Bacterial Skin Infections

Question 1

cellulitis pres

Answer 1

spreading erythematous, non fluctuant tender plaque

most common on lower leg, streaks of lymphangitis could be seen

more pain than itching

can cause sepsis and death if untreated

Question 2

risk factors for cellulitis

Answer 2

local trauma, inflammation, edema, systemic infection

group A strep most common
and staph aureus

Question 3

differentiating cellulitis

Answer 3

rapidly spreading (not chronic) and painful w/ systemic sx

Question 4

cellulitis tx

Answer 4

outpts: covered for group A strep and staph aureus w/ cephalosporin

inpatients need MRSA coverage w/ vanc

w/ recent exposures or prurulent drainage- doxy, bactrim, clinda

Question 5

pres of erysipelas

Answer 5

superficial cellulitis w/ dermal lymph involvement causing edema

usually GAS, lower extremities and face

pain, erythema, plaque like edema w/ sharp margins, can have high WBC and systemic sx

Question 6

erysipelas tx

Answer 6

immediate empiric abx- cover strep w/ cephalosporin

tx tinea pedis if present (portal for infection)

Question 7

required tx for abscess

Answer 7

incision and drainage- topical abx not enough

oral abx w/ multi lesions extensive cellulitis, immune suppression, risk for MRSA

Question 8

pres of furunculosis

Answer 8

aka boil

acute, round, tender, circumscribed, perifollicular abscess

usually central suppuration

Question 9

pres of abscess

Answer 9

erythematous warm nodule, very tender to palpation, may drain spontaenously

Question 10

define carbuncle

Answer 10

coalescence of several inflamed follicles into single mass, purulent drainage

Question 11

typical cause of furuncles and carbuncles

Answer 11

Staph aureus, on skin ares w/ follicles exposed to friction and perspiration

Question 12

tx of furuncles/carbuncles

Answer 12

oral abx

solitary- warm compress may be enough

larger ones manages like abscess- I and D

Question 13

folliculitis patho

Answer 13

superficial bacterial infection of follicles

Question 14

folliculitis pres

Answer 14

small raised erythematous, sometimes prurutic pustules

genital may be sexually transmitted

Question 15

what is hot tub folliculitis

Answer 15

pseudomonas infection- typically below submerged areas like shoulders

Question 16

folliculitis tx

Answer 16

cleansing, avoid shaving, oral or topical anti staph agents

drain deeper lesions

Question 17

impetigo pres

Answer 17

honey colored crust

peri oral papules and plaques, minimal erythema

Question 18

spread of impetigo

Answer 18

contagiouis among close contact, mostly staph aureus

Question 19

bullous impetigo

Answer 19

flaccid bullae w/ clear yellow fluid, later causes honey crust

caused by staph exotoxin

Question 20

staph scalded skin syndrome

Answer 20

focus of infection secretes toxin in blood, widespread blisters

skin peels away, would cultures negative

Question 21

at risk for scalded skin

Answer 21

young kids, adults w/ renal disease

Question 22

tx for scalded skin

Answer 22

good prognosis w/ abx

Question 23

impetigo tx

Answer 23

topical mupirocin ointment in localized disease

oral abx for strep and staph like cephalosporins and clinda

Question 24

necrotizing fascitis cause/ pres

Answer 24

hematogenous or result of deep puncture (poor immune surveillance)

high mortality- fever, spreading rash, indistinct border, central patches of dusky blue discoloration

Question 25

tx of necrotizing fascitis

Answer 25

surgical emergency- tx w/ debridement and broad systemic abs

poor px w/ delay, old age, DM, atherosclerosis, trunk infection