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Dermatology > Bacterial Skin Diseases and Treatment > Flashcards

Bacterial Skin Diseases and Treatment Flashcards

1
Q

What are the 3 classifications of cutaneous bacteria?

A
  1. Residents
  2. Transients
  3. Pathogens
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2
Q

What bacteria are part of the normal flora on feline skin?

A 
Staph pseudointermedius
Staph aureus
Staph simulans
Staph epidermis
Staph xylosus
Pasteurella multocida
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3
Q

What bacteria are part of the normal flora on equine skin?

A

Staph aureus
Staph pseudointermedius
Dermatophilus congolensis

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4
Q

What bacteria are part of the normal flora on porcine skin?

A

Staph hyicus

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5
Q

What are some physical defense mechanisms of skin?

A

Hairs
Stratum corneum
Lipid envelope

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6
Q

What are some chemical defense mechanisms of skin?

A

Sebum

Fatty acids

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7
Q

What are some immune defenses of skin?

A 
Lymphocytes
Langerhans cells
Keratinocytes
Cytokines
AMPs
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8
Q

What are some microbial defenses of skin?

A

Competition from normal skin flora

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9
Q

How do you know if infection is present?

A

Clinical signs

Cytology

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10
Q

What are examples of surface pyodermas?

A 
Pyotraumatic dermatitis ("hot spot")
Skin fold pyoderma ("intertrigo")
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11
Q

What are pre-disposing factors for pyotraumatic dermatitis?

A

Thick or long hair

Warm weather

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12
Q

What is the most common underlying problem for pyotraumatic dermatitis?

A

Flea allergy

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13
Q

What is a common therapy for pyotraumatic dermatitis?

A 
Clip 
Clea
Topical astringents
Topical antiseptics
Address underlying problem
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14
Q

What areas are susceptible to skin fold pyoderma?

A

Lip folds
Facial folds
Tail folds

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15
Q

What is a superficial pyoderma?

A

Pustules that are present in/under stratum corneum or inside hair follicles

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16
Q

What are examples of superficial pyodermas?

A 
Impetigo "puppy pyoderma"
Superficial bacterial folliculitis
Dermatophilosis
Staphylococcal folliculitis/furunculosis
Exudative epidermitits
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17
Q

What is impetigo?

A

Subcorneal pustules in glabrous areas

Not contagious

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18
Q

What is the treatment for impetigo?

A

Topical therapy
Ensure clean environment
+/- systemic antibiotics

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19
Q

What are common types of folliculitis?

A

Bacterial (most common)
Demodex
Dermatophyte

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20
Q

What are primary lesions in pyoderma?

A

Papules
Pustules
Erythematous macules

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21
Q

What are secondary lesions in pyoderma?

A 
Circular crusts
Epidermal collarettes
Focal scaling
Alopecia
Hyperpigmented macules
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22
Q

What is the most common pyoderma in horses and what is it caused by?

A

Equine folliculitis

Caused by staph spp, dermatophilus congolensis

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23
Q

What are other names for dermatophilosis in horses?

A 
Strawberry foot rot
Rain rot
Rain scald
Rain rotscald
Lumpy wool
Streptothricosis
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24
Q

What is dermatophilosis?

A

Caused by dermatophilus congolensis
Common during rainy season
Affects horses, cattle, sheep, goats, dogs
Potentially zoonotic

