Bacterial Skin Disorders Lecture Powerpoint

Question 1

Folliculitis

Answer 1

Papular or pustular inflammation of hair follicles with purulent material IN THE EPIDERMIS, most often caused by staph or pseudomonas (hot tub foliculitis) with increased risk factors by poor hygiene

Question 2

Cellulitis

Answer 2

Painful, erythematous infection of the dermis and subQ with poorly demarcated borders

Question 3

Erysipelas

Answer 3

Fiery red, painful infection of superficial dermis with sharply demarcated borders

Question 4

Cellulitis differs from erysipelas in that it…

Answer 4

…affects deeper dermis and sub Q opposed to the superficial dermis and has poorly demarcated borders

Question 5

Impeteigo

Answer 5

Superficial epidermal infection often caused by S aureus and occasionally GABHS or MRSA, often entering the body thru cuts or abrasions in moist areas and very contagous causing a characteristic honey colored crust

Question 6

Nonbullous impetigo vs bullous

Answer 6

Nonbullous often occurs on the face and does not scar while bullous occurs on the body and does cause scarring

Question 7

Impetigo caused by strep can result in…

Answer 7

….post streptococcal clomerulonephritis (hematuria) after initial infection

Question 8

Impetigo treatment (3)

Answer 8

-wash with antibacterial soap to remove crusts -mupirocin (bactroban) topical therapy -oral antibiotics such as cephalosporin especially in regions hard to reach

Question 9

Erysiipelas and cellulitis examples of route of entry, and causative agents

Answer 9

-trauma, surgery, drug use, insect bite, fissure -GABHS, S aureus, MRSA, psudomonas, haemophilus, meningococcus

Question 10

Why is erysipelas and cellulitis seen in the extremities most often?

Answer 10

More likely to undergo trauma

Question 11

Best imaging studies (2), best labs (3) for erysipelas and cellulitis, but diagnosis is generally…

Answer 11

MRI or x ray, CBC or gram stain or blood cultures …clinical

Question 12

During initial treatment of ereysipelas and cellulitis it isn’t uncommon to see….

Answer 12

….the rash to worsen (this is why we mark borders), not cause of concern

Question 13

Clindamycin 2 issues with it

Answer 13

-requires multiple dosages every day -can cause nausea and GI upsets

Question 14

Facial cellulitis is characterized by these 2 things

Answer 14

-pain with eye movement -vision loss due to obstruction or inflammation of tissue around eye

Question 15

Necrotizing fascitis

Answer 15

Flesh eating, rapidly spreading infection of deep fascia with inflammation leading to necrosis, can be idiopathic or due to trauma or surgical wounds and has a mortality rate of 30% requiring surgical treatment and antibiotics quickly

Question 16

Fournier’s gangrene

Answer 16

Necrotizing fasciitis of the perineum region

Question 17

Signs and symptoms of a ___ bite is faster than a doge bite

Answer 17

Cat

Question 18

Predominant infection obtained from dog/cat bites

Answer 18

Pasteurella multocida

Question 19

Primary treatment for dog/cat bite

Answer 19

(prophylactic or therapeutic) amoxicillin/clavulanic acid for 10 days (augmentin)

Question 20

___% of cat bites become infected, ___% of dog bites do

Answer 20

80, 5

Question 21

Delayed closure for animal bites

Answer 21

Technique to allow for open drainage for up to 72 hrs following a bite in case of infection occurring

Question 22

2 booster vaccines for animal bites

Answer 22

-tetanus -rabies

Question 23

cephalexin will often treat most ____, but do NOT use it for ____

Answer 23

cellulitis, animal bites

Question 24

Human bites key points

Answer 24

-consider early IV antibiotics -leave open if possible -give tetanus booster -human mouth has many more pathogens than animals and thus requires wide antibiotics

Question 25

Antibiotic of choice for human bites and the best alternative

Answer 25

Augmentin, alternatively clindamcin and cipro

Question 26

Pseudofolliculitis, and treatment

Answer 26

Slightly inflamed papules in the area of shaving or plucking also known as razor bumps or ingrown hairs caused by foreign hair growth inward causing inflammation, prevented by not shaving or plucking hair and can be treated with topical creams or laser hair removal

Question 27

Pseudofoliculitis barbae

Answer 27

Refers to razor bumps of the beard

Question 28

Furuncle treatment options (4)

Answer 28

-may spontaneous drain -broad spectrum antibiotics then narrow down -I&D -nasal decolonization using mupirocin if suspected MRSA

Question 29

Staph scalded skin syndrome

Answer 29

Acute exfoliation of skin following erythematous cellulitis due to exotoxin produed by 5% of staph aureus strains, highly contageous and causes blistering, fever, and desquamation most often in children***

Question 30

Nikolsky’s sign

Answer 30

Slight rubbing of skin resulting in exfoliation and wet appearance of skin indicating staph scalded skin syndrome

Question 31

staph scalded skin syndrome treatment

Answer 31

-rehydration, topical wound care -oxacillin or IV vancomycin to cover mrsa

Question 32

2nd most common cause of all bloodstream infeections

Answer 32

MRSA

Question 33

Community acquired MRSA vs Hospital acquired

Answer 33

Considered community acquired if not undergone any medical procedure or hospitalized within the past year

Question 34

CA (3) and HA (2) MRSA treatment

Answer 34

Community: -Sulfamethoxazole (bactrim) -tetracyclines -clindamycin Hospital: -vancomycin -linezolid

Question 35

What is the condition pictured?

Answer 35

Erysipelas

Question 36

What condition is pictured?

Answer 36

Cellulitis

Question 37

What condition is this?

Answer 37

Hot tub folliculitis

Question 38

What condition is pictured?

Answer 38

Scalded Skin sydnrome