Bacterial skin infections

Question 1

What are exanthems?

Answer 1

Widespread rashes that are usually accompanied by systemic symptoms such as fever, malaise and headache

Question 2

Name some erythematous exanthems that tend to start on the face?

Answer 2

Measles
Rubella
Erythema infectiosum - fifth disease

Question 3

Name some erythematous exanthems that tend to start on the trunk?

Answer 3

Roseola
Scarlet fever

Question 4

Name a common papulo-vesicular exanthem?

Answer 4

Chickenpox (syn. varicella)

Question 5

Name an exanthem of the extremities?

Answer 5

Hand, foot and mouth disease

Question 6

What are the first stage symptoms of measles?

Answer 6

Mild fever
Cough
Coryza
Conjunctivitis
Koplik spots

Question 7

What are the first stage symptoms of scarlet fever?

Answer 7

Fever
Sore throat

Question 8

What are the first stage symptoms of fifth disease - human parvovirus B19?

Answer 8

Malaise
Fever
Red ‘slapped’ cheeks

Question 9

What are the second phase symptoms of measles?

Answer 9

Maculopapular rash beginning on head and spreading to trunk and extremities

Question 10

What are the second phase symptoms of scarlet fever?

Answer 10

Fine, erythematous papular eruption

Question 11

What are the second phase symptoms of fifth disease - human parvovirus B19?

Answer 11

Pruritic, lacy rash sparing palms and soles

Question 12

How is measles treated?

Answer 12

Vaccination causing activation of WBCs

Question 13

How long does measles commonly last for?

Answer 13

~10 days

Question 14

What is similar to measles bit is less red and lasts for ~3 days?

Answer 14

Rubella

Question 15

What is the identifiable pattern of erythema infectiosum (fifth disease) ?

Answer 15

Reticular lacy pattern

Question 16

What causes erythema infectiosum?

Answer 16

Human herpes virus 6 (HHV-6)

Question 17

What is varicella zoster?

Answer 17

Infection that comes up in ‘crops’ on the skin which is worse in adults

Question 18

What is shingles?

Answer 18

A reactivation of varicella zoster

Question 19

What is the antibiotic of choice for MSSA?

Answer 19

Flucloxacillin

Question 20

What are the treatment options for MRSA?

Answer 20

Oral doxycycline
Oral cotrimoxazole

IV vancomycin

Question 21

What is cellulitis?

Answer 21

Infection of the lower dermis and subcutaneous tissue, typically on lower limb

Question 22

What is erysipelas?

Answer 22

Infection of the upper dermis and lymphatics, typically on face

Question 23

How does cellulitis present?

Answer 23

Red, hot painful skin
Systemic symptoms may occur

Question 24

What are the risk factors for cellulitis?

Answer 24

Previous cellulitis
Broken skin
Lymphoedema
High BMI
SKD, chronic liver disease
Immunosuppression

Question 25

How is cellulitis diagnosed?

Answer 25

Often clinical diagnosis Swab can be done to confirm Blood cultures may be done

Question 26

What is impetigo?

Answer 26

A contagious, painful, itchy crusted rash often seen in children

Question 27

What organisms are common causatives of impetigo?

Answer 27

Staph. Aureus Group A beta haemolytic streptococcus

Question 28

How can impetigo be investigated?

Answer 28

Bacterial swab Blood cultures

Question 29

What is the treatment of impetigo?

Answer 29

Initial topical fusidic acid or mupirocin Flucloxacillin if MSSA Clarithromycin / vancomycin if MRSA

Question 30

How does necrotising fasciitis typically present?

Answer 30

Severe disproportionate pain under the skin

Question 31

What is the treatment for necrotising fasciitis?

Answer 31

Urgent surgical opinion and debridement

Question 32

How should group A strep necrotising fasciitis be treated?

Answer 32

Penicillin If allergic: flucloxacillin

Question 33

How should Staph. Aureus necrotising fasciitis be treated?

Answer 33

Flucloxacillin