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25
What are 3 important factors for dermatophilosis infection?
1. Chronic carriers 2. Moisture, rain, sweating 3. Break in skin integrity
26
How is dermatophilosis transmitted?
Mechanically (e.g. contaminated clippers)
27
What are some clinical features of dermatophilosis?
Thick "paintbrush" crusts on dorsal surface of animal Hair easily removed, exposing pink, moist skin Green exudate and erosions
28
What is a key feature of cytologic diagnosis of dermatophilosis?
"Railroad tracks"
29
What is the treatment for dermatophilosis?
Usually self-limiting Remove from rain Topical treatments- benzoyl peroxide, chlorhex shampoo Systemic antibiotics for 2 weeks
30
What is staphylococcal folliculitis/furunculosis?
Caused by staphylococcus aureus Complication of most pruritic diseases Has 3 main syndromes (trunk, tail, pastern)
31
What is exudative epidermitis?
Caused by S.hyicus Toxins are absorbed -> liver and kidney disease Suckling piglets Disease usually confined to individual animals
32
What are examples of deep pyodermas?
``` Furunculosis Abscess Cellulitis Panniculitis Pressure point pyoderma ```
33
What is furunculosis?
Hair follicles rupture and infection spreads to dermis
34
What are some clinical signs of deep pyoderma?
Ulcers Fistulous tracts Pustules/bulla Cellulitis
35
What is an acral lick dermatitis?
Constant licking causes lesion | May be caused by allergy, behavioral, neurologic/chronic pain
36
What are common causes of abscesses in cats?
Pasturella Cryptococcus Nocardia Mycobacteria
37
What antibiotics would you use to treat a cat abscess?
Penicillin | Amoxicillin/clavulanic acid
38
What is atypical mycobacteria?
``` Bacteria that causes opportunistic infections Recurrent draining tracts and cellulitis More common in humid, warm climates Cats Cause chronic, non-healing wounds Animal is not sick! ```
39
What is juvenile pyoderma/canine juvenile cellulitis and lymphadenitis/puppy strangles?
Idiopathic disease Not a real infection Immune-mediated response
40
What are the clinical signs of juvenile pyoderma/canine juvenile cellulitis and lymphadenitis/puppy strangles?
Edema of face, lips, pinna | Pustules, lymphadenopathy, fever, depression
41
What is the treatment for juvenile pyoderma/canine juvenile cellulitis and lymphadenitis/puppy strangles?
Glucocorticoids at high doses Cyclosporine Antibiotics for secondary infection
42
In what cases should you culture?
Recurrent pyodermas Pyodermas that fail to respond to initial treatment Deep pyodermas
43
What lesion do you want o get a culture from? What should you avoid?
Look for primary lesions (papules, pustules, nodules) | Avoid secondary, ulcerated, or opened lesions
44
Before culture, when should you stop antibiotics?
3-5 days before culture
45
What are the general rules of antibiotic therapy?
Use AB with narrow spectrum first Use AB with fewest adverse effects If many bacteria are isolated, select AB effective against various organisms. If not possible, focus on Stapylococci first.
46
What are the appropriate lengths of antibiotic therapy for superficial and deep pyodermas?
Superficial: min 3-4 weeks, continue 7-10 days past resolution of CS Deep: min 2-3 months, continue 4 weeks past resolution of CS
47
What are some common reasons for treatment "failure"?
``` Failure to identify all underlying causes Wrong antibiotic Inappropriate dose Inappropriate length of therapy Concurrent use of steroids Foreign body reaction ```
48
What antibiotics would you use for pyoderma?
1st tier: macrolides, 1st gen cephalosporin, amoxicillin, sulfonamines 2nd tier: 3rd gen cephalosporin, doxy, fluroquinolones, chloramphienicol, aminoglycosides 3rd tier: vancomycin, linezolid, teicoplanin
49
What is MRSA?
Has abnormal penicillin binding protein (PBP2a) Is not more virulent, is just harder to treat Resistant to all B lactams Clindamycin is a good choice
50
What antibiotic inhibits cytochrome p450?
erythromycin
51
What is macrolide-inducible resistance?
A clindamycin- macrolide interaction | Inducible methylase that alter the common ribosomal binding site for macrolides, clindamycin, and group B stetrogrammins
52
What are the mechanisms of action of common antibiotics?
B lactams (amoxicillin, cephalosporins)- cell wall inhibitors Macrolides (erythromycin lincomycin, clindamycin) - protein synthesis inhibitor Potentiated sulfonamindes - interfere with folic acid synthesis Tetracyclines (doxycycline)- protein synthesis inhibitors Phenicols- protein synthesis inhibitor Fluoroquinolones - inhibit DNA gyrase/replication Polymyxin B - inc permeability of cell membrane
53
What antibiotics are very allergenic and may trigger hypersensitivity reactions?
Potentiated sulfonamides
54
What is a main adverse effect of potentiated sulfonamides?
Hepatopathy (nitrous metabolite is cytotoxic) Also: anemia, leukopenia, thrombocytopenia, fever, arthropathy
55
Potentiated sulfonamides should not be used in what breeds?
Dobermans and Rottweilers | Increased risk of arthropathy
56
What is silver sulfadiazine?
Topical sulfonamide | Ideal for pseudomonas spp
57
What are potential disadvantages of cephalosporins?
Potential selection for MRSA | Very expensive
58
When and how should you use fluoroquinolones?
Resistant cases Cases with Gram - bacteria *Once daily high dose*
59
What is Vetericyn spray?
Topical oxychlorine used in humans for MRSA | Well-tolerated
60
What is a main side effect of chloramphenicol?
Peripheral neuropathy

Dermatology (8 decks)

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