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Medicine > Dermatology - Bacterial Skin Infections > Flashcards

Dermatology - Bacterial Skin Infections Flashcards

1
Q

Pustules
Furuncls
Erosions with honey colored crusts

A. Gram (+) cocci
B. Gram (-) cocci

A

A. Gram (+) cocci

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2
Q

Indicators of Staphylococcus aureus infection

A

Bullae
Widespread erythema
Desquamation (scaling and crusting)
Vegetating pyodeermas

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3
Q

Confluence of pustules

A

Pyodermas

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4
Q

Indicated by a purulent purpura

Caused by S. Aureus or immunocompromised ptx infected with S. Epidermidis

A

endocarditis

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5
Q

Painful, erythematous nodule with pale center located ion the fingertips

A

Osler node

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6
Q

3 signs of endocaditis

A

Purulent purpura
Osler node
Janeway lesion

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7
Q

Nontender, angular hemorrhagic lesion of the palms and soles

A

Janeway lesion

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8
Q

Janeway lesion is likely to be due to

A

Septic embolic

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9
Q

Normal habitation of S. Aureus

A

Anterior nares (20-40%)
Hands
Perineum

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10
Q

Spread of S. Aureus in the hospital is frequently traced to

A

Hands of a healthcare worker

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11
Q

Is essential in limiting nosocomial complication of S. Aureus

A

Proper handwashing

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12
Q

PF to MRSA

A

Age (older thna 65)
Exposure to others with MRSA
Prior antibiotic therapy
Recent hospitalization or chronic illness

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13
Q

Tx MRSA

A

IV vancomycin

Linezolid

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14
Q

Ptx with no RF for MRSA

Tx of S. Aureus infection

A

Clindamycin
Trimethoprim - sulfamethoxazole (alone or w/ rifampin)
Minocycline
Oral linezolid

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15
Q

Mamaso

A

Impetigo

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16
Q

Tagalog word for Impetigo

A

Mamaso

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17
Q

T/F
Impetigo
Common contagious superficial skin infection

A

T

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18
Q

Impetigo

Does it scar?

A

No

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19
Q

RF for impetigo

A

Any spontaneous or induced lesions may become secondarily infected

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20
Q

Causative agents

A

Staphylococci -
Streptococci
Combination of both

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21
Q

What is the specie isolated from majority of lesions in both bullous and nonbullous impetigo

A. Staphylococci
B. Streptococci

A

A. Staphylococci

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22
Q

Now known as the primary pathogen to both bullous and nonbullous impetigo

A

S. Aureus

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23
Q

Produces an epidermolytic toxin that lyses the desmosomes which chemically split the epidermis

A

S. Aureus

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24
Q

S. Aureus

What causes the blister formation

A

Epidemolytic toxin

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25
Q

Start as oozing erosion, or transient thin-roofed vesicle which inc. in size rapidly that develop honey colored crust
Thought to be primarily streptococcal dse (now staphylococcal)

A

Non-bullous impetigo

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26
Q

Age demographic common to have bullous impetigo

A

Infants

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27
Q

Staphyloccocal disease
Lesions are vesicles (fluid filled <5 mm) and bullae (>5mm) on bland, non-inflamed skin
Dried, collapsed roofs of vesicles cover very superficial erosions

A

Bullous impetigo

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28
Q

Consitutional sx

Bullous impetigo

A

Initially absent
Later, weakness, fever, subnormal tempetrature
Diarrhea with green stools

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29
Q

Bullous impetigo complication

A

Bacteremia
