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Dermatology > Bacterial Skin Diseases and Treatment > Flashcards

Bacterial Skin Diseases and Treatment Flashcards

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Dermatology Board Prep 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
Q

What are 3 important factors for dermatophilosis infection?

A
  1. Chronic carriers
  2. Moisture, rain, sweating
  3. Break in skin integrity
26
Q

How is dermatophilosis transmitted?

A

Mechanically (e.g. contaminated clippers)

27
Q

What are some clinical features of dermatophilosis?

A

Thick “paintbrush” crusts on dorsal surface of animal
Hair easily removed, exposing pink, moist skin
Green exudate and erosions

28
Q

What is a key feature of cytologic diagnosis of dermatophilosis?

A

“Railroad tracks”

29
Q

What is the treatment for dermatophilosis?

A

Usually self-limiting
Remove from rain
Topical treatments- benzoyl peroxide, chlorhex shampoo
Systemic antibiotics for 2 weeks

30
Q

What is staphylococcal folliculitis/furunculosis?

A

Caused by staphylococcus aureus
Complication of most pruritic diseases
Has 3 main syndromes (trunk, tail, pastern)

31
Q

What is exudative epidermitis?

A

Caused by S.hyicus
Toxins are absorbed -> liver and kidney disease
Suckling piglets
Disease usually confined to individual animals

32
Q

What are examples of deep pyodermas?

A 
Furunculosis
Abscess
Cellulitis
Panniculitis
Pressure point pyoderma
33
Q

What is furunculosis?

A

Hair follicles rupture and infection spreads to dermis

34
Q

What are some clinical signs of deep pyoderma?

A

Ulcers
Fistulous tracts
Pustules/bulla
Cellulitis

35
Q

What is an acral lick dermatitis?

A

Constant licking causes lesion

May be caused by allergy, behavioral, neurologic/chronic pain

36
Q

What are common causes of abscesses in cats?

A

Pasturella
Cryptococcus
Nocardia
Mycobacteria

37
Q

What antibiotics would you use to treat a cat abscess?

A

Penicillin

Amoxicillin/clavulanic acid

38
Q

What is atypical mycobacteria?

A 
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
Q

What is juvenile pyoderma/canine juvenile cellulitis and lymphadenitis/puppy strangles?

A

Idiopathic disease
Not a real infection
Immune-mediated response

40
Q

What are the clinical signs of juvenile pyoderma/canine juvenile cellulitis and lymphadenitis/puppy strangles?

A

Edema of face, lips, pinna

Pustules, lymphadenopathy, fever, depression

41
Q

What is the treatment for juvenile pyoderma/canine juvenile cellulitis and lymphadenitis/puppy strangles?

A

Glucocorticoids at high doses
Cyclosporine
Antibiotics for secondary infection

42
Q

In what cases should you culture?

A

Recurrent pyodermas
Pyodermas that fail to respond to initial treatment
Deep pyodermas

43
Q

What lesion do you want o get a culture from? What should you avoid?

A

Look for primary lesions (papules, pustules, nodules)

Avoid secondary, ulcerated, or opened lesions

44
Q

Before culture, when should you stop antibiotics?

A

3-5 days before culture

45
Q

What are the general rules of antibiotic therapy?

A

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
Q

What are the appropriate lengths of antibiotic therapy for superficial and deep pyodermas?

A

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
Q

What are some common reasons for treatment “failure”?

A 
Failure to identify all underlying causes 
Wrong antibiotic
Inappropriate dose
Inappropriate length of therapy
Concurrent use of steroids
Foreign body reaction
48
Q

What antibiotics would you use for pyoderma?

A

1st tier: macrolides, 1st gen cephalosporin, amoxicillin, sulfonamines

2nd tier: 3rd gen cephalosporin, doxy, fluroquinolones, chloramphienicol, aminoglycosides

3rd tier: vancomycin, linezolid, teicoplanin

49
Q

What is MRSA?

A

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
Q

What antibiotic inhibits cytochrome p450?

A

erythromycin

51
Q

What is macrolide-inducible resistance?

A

A clindamycin- macrolide interaction

Inducible methylase that alter the common ribosomal binding site for macrolides, clindamycin, and group B stetrogrammins

52
Q

What are the mechanisms of action of common antibiotics?

A

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
Q

What antibiotics are very allergenic and may trigger hypersensitivity reactions?

A

Potentiated sulfonamides

54
Q

What is a main adverse effect of potentiated sulfonamides?

A

Hepatopathy (nitrous metabolite is cytotoxic)

Also:
anemia, leukopenia, thrombocytopenia, fever, arthropathy

55
Q

Potentiated sulfonamides should not be used in what breeds?

A

Dobermans and Rottweilers

Increased risk of arthropathy

56
Q

What is silver sulfadiazine?

A

Topical sulfonamide

Ideal for pseudomonas spp

57
Q

What are potential disadvantages of cephalosporins?

A

Potential selection for MRSA

Very expensive

58
Q

When and how should you use fluoroquinolones?

A

Resistant cases
Cases with Gram - bacteria

Once daily high dose

59
Q

What is Vetericyn spray?

A

Topical oxychlorine used in humans for MRSA

Well-tolerated

60
Q

What is a main side effect of chloramphenicol?

A

Peripheral neuropathy

Dermatology (8 decks)

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