Day 3- Skin and Soft tissue infections Flashcards
What is impetigo and what commonly causes it?
What is therapy for impetigo and when is Oral therapy appropriate?
How do you treat impetigo in MRSA suspected?
Superficial infection, buliouos and non bullous lesions. S.aureus and Group A strep.
Cephalexin, topical mupirocin and retapumilin for 5 days for mild bullous and non bullous. Oral therapy is appropriate for numerous lesions or in outbreaks to reduce transmission.
Doxycycline, Clindamycin, SMX/TMP.
What are comments about impetigo?
What are your purulent infections and what bacteria causes them?
What is a furuncle?
Clinical diagnosis,commonly seen in children, highly contagious, common in hot and humid weather.
Furnucle, Carbuncle, Abscess. S.aureus.
boils that affect the hair follicles
How do you treat a furuncle and carbuncle and when do you give antibiotics for it?
What are your antibiotics for moderate furuncle’s?
What is DOC for severe MRSA abscesses?
Moist heat to promote drainage, May also need I & D. Antibiotics usually not needed however if there is a fever present or a moderate to severe infection you do.
Tmp/Smx or Doxycycline.
IV vancomycin
What is DOC for MSSA abscesses?
How are Erysipelas and cellulitis different and what typically causes them?
How do you treat mild erysipelas and cellulitis?
Nafcillin, Cefazolin, Clindamycin.
They are similar however Erysipelas have elevated lesions and well defined margins. Caused by group A strep most common, S.aureus.
Mild is non systemic. Cephalexin and other oral betalactams for 5 days.
How do you treat moderate to severe erysipelas and cellulitis?
What are some clinical nuggets to know for severe erysipelas and cellulitis?
How long is treatment for erysipelas and cellulitis?
IV beta lactams(Cefazolin, Ceftriaxone, Penicillin G(cellulitis only).
Symptoms may improve in 24-48 hours but visible improvement may take up to 72 hours.
5 days.
What causes type 1 necrotitis and is it most common and how do they compare to type 2 and 3?
How do you treat necrotizing fascitis?
What are your necrotizing facitis risk factors?
type 1–> most common, Bacteroides or preptostreptococcus, or streptococcus. 2 is flesh eating and 3 is gangrene.
Immediate surgery and Empiric antibiotics(vanco + pip/tazo for example).
Diabetes, vascular insuffiency, insect bites, injection site for IVDA
How do you deescalate in type 1?
How do you deescalate in type 2?
What bacteria infect human bites and animal bites?
Vanco + Pip/tazo.
Group A Strep: Penicillin + Clindamycin.
Staph and Strep. Eikenella in humans and Pasturella in animal.
How long do we do prophylaxis for human bites?
What is your prophylaxis/treatment options for human bites?
What do you give for allergy to beta lactams in human bites?
3-5 days.
Augmentin or Ampicillin/sulbactam if IV needed for 7-14 days.
Fluoroquinolone + clindamycin or metronidazole for 7-14 days.
When do you give a tetanus vaccine?
When do you give prophylaxis in bites?
When do you do surgical prophylaxis and what do you use?
Dirty >5 years, Clean > 10 years since last.
asplenic patients, advanced liver disease, immunocompromised, preexisiting or resultant edema, moderate to severe bite especially on hands, face, genitals, penetrated periosteum or joint capsule
An hour before surgery and usually Cefazolin. Use Clindamycin if PCN allergy.
How do you know what to treat in surgery?
What are your IV treatments for surgery?
What are your 3 diabetic foot infection categories?
Always gram positive and gram negative if GI tract.
Vanco, linezolid, daptomycin, ceftaroline.
Mild, Moderate, Severe(high risk for amp and hosp)
What are your risk factors for MRSA in diabetic foot infection?
How do you treat a mild diabetic foot infection?
How do you treat moderate-severe diabetic foot infection?
Previous MRSA, severe infection, recent antibiotic use, hospitilization, long term care facility. Peripheral neuropathy, osteoarthopatic deformaties
,vascularization for normal risk factors
Cephalexin, Augmentin, Clindamycin in beta lactam allergy.
Amp/sulbactam, Ertapenem, Moxifloxacin, ceftriaxone. Pip/tazo, carabpenems except ertapenem, Cefepime, Ceftazidime for pseudomonas.
What are your 3 ways to classify osteomylitis?
What bacteria do you deal with a majority of the time in osteomyelitis?
How long is your length of IV therapy for osteomylitis?
Hematogenous osteomylitis(normally in kids), continuous(usually in adults, tissue to bone), vertebral is location.
S.aureus.
6 weeks.
How do you treat MRSA related osteomylitis?
How do you treat normal S.aureus osteomylitis?
What are cellulitis risk factors?
Vancomycin +/- Rifampin. Pseudomonas is Cipro, Cefepime.
Nafcillin or Cefazolin.
Obesity, previous cutaneous trauma, previous cellulitis, edema form venous insuffiency/lymphedema, diabetes.
How do you monitor for osteomylitis?
Weekly ESR, CRP, WBC
