-iodine)
  • Drying agents/astringents
  • Topical medication containing an antibiotic and steroid
  • Short course (days) of systemic corticosteroids to relieve intense pruritus and irritation
45
Q

What is intertriginous Pyoderma?

A
  • Skin fold dermatitis or Intertrigo
  • Predisposing factors:
    • breed
    • Conformation
    • poor husbandry
46
Q

What are the clinical signs of intertriginous pyoderma?

A
  • Skin folds are erythematous, eroded or ulcerated
    • Lip folds (spaniels)
    • facial folds (brachycephalic breeds)
    • vulvar folds
    • corkscrew tails
    • body folds (Shar Pei, obese dogs)
  • Odiferous
  • Often pruritic
  • +/- pain
47
Q

How is Intertriginous pyoderma diagnosed?

A
  • Clinical presentation
  • Impression smear of fold
48
Q

What is the treatment for Intertriginous pyoderma

A
  • Medical management (keep folds clean/dry)
  • Topical antibacterials
    • antifungals if yeast is present
  • Systemic antibiotics may be needed initially, in severe cases
  • Surgical correction to remove folds may be considered
49
Q

What is Bacterial Overgrowth Syndrome (BOG Syndrome)? why does it occur?

A
  • Can be surface to superficial pyoderma
  • Hyperproliferation of bacteria (usually S. pseudointermedius)
    • cocci adhere to and colonize corneocytes
  • Fairly common
  • Usually secondary to underlying skin disease
    • especially allergic dermatitis
50
Q

What are the clinical signs of BOG Syndrome?

A
  • Erythema
  • hyperpigmentation
  • lichenification
  • Usually do Not have papules or crusts
  • Pruritus
  • Distribution is mainly ventral
51
Q

How is BOG syndrome diagnosed?

A
  • Clinical presentation
  • Impression smear cytology
52
Q

What is the treatment for BOG syndrome?

A
  • Topical antiseptic shampoos and rinses
  • systemic antibiotic therapy may be necessary
53
Q

What is Superficial Bacterial Folliculitis? How does it develop?

A
  • Bacterial infection of the superficial portion of the hair follicle and adjacent epidermis
    • Lead to destruction of the hair with resulting alopecia
    • Can progress to hair follicle rupture (furunculosis ) leading to deep pyoderma
  • Usually Staph. Pseudointermedius
  • Usually secondary to other skin diseases
54
Q

How is Superficial Bacterial Folliculitis diagnosed?

A
  • Cytology
  • Culture (not usually necessary initially when cytology shows cocci)
  • Biopsy (especially to evaluate for underlying causes in certain cases)
  • Rule out other causes of folliculitis
    • especially demodicosis and dermatophytosis
55
Q

What is the etiology of mucocutaneous pyoderma

A

unknown

56
Q

What are the clinical signs of Mucocutaneous Pyoderma

A
  • Lips become swollen, erythematous, and crusted
  • Erosions and ulcers may occur in severe cases
  • May also see lesions on the eyelids, nares, anus
57
Q

How is mucocutaneous pyoderma diagnosed

A
  • Clinical presentation
  • Cytology
  • Biopsy is sometimes done
58
Q

What is the treatment for Mucocutaneous pyoderma?

A
  • Topical antibacterial ointments
  • Systemic antibiotic therapy is usually required
59
Q

What are the common deep pyodermas

A
  • Deep Folliculitis, Furunculosis, and Cellulitis
  • Canine Acne (muzzle folliculitis and furunculosis)
  • Bacterial Pododermatitis
  • German Shepherd Dog Folliculitis, Furunculosis and Cellulitis
  • Feline Abscessation (cellulitis)
60
Q

What is Deep Folliculitis, Furunculosis, and Cellulitis?

A
  • Hair follicle rupture and spread of infection into dermis
  • Usually Staph pseudointermedius
  • Usually associated with underlying cause(s)
61
Q

What are the clinical signs of Deep Folliculitis, Furunculosis, and Cellulitis?

A
  • Papules and pustules
  • +/- Hemorrhagic bullae
  • +/- Fistulae/oozing tracts
  • Circular areas of erythema, scaling, crusting, and alopecia
  • Variable pruritus
  • More common in dogs
    • deep pyoderma of pressure points in large/giant breeds)
  • Feline deep pyoderma is Rare
    • chin acne may progress to furunculosis
62
Q

How is Folliculitis, Furunculosis, and Cellulitis diagnosed?

