DERM- BACTERIAL

Question 1

Impetigo in a Child:
Symptoms?

Answer 1

Vesicular lesions with honey-colored crusts commonly around the nares and mouth

Question 2

Causative Organisms of Impetigo?

Answer 2

• Staphylococcus aureus (most common)
  
  • Streptococcus pyogenes (highly contagious)

Question 3

Treatment for impetigo?

Answer 3

Mild soap and warm water to clean the area.
- 1-2 lesions: Topical Mupirocin (Bactroban) ointment TID x 7 days.
- Extensive/widespread lesions: Oral antibiotics like Sulfamethoxazole/Trimethoprim, Clindamycin, or Keflex, based on severity.

Question 4

. Widespread Impetigo:
Treatment?

Answer 4

• Clean with mild soap and apply Mupirocin.
  
  • Oral antibiotics if initial topical treatment fails

Question 5

Recurrent Impetigo:
Cause?

Answer 5

• Possible colonization of Staphylococcus aureus in nares.

Treatment:
- Apply Mupirocin ointment to nares TID for decolonization.

Prevention:
- Good hygiene, avoiding shared towels, keeping fingernails short.

Question 6

Cellulitis?

Answer 6

General Symptoms:
- Swelling, erythema, warmth, tenderness, with or without fever.
-Locations:
- Any area, especially previously injured or compromised skin.
Diagnostic Tests:
- CBC and blood cultures if febrile.
- Culture if there is purulent drainage.

Question 7

Periorbital Cellulitis:

Answer 7

Symptoms:
- Swelling, redness, and tenderness around the eye.
- Fever and other systemic signs may be present.
Severity: - High risk for complications like septicemia.
- Requires close monitoring and possibly hospital admission

Question 8

Treatment of Cellulitis

Answer 8

Streptococcal Origin:
- Amoxicillin/Clavulanic Acid (Augmentin) 90mg/kg/day divided BID x 10 days.
- Clindamycin or Ceftriaxone as alternatives.

-Staphylococcal Origin:
- Sulfamethoxazole/Trimethoprim or Clindamycin.
- Possible initial dose of Ceftriaxone for severe cases.

Follow-Up:
- Mark the affected area to monitor spread. Daily follow-ups initially, then as needed until resolution.

Question 9

Folliculitis/Furuncle:?

Answer 9

Symptoms:
- Erythematous papules/pustules (folliculitis) or erythematous nodules with possible purulent drainage (furuncle).

Causative Organisms:
- Staphylococcus aureus, Pseudomonas (hot tub-associated).
Treatment:
- Warm compresses, Mupirocin ointment TID for 7-10 days.
- Oral antibiotics if severe (Sulfamethoxazole/Trimethoprim).
- Consider incision and drainage for furuncles.

Hygiene:
- Educate on personal hygiene, proper shaving techniques, and use of antibacterial soap.