Dermatolgoy Emergencies Flashcards
Meningealcoccal infections
Caused by neisseria meningitis is, strep pneumonia or H. Influenza
Symptoms:
- petechiae rash
- vomiting
- fever
- stiff neck
- (+) kernig and brudzinski
- stroke symptoms
- shock
- seizures
If getting an LP, make sure to get CT first to check for any masses that could cause intracranial pressure increases
Treatment:
- treat shock first with fluids and pressers
- IV antibiotics (3rd gen cephalad) next
- steroid adjuvant = strep pneumoniae ONLY
SJS and TEN
Mortality is caused by ARDS developing
develops from Erythema multiforme
- is most often drug induced autoimmune
- can be infectious (herpes = #1)
Treatment = treat as if a burn victim
- also immediately remove agent
Necrotizing fasciitis
Always presents with mild erythema and POOP
Need to get xrays to determine cause (will show gaseous bubbles in imaging
Treatment
- safety net and fluids as needed
- immediate surgical consult
- treat with broad spectrum that includes clostridium (usually piperacillin taxobactum and clindamycin)
- *give vancomycin if you believe MRSA is present
Rocket mountain spotted fever
Caused by dermacentor tick carrying rickettsia rickettsii
High mortality if not treated
Symptoms:
- fever, malaise and arthralgia
- “target” lesion initially
- intermittent headaches and vomiting
- late rash = petechiae with blanching macules
Treatment = doxycycline or chloramphenicol
Toxic shock syndrome
Caused by either staph or strep
Strep:
- usually younger than 13
- more deadly and more likely ARDS
- presents with high CRP and leukocyte counts
- strep = more obvious and bad looking and is focal to the wound site (staph spreads throughout body
Staph:
- usually older than 13
- rash = looks like a sunburn but includes the face, palm, hands and soles of feet
OTHER than rash, all share symptoms
- lethargy
- vomiting
- headache
- fever
- conjunctivitis
- hypotension shock
Treatment:
- staph and strep = nafcillin/clindamycin/3rd gen cephalad or vancomycin(MRSA only)
