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Infectious Disease > Common Bacterial Infections > Flashcards

Common Bacterial Infections Flashcards

1
Q

Staphylococcus

A

Gram positive
Grape-like cocci clusturs
Most are harmless residents of skin and mucous membranes.

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2
Q

MRSA

A

Methicillin-resistant Staphylococcus Aureus
Resistent to beta lactam abx
Occur is people that have been in hospitals
Can also be community associated (CA-MRSA)

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3
Q

MRSA presentation

A

Looks like a false spider bite
Develop into deep, painful abscesses
Can cause life-threatening infxns

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4
Q

MRSA tx

A 
Culture and sensitivity
Septra DS 1po bid x 10 days
OR
Doxycycline 100mg po bid x 10 days
Bactroban in the nose
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5
Q

Full body wash rules of 3

A

3 times a day for 3 days then 3 times a week for 3 weeks

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6
Q

Cellulitis

A

Red, swollen tender skin that is warm to the touch and does not pus.

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7
Q

Group A Streptococci Cellulitis

A

Typically follows unrecognized injury

Inflammation is diffuse, spreading along tissue planes

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8
Q

Staphylococcus Aureus Cellulitis

A

Usually associated with wound or penetrating trauma.

Localized abscess becomes surrounded by cellulitis.

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9
Q

Cellulitis Tx

A

Not Keflex!
Clindamycin, doxycycline or trimethoprim-sulfa
Severe cellulitis should be treated with IV abx

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10
Q

Cellulitis admission criteria

A 
Animal bite on pt's face
>50% of limb involved, 
>10% of body surface
Coexisting morbidity
Compromised host
Need for IV abx
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11
Q

Abscess

A

When tissue in an area of cellulitis turns to pus under surface of skin.
The most common bacteria is Staph Aureus
Must be distinguished from empyemas

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12
Q

Abscess clinical features

A

Superficial
Infxns of head and neck
Can be deep seated abscess

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13
Q

Abscess Tx

A

Should be drained by I and D
If abscess has lots of cellulitis surrounding it, use antibiotic (same as cellulitis)
Abx cannot penetrate w/o drainage

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14
Q

Necrotizing Fasciitis

A

When cellulitis quickly spreads to fat and muscle .
Flesh is killed because blood supply is cut off
May also go septic

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15
Q

Necrotizing Fasciitis Tx

A

Cut ALL the dead tissue out
Keep cutting dead tissue until infxn stops spreading
Abx help, but will not cure
Use skin grafts for open muscle
Abx for anaerobes, gram- bacilli, strep, staph
Use abx for 3 weeks

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16
Q

Myonecrosis (Gangrene)

A

Pure clostridium perfringes infxn
incubates for hours to days
Local edema, pain, fever, tachy
Surgically remove infected muscle

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17
Q

Gangrene Tx

A

Surgical rescection
Consider hyperbaric chamber
Pen G and Chloramphenicol

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18
Q

Pyomyositis

A

A purulent bacterial infxn of skeletal muscles that results in pus-filled abscess
Most common in tropical areas
Usually caused by Staph A
Mainly a disease of children

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19
Q

Pyomyositis

A

Drainage and ABx for 3 wks

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20
Q

Pyomyositis predisposing factors

A

Immunodeficiency

25% report previous trauma

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21
Q

Erysipelas

A

Acute streptococcus infxn of upper dermis and superficial lymphatics
Caused by streptococcus pyogenes

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22
Q

Erysipelas Dx

A

Skin and soft tissue erythema, warmth, edema pain
Fever and leukocytosis
Hx of trauma, abrasion, skin ulceration
Has fiery red appearance w/ raised border

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23
Q

Erysipelas Tx

A

Immobilization
Elevate to reduce swelling
Draw lines to assess response to tx
2 wks of penicillin or dicloxacillin

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24
Q

Impetigo

A

Highly contagious superficial infxn
Non-bullous caused by strep A or staph A, pre-school, yellowish crusts
Bullous causes by staph A, all ages, brownish crust

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25
Q

Honey brown crusts =?

A

Impetigo

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26
Q

Impetigo causes

A

Malnutrition, diabetes, immuno-compromised

27
Q

Impetigo complications

A

Scarlet Fever
Strawberry tongue
Urticaria
Erythema Multiforme

28
Q

Impetigo Tx

A

Usually diagnosed by classic presentation
Soak in warm water, use wet compress to remove scabs
Abx creams: bactroban, fusidic acid, Retapamulon
Consider septra/bactrim if hx of MRSA

29
Q

Superficial Folliculitis

A 
Infxn of hair follicles
Commonly caused by staph A
Scalp and limb
Rarely painful
Heals in a week
30
Q

Risk factors for folliculitis

A 
Immunosuppression
Acne or dermatitis
long-term abx for acne
Topical steroids
Obesity
Hot tub
31
Q

Deep folliculitis

A

Starts deeper in skin surrounding hair follicle
Large swollen lump
Puss-filled blisters that break and crust
Pain, scars

32
Q

PFB (pseudo folliculitis barbae)

A

Common problem with african americans
Persistent irritation from shaving
Curly hair curls into skin

33
Q

PFB Tx

A 
No shaving
Use clippers
Keep beard at 1/8 inch
Cleocin T gel
Erythro topical
34
Q

Furuncle (Boil)

A

A deep folliculitis caused by staph A resulting in painful swollen areas on skin. Usually heals with scar

35
Q

Furuncle Tx

A 
May burst and heal on its own
Warm compress, salts bring to a head
Abx for recurrent boils
Associated with poor hygiene
Associated with iron deficiency anemia
36
Q

Carbuncle

A

An abscess larger than a furuncle, connected to eachother under the skin
Usually one or more open sores
Contagious
Usually caused by staph A or Strep

37
Q

Carbuncles Tx

A 
Probably I & D and culture
Oral abx for gram+ when larger than 5cm diameter or 2 cm proud
Avoid squeezing and irritating
NSAIDS for imflammation
Monitor for sepsis
38
Q

Paronychia

A

Seen often, a nail infection where skin meets the nail.
Acute (caused by basteria)
Chronic (caused by fungus)

39
Q

Paronychia Causes

A

Trauma to cuticles
repeatedly washing hands
Acne medication use
diabetes, immunosuppression

40
Q

Paronychia Tx

A

Acute: Warm soak, I&D if abscess, ABx (clind if hx of MRSA) Keflex po x 10 days
Chronic: Avoid etiological aspect
topical antifungal, steroid, remove fold surgically

41
Q

Staphylococcal Scalded Skin Syndrome (SSSS)

A

Ritters Disease
Cause by staph A
Red, blistering skin that looks like a burn mostly in young children.

42
Q

SSSS characteristics

A

Tissue paper wrinkling of skin followed by bullae
Rash spreads to other parts of body (arms, legs)
Top layer of skin peels in sheets

43
Q

SSSS Tx

A 
Supportive care
Eradication of primary infxn
Rehydration, antipyretics
IV Abx for staph A
 - Naficillin, oxacillin, vanco
44
Q

Pressure Ulcers

A

AKA decubitus ulcers
Any lesion caused by unrelieved pressure
Can occur anywhere in the ody
Common in hospital setting

45
Q

Pressure ulcer staging

A

I: persistent redness
II: Partial thickness skin loss
III: FUll thickness skin loss (subQ)
IV: Full thickness skin loss (fascia)

46
Q

pressure ulcer etioogy

A

Pressure from bones cuts off blood flow to tissue, causing necrosis

47
Q

Osteomyelitis

A

Infection and inflammation of bone or bone marrow.

Most commonly caused by staph A

48
Q

Osteomyelitis risk factors

A

Puncture wound to foot
Children and neonates
Higher in developing countries

49
Q

Pediatric Osteomyelitis

A

Blood-stream sourced most common
90% are S. Aureus
Long bones generally affected

50
Q

Adult Osteomyelitis

A

Commonly caused by immunosuppression
Open injury is most common cause
Usually S. Aureus
Leading cause of amputations

51
Q

Osteomyelitis mgmt

A

Admit
Ortho-surg consult
Closed needle biop/drainage
Start on IV meds empirically

52
Q

Osteomyelitis findings

A

Increased WBC, ESR, CRP
Plain film: 2-3 weeks show no changes
Abnormal bone scan in 1-2 wks
MRI works best**

53
Q

Acute septic arthritis

A

Infxn of one or more joints, most commonly one.
Most commonly caused by S Aureus and H. Flu
Sexually active: gonorrhea
IV drugs and elderly: Pseudomonas

54
Q

Acute septic arthritis causes

A

Direct invasion
Penetrating wound, arthroscopy
Complete destruction of articular cartilage
Considered to be a medical emergency

55
Q

Acute septic arthritis diagnosis

A

Diagnosed by aspiration
Fever, WBC > 12k
ESR, CRP

56
Q

Acute septic arthritis Tx

A

Same day ortho consult
IV Abx
Analgesia

57
Q

Legionnaieres

A

Severe form of pneumonia

Most commonly affects smokers and older persons

58
Q

Yersenia Pestis

A

Plague
Spread by fleas
Found in rodent species, re-emerging

59
Q

Lyme Disease

A

Most common tick-bourne disease in North Hemi
Rash, may not be bulls-eye
Later symptoms involve joints, heart, CNS
Abx can treat

60
Q

Lyme Dx

A

Western blot, Elisa

Bulls eye rash

61
Q

Lyme Tx

A

Doxycycline or amox for 2-4 wks

62
Q

Brucella

A

Brucellosis

Caused by consumption of unpasteurized cheese made from milk of infected animals.

63
Q

Tularemia

A

Caused by Francisella tularenis
Tick and deer, contaminated water, inhallation
Symptoms vary, can be treated with abx

64
Q

Animal BItes

A

Pasturella Multocida

Tx with augmentin

Infectious Disease (12 decks)

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