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Dermatology > Bacterial Skin Infections > Flashcards

Bacterial Skin Infections Flashcards

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Dermatology Board Prep flashcards
1
Q

What is Impetigo

A

Contagious bacterial skin infection

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2
Q

Bacteria causing Impetigo

A

Staph aureus

Strep pyogenes

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3
Q

Who normally gets impetigo

A

Children

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4
Q

Impetigo can occur as a complication of what conditions

A

Eczema
Scabies
Insect bites

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5
Q

Presentation of impetigo

A

Well-defined honey-coloured lesions with erythematous bases around the nose and face

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6
Q

Ix for impetigo

A

Clinical diagnosis

+/- bacterial skin culture if treatment isn’t resolving

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7
Q

Tx of impetigo

A

Localised disease:
1. topical fusidic acid
2. topical retapamulin
If MRSA - topical mupirocin

Extensive disease:

  1. Oral flucloxacillin
  2. Oral erythromycin if pen allergic
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8
Q

What advice should be given to children with impetigo about attending nursery/school?

A

Excluded from school until lesions are crusted and healed, or 48h after commencing Abx treatment

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9
Q

What is cellulitis

A

Acute bacterial infection of the dermis and subcutaneous fat

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10
Q

Bacteria causing cellulitis

A

Staph. aureus

Strep. pyogenes (group A beta haemolytic strep)

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11
Q

Risk factors for cellulitis

A

any breaks in the skin, venous insufficiency/stasis

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12
Q

What is erysipelas

A

distinct form of superficial cellulitis with notable lymphatic involvement. Raised, sharply demarcated from uninvolved skin

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13
Q

Presentation of cellulitis

A

pain, swelling, erythema, warmth, systemic upset, +/- lymphadenopathy

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14
Q

Ix for cellulitis

A

FBC, swab of lesion if surface broken, blood cultures

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15
Q

Mx cellulitis

A

Flucloxacillin - MSSA

If pen allergic - Doxycycline

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16
Q

What is folliculitis

A

Inflammatory process involving any part of the hair follicle

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17
Q

Most common cause of folliculitis

A

Staph. aureus

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18
Q

Presentation of folliculitis

A

erythematous papules or pustules around hair follicles

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19
Q

What is furunculosis

A

an acute deep infection of the hair follicles

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20
Q

2 types of furunculosis

A

Boil > single hair follicle

Carbuncle > collection of hair follicles

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21
Q

Ix for folliculitis

A

Gram stain

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22
Q

Mx folliculitis if organism unknown

A

Benzoyl peroxide

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23
Q

Mx folliculitis is MSSA

A

Cefalexin

Flucloxacillin

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24
Q

Mx MRSA cellulitis

A

Vancomycin

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25
Q

What is Bullous impetigo

A

Blistering impetigo - dermal inflammatory response

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26
Q

What can bullous impetigo progress to

A

Staphylococcal Scalded Skin Syndrome (SSSS)

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27
Q

What is Staphylococcal Scalded Skin Syndrome (SSSS)

A

Detachment within the epidermal layer by breaking down the desmosomes, caused by the exotoxins A and B which are released by Staph. aureus

28
Q

Presentation of SSSS

A

widespread fluid filled blisters that are easily ruptured

Nikolsky sign +

29
Q

Are the mucous membranes affected in SSSS

A

No

30
Q

Most common groups to get SSSS

A

children < 6 y
immunosuppressed adults
adults with renal failure

31
Q

Ix for SSSS

A

Skin biopsy - shows intradermal separation

32
Q

Histological appearance in TENS

A

separation along DEJ

33
Q

Mx SSSS

A

Supportive care - rehydration, Mx of burns

Tx of primary infection

Parenteral Abx

34
Q

What is necrotising fasciitis

A

Bacterial infection of subcutaneous tissue, spreading along fascial planes below the skin surface causing rapid tissue destruction

35
Q

2 types/causes of necrotising fasciitis

A
  1. Mixed anaerobes and coliforms

2. Group A Strep infection

36
Q

What does necrotising fasciitis NOT affect

A

the underlying muscle beneath fascia

37
Q

presentation of necrotising fasciitis

A

pain +++, disproportionate to visible skin changes

fever
palpitations
tachycardia
hypotension

38
Q

predisposing risk factors for causing necrotising fasciitis

A 
Diabetes Mellitus 
Peripheral Vascular Disease
Immunocompromised 
Chronic renal or hepatic insufficiency 
Herpes Zoster
IVDU
39
Q

How does bacteria get to the fascia in necrotising fasciitis

A

it is introduced to skin and soft tissue from minor trauma, puncture wounds or surgery

40
Q

Ix for necrotising fasciitis

A

FBC, U+Es, CRP, CK, lactate

Blood + tissue cultures

41
Q

Tx necrotising fasciitis

A

immediate surgical debridement
+
empirical broad spec Abx
e.g. IV vancomycin + IV Tazocin

42
Q

what is pitted keratolysis

A

a superficial bacterial skin infection affecting the soles of feet and sometimes palms of hands

43
Q

cause of pitted keratolysis

A

corynebacteria

44
Q

presentation of pitted keratolysis

A

smelly feet

white appearance with clusters of punched-out pits

45
Q

treatment of pitted keratolysis

A 
topical Abx - 
erythromycin 
clindamycin 
mupirocin 
fusidic acid
46
Q

bacteria causing syphilis

A

treponema pallidum (spirochaete)

47
Q

how many stages of syphilis is there

A

3

48
Q

describe primary syphilis presentation

A

initially macule > papule > ulcerating to form hard chancre

49
Q

how long after exposure to infection does primary syphilis occur

A

14-21 days

50
Q

describe secondary syphilis presentation

A

symmetrical maculopapular rash over the body, non-itchy, prominent on soles of feet and palms

generalised lymphadenopathy

constitutional symptoms

51
Q

describe tertiary syphilis presentation

A

gummas - granulomas in skin, mucosa, bone, joints, viscera

52
Q

Ix for syphilis

A

swab of chancre for PCR

53
Q

Tx of syphilis

A

IM injection of benzathine benzylpenicillin

54
Q

What is Lyme disease

A

tick-borne infection by transmission of Borriela Burgdoferi

55
Q

What shape is the Borriela Burgdoferi organism

A

spirochaete

56
Q

explain the transmission process of Lyme disease

A

the tick gets the spirochaete from an infected host

the infection is then transmitted to a new host via tick saliva

57
Q

When is the chance of transmission of Lyme disease from an infected tick most likely to happen

A

after 48h

58
Q

1st sign of Lyme disease

A

Erythema migrans - erythematous bullseye lesions

  • a circular rash beginning at the site of the tick bite that gradually expands
59
Q

How soon does Erythema migrans resolve in Lyme disease

A

a few days after Tx

if untreated resolves within a month

60
Q

How soon does Erythema migrans appear after tick bite in Lyme disease

A

around 14 days after the bite

61
Q

2nd sign of Lyme disease

A

Borriela Lymphocytoma

  • firm blush/red swelling and tender, local lymphadenopathy
62
Q

Most common locations for Borriela Lymphocytoma in Lyme disease

A

children - earlobe

adults - nipple

63
Q

Non-cutaneous late features of Lyme disease

A

numbness/arthralgia/facial paralysis/meningitis/arrhythmia

64
Q

3rd sign of Lyme disease

A

Acrodermatitis Chronica Atrophicans

- blue/red discolouration progressing to atrophy

65
Q

How soon does Acrodermatitis Chronica Atrophicans appear after a tick bite in Lyme disease

A

6/12 months - 8 years after initial infection

66
Q

Tx of Lyme disease

A

Solitary lesion - oral doxycycline or amoxicillin 2-3wk course

Severe - IV penicillin/Ceftriaxone 14-21 days

67
Q

Reaction that can be induced by Lyme disease treatment

A

Jarisch Herxheimer - fever, malaise, headache due to endotoxin release due to large numbers of organisms being killed

Dermatology (20 decks)

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