Bacterial Skin Infections Flashcards
cellulitis pres
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
risk factors for cellulitis
local trauma, inflammation, edema, systemic infection
group A strep most common
and staph aureus
differentiating cellulitis
rapidly spreading (not chronic) and painful w/ systemic sx
cellulitis tx
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
pres of erysipelas
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
erysipelas tx
immediate empiric abx- cover strep w/ cephalosporin
tx tinea pedis if present (portal for infection)
required tx for abscess
incision and drainage- topical abx not enough
oral abx w/ multi lesions extensive cellulitis, immune suppression, risk for MRSA
pres of furunculosis
aka boil
acute, round, tender, circumscribed, perifollicular abscess
usually central suppuration
pres of abscess
erythematous warm nodule, very tender to palpation, may drain spontaenously
define carbuncle
coalescence of several inflamed follicles into single mass, purulent drainage
typical cause of furuncles and carbuncles
Staph aureus, on skin ares w/ follicles exposed to friction and perspiration
tx of furuncles/carbuncles
oral abx
solitary- warm compress may be enough
larger ones manages like abscess- I and D
folliculitis patho
superficial bacterial infection of follicles
folliculitis pres
small raised erythematous, sometimes prurutic pustules
genital may be sexually transmitted
what is hot tub folliculitis
pseudomonas infection- typically below submerged areas like shoulders
folliculitis tx
cleansing, avoid shaving, oral or topical anti staph agents
drain deeper lesions
impetigo pres
honey colored crust
peri oral papules and plaques, minimal erythema
spread of impetigo
contagiouis among close contact, mostly staph aureus
bullous impetigo
flaccid bullae w/ clear yellow fluid, later causes honey crust
caused by staph exotoxin
staph scalded skin syndrome
focus of infection secretes toxin in blood, widespread blisters
skin peels away, would cultures negative
at risk for scalded skin
young kids, adults w/ renal disease
tx for scalded skin
good prognosis w/ abx
impetigo tx
topical mupirocin ointment in localized disease
oral abx for strep and staph like cephalosporins and clinda
necrotizing fascitis cause/ pres
hematogenous or result of deep puncture (poor immune surveillance)
high mortality- fever, spreading rash, indistinct border, central patches of dusky blue discoloration
tx of necrotizing fascitis
surgical emergency- tx w/ debridement and broad systemic abs
poor px w/ delay, old age, DM, atherosclerosis, trunk infection