A
  • Cytology (neutrophils usually predominate)
  • C&S (deep pyos should be cultured!)
  • Biopsy (histopath and deep tissue culture)
  • Evaluate for underlying cause
    • immunodeficiency, endocrinopathy, etc
  • Rule out other causes of similar signs:
    • demodicosis
    • dermtophytosis
    • etc
63
Q

What is the treatment for Folliculitis, Furunculosis, and Cellulitis?

A
  • Systemic antibiotics for 4-6 weeks
      • 2-3 weeks beyond clinical resolution
  • Warm soaks/Whirlpools may help
  • Adjunctive topical antimicrobial shampoos and rinses
  • Correct underlying cause(s)
64
Q

What is Canine Acne? why does it develop?

A
  • Muzzle folliculitis and furunculosis
  • Common inflammatory disorder, usually associated bacterial infection
    • affect young dogs (<6mo)
  • Affects areas rich in sebaceous glands (chin, lips)
  • Hair impaction/trauma may be initiating cause
  • Folliculitis may progress to furunculosis or cellulitis
65
Q

What are the clinical signs of Canine Acne?

A
  • Papulopustular eruptions
    • may ooze bloody, purulent discharge
66
Q

How is Canine Acne Diagnosed?

A
  • Clinical signs are suggestive
  • Cytology (neutrophils, macrophages, eosinophils, may not see many bacteria)
  • Culture
  • Possible biopsy (usually not needed)
  • Rule Out: demodicosis, dermatophytosis, contact dermatitis (uncommon)
67
Q

What is the Treatment for Canine Acne?

A
  • Topical antibacterials
  • Systemic antibiotic therapy is necessary for advanced cases
  • Mild cases may regress with sexual maturity
  • Topical corticosteroids my help prevent recurrence
    • decrease the inflammatory reaction
68
Q

What is Pododermatitis? Why does it occur?

A
  • Dermatitis of the feet
  • Numerous etiologies, may occur as a result of underlying causes such as:
    • bacterial infection
    • parasitism (demodicosis)
    • fungal infections
    • allergies
    • immune mediated conditions
    • Irritation
    • Trauma
    • Foreign bodies
  • Furunculosis may develop
  • Rare in cats
69
Q

What are the clinical signs of Pododermatitis?

A
  • One or all feet
  • Interdigital pustules, papules, nodules, hemorrhagic bullae
    • may have fistulae and interdigital cystic-like lesions
  • Serosanguineous and/or purulent exudate
  • Feet may be swollen and painful
70
Q

How is Pododermatitis diagnosed?

A
  • Physical Exam
  • Cytology
  • Culture
  • Possible biopsy
  • Work-up for possible underlying etiologies
71
Q

What is the treatment for Pododermatitis?

A
  • Long term systemic antibiotics based on C&S
  • Antibacterial soaks/whirlpools
    • especially w/ oozing, exudative tracts
  • Surgical debridement, drainage, and curettage may be necessary
  • Sterile dermal granulomas may develop after the infection has resolved
    • may then respond to therapy such as prednisone or cyclosporine
  • Correct underlying cause
72
Q

What is German Shepherd Dog Folliculitis, Furunculosis and Cellulitis?

A
  • Heritable defect
    • possibly autosomal recessive
  • Uncommon condition
    • once it occurs, relapses are common
  • Immunodeficiencies have been demonstrated (lymphocyte subset and immunoglobulin abnormalities, defects in cell-mediated immunity)
    • hypothesis: exaggerated tissue response to shaphylococci triggering release of inflammatory mediators
  • Lesions triggered by an insult to the skin or occur spontaneously
73
Q

What are the clinical signs of German Shepherd FFC?

A
  • Middle age dogs, males at increased risk
  • Lesions are papules, pustules, crusts
  • ALopecia, hyperpigmentation, ulceration and fisulae as disease progresses
  • Distribution:
    • back, rump, ventral abdomen and thighs
    • may become generalized
  • May have some degree of pruritus
  • Lesions may be painful
74
Q

How is German Shepherd FFC diagnosed?

A
  • Physical exam (distinctive distribution pattern)
  • Cytology
  • Culture
  • +/- Biopsy
  • Evaluate for underlying disease
  • Rule out other dermatoses that cause papules and crusting
75
Q

How is German Shepherd FFC treated?

A
  • Clip and bathe with antibacterial shampoo, whirlpools
  • Long term systemic antibiotics
  • Immunomodulatory therapy (certain cases)
  • May relapse when antibiotics discontinued
    • may require maintenance therapy
  • Resolve possible trigger factors/other skin disease
76
Q

What is Cat Abscessation?

A
  • Abscess - Focal accumulation of pus
  • Cellulitis - diffuse dermal and subcutaneous infection
  • Common in cats
  • Secondary to cat bite wounds
  • Pasteurella multocida common isolate
77
Q

What are the clinical signs of Feline Abscessation

A
  • Signs vary from classic, focal abscess to asymptomatic swelling
    • Commonly: face, limbs, tail base, back
  • Very painful
  • +/- Fever
  • Other signs:
    • pyothorax
    • osteomyelitis
    • septic arthritis
    • sinusitis
    • bacteremia
78
Q

How is Cat abscessation diagnosed

A
  • Physical exam
  • Cytology
  • Culture
79
Q

What is the Treatment for Cat Abscessation?

A
  • Drainage and flushing
  • warm packs
  • Topical antiseptics/antibiotics
  • Systemic antibiotic
80
Q

What are examples of Nontuberculous Mycobacteriosis?

(mycobacterium infections that is not tuberculosis)

A
  • Feline leprosy
  • Canine leproid granuloma
  • Opportunistic Mycobacterial Infections (Atypical Mycobacterial Infections)
81
Q

WWhat is Feline Leprosy caused by?

A
  • Mycobacterium lepraemurium, and others species (Aerobic, acid-fast bacilli)
  • Rare
  • Transmitted by rodent bites and insect vectors
82
Q

What are the clinical signs of Feline Leprosy

A
  • Cutaneous or subcutaneous nodules or plaques
  • Lesions may be solitary or multiple
  • Lesions may be ulcerated
  • Head and limbs are often affected
  • Rarely disseminates to organs
83
Q

How is Feline Leprosy diagnosed?

A
  • Cytology (acid-fast stains)
  • PCR
  • Biopsy - intact nodules if possible
  • Culture is very difficult
84
Q

What is the treatment for Feline Leprosy

A
  • Wide surgical excision with antimicrobial therapy
  • Combination therapy with antibiotics such as rifampin, clarithromycin, pradofloxacin
85
Q

What causes Canine Leproid Granulomas?

A
  • Uncommon
  • Inoculation route unknown - biting insects?
86
Q

What are the clinical signs of Canine Leproid Granuloma

A
  • Short-coated breeds
  • Cutaneous or subcutaneous granulomatous or pyogranulomatous nodules are often located on the head and dorsal fold of the pinnae
  • Otherwise healthy
87
Q

How is Canine Leproid Granulomas diagnosed

A
  • Cytology (acid-fast)
  • PCR
  • Biopsy
88
Q

What is the treatment for Canine Leproid Granuloma?

A
  • Most spontaneously resolve w/in 3 months
    • cell-mediated immune response by host
89
Q

What are Opportunistic Mycobacterial Infections?

A
  • Uncommon/Rare infections of dogs/cats
  • Nontuberculous mycobacteria - aerobic, acid-fast bacilli
    • Mycolicibacterium fortuituitum
    • Mycolicibacterium phlei
    • Mycolicibacterium smegmatis
    • Mycobacteroides chelonae/abscessus
    • M. thermoresistable
  • Bacteria inhabit soil/water ⇢ contaminate broken skin and wounds
89
Q

What are the clinical signs of Opportunistic Mycobacterial Infections?

A
  • Dermal and subcutaneous nodules, ulcers, fistulae
  • Lesions frequently located on the ventrum, lumbar region and extremities
90
Q

How are Opportunistic Mycobacterial Infections diagnosed?

A
  • Cytology
  • Culture (exudate from aspirates of affected tissue)
  • Biopsy (special stains, PCR testing)
91
Q

How are Opportunistic Mycobacterial Infections treated?

A
  • Surgical excision of affected tissue
  • Antimicrobial therapy (empirical until C&S results)
    • Doxycycline
    • Fluoroquinolones
    • Clarithromycin
  • Treated fir 3 - 12 months
92
Q

Do cats/dogs get Tuberculosis?

A
  • Rare
  • Mycobacterium tuberculosis & M. tuberculosis bovis
  • Airborne transmission and ingestion of unprocessed meat/milk
  • Clinical signs:
    • respiratory signs
    • Digestive signs
    • Cutaneous nodules and ulcers
  • Public Health Hazard - euthanasia recommended

Medicine I (43 decks)

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