Cellulitis,gastroenteritis Flashcards
How does a patient usually present with cellulitis?
- Erythema
- Warm or hot to touch
- Tense
- Thickened
- Odematous
- Bullae (fluid-filled blisters) —-> in severe cases
- Golden-yellow crust ——→ indicates a staphylococcus aureus infection (like impetigo which is also caused by satphylococcus infection)
What are the most common causes of cellulitis?
Strep pyogenes is most common and less commonly streptococcus aureus
Staphylococcus aureus
Group A strep (mainly strep pyogenes)
Group C (mainly strep dysgalactiae)
MRSA (pts in nursing homes/ repeated hospital admissions)
What is the ERON classification used for and what are the different classes?
It is used for making management decisions for patients that have cellulitis.
There are 4 classes.
Class 1: No systemic toxicity or comorbidity
Class 2: Systemic toxicity or comorbidity
Class 3: Significant systemic toxicity or significant comorbidity
Class 4: Sepsis or LIFE-threatening infection
What group of patients are considered admission when they have cellulitis?
Immunocompromised, young, frail pts and those with facial,periorbital and orbital cellulitis
What class of patients are givne IV antibiotics immediately in cellulitis?
Class 3 and 4
WHat is the first line of treatment for cellulitis and what are the routes it’s given?
Flucloxacillin (oral or IV)
Is primarily effective against staphylococcus aureus and also works against other gram-positive cocci
What are the alternatives to use the first-line treatment for cellulitis?
- Clarithromycin (which is a macrolide)
- Clindamycin (broad-spectrum antibiotic)
- Co-amoxiclav (the usual first choice for cellulitis near the eyes or nose)—→ contains penicillin so avoid in penicillin allergy
What bacteria prodcues shiga toxin, what are the symptoms and what complication can this lead to?
E.Coli 0157
It causes abdominal cramps, BLOODY diarrhoea and vomiting
It can lead to haemolytic uraemic syndrome (a disease that affects kidneys and blood clotting factors)
What should be avoided if a patient has a suspected E.Coli gastroenteritis? Why?
ANTIBIOTICS
As this increases the risk of haemolytic uraemic syndrome
What type of bacteria is camplyobacter jejuni?
Gram-negative spiral shaped bacteria
What type of bacteria is esterichia coli?
Gram-negative bacillus
What is the incubation period for campylobacter jejuni infection?
2-5 days
What are the symptoms of campylobacter jejuni infection?
Abdominal cramps, diarrhoea OFTEN with blood, vomiting and fever
What is the first-line medication to use when a patient has camplyobacter jejuni infection?
Clarithromycin (which is a macrolide)
What is the incubation period for shigella toxin and how long does it roughly take for the symptoms to resolve?
Incubation period is 1- 2 days
Symptoms usually resolve within a week
