Bacterial Skin Infections Flashcards
What is lymphangitis?
Red streaks extending proximally from areas of cellulitis
Which organism is the most common cause of folliculitis
Staph aureus
Which organism causes “hot tub folliculitis”
Psuedomonas
Does folliculitis itch?
Yes
Which is worse: a furuncle or a carbuncle
Carbuncle
True or false:
Most cases of folliculitis are self limiting and do not require antibiotics
True
What are the 3 variants of impetigo?
- Nonbullous
- Bullous
- Ecthyma
“Honey colored crusting”
Non bullous impetigo
“Punched out” ulcers with overlying crust (look like cigarette burns)
Ecthyma
Which organism usually causes Nonbullous and Bullous impetigo
staph aureus
Which organism usually causes ecthyma
Strep
What is the most common organism that causes cellulitis
B-hemolytic strep
If cellulitis has purulent drainage, it is more likely to be caused by (strep/staph)
Staph
What is this:
A superficial raised cellulitis with a sharply demarcated border. Tender, warm, and intensely erythematous
Erysipelas
Which parts of the body are usually affected by erysipelas?
Cheeks
Legs
Which bacteria is the main pathogen that causes erysipelas?
B-hemolytic strep (GAS)
True or false:
Erysipelas is a form of cellulitis
True
Best treatment for abscess
Incision and drainage
Patients with erysipelas are (very sick/not sick)
Very sick
Which bacteria most commonly causes abscesses?
Staph aureus
Abscesses do not always require antibiotics after you drain them.
When DO they need antibiotics?
> 2cm or multiple abscesses
Toxic
Extensive cellulitis
Immunosuppression
Indwelling medical device
High risk for transmission (athlete, military)
Risk factors for MRSA
Antibiotic use
Invasive device
Hospitalization
Group settings (miliatary, nursing home, etc)
Chronic wound
MRSA colonization in nose
Skin trauma (tattoo, IVDU)
“I have a spider bite”
MRSA
Oral antibiotics for MRSA
Bactrim
Doxycycline
Clindamycin
risk factors for cellulitis
local trauma (bug bites, lacs, punctures)
spread of preceding or concurrent skin lesion (furuncle, ulcer)
preexisting skin infection (tinea pedis)
inflammation (local dermatitis, radiation)
edema and impaired lymphatics
non-purulent cellulitis abx tx
tx for b-hemolytic strep (GAS) with:
cephalexin
amoxicillin
augmentan
clindamycin
purulent cellulitis abx tx
call ID and tx for MRSA and strep with:
clindamycin
bactrim
doxycycline + amoxicillin
how many days do you need to give abx in cellulitis
5
what could you use to decrease post inflammatory lymphatic damage by cellulitis
oral steroids
for hospitalized pts w/ cellulitis, what tx should you consider
empiric tx for MRSA
abx used to tx MRSA
IV vancomycin- DOC
the rest have adverse effects/ are unreliable:
linezolid
doxycycline/ minocycline
bactrim
clindamycin
pain, bright erythema, shiny, plaque like edema w/ sharply defined margins
erysipelas
erysipelas has what associated sxs
chills, fever, HA, vomiting, joint pain, high white count
erysipelas tx
empiric oral abx:
Pen V
amoxicillin
clindamycin
macrolide
erythematous, warm, fluctuant nodule w/ several small pustules throughout surface, TTP
abscess
what abx are recommended with abscess tx
clindamycin
bactrim
tetracycline
hospitalized- vanco/ linezolid/ daptomycin
acute, round, tender, circumscribed perifollicular abscess that ends in central pus
furuncle aka boil
coalescence of several inflamed follicles into a single inflammatory mass w/ purulent drainage from multiple follicles
carbuncle
furuncle/carbuncle tx
oral abx, warm compress, +/- I and D
small, raised, erythematous, occasionally itchy pustules less than 5 mm
folliculitis
can folliculitis be transmitted
genital folliculitis can
folliculitis tx
clean w/ abx soap
oral/ topical anti-staph (mupirocin)
topical clindamycin
+/- drainage
is impetigo infectious
yes- easily
common locations of bullous impetigo
face, extremities, diaper area
in bullous impetigo, the bullae are ____ and when they rupture they leave a ___
in bullous impetigo, the bullae are FLACCID and when they rupture they leave a THICK BROWN CRUST
tx of impetigo
oral abx
rapidly progressing erythema, edema, fever, systemic sxs, crepitus, ecchymosis
necrotizing fasciitis
what are poor prognostic factors associated w/ necrotizing fasciitis
delayed dx
over 50 yo
diabetes
atherosclerosis
infection involving trunk
who do you immediately consult if you suspect necrotizing fasciitis
surgery- immediately
is cellulitis dangerous
yes- untreated cellulitis can lead to sepsis and death
abscess subtypes
furuncles and carbuncles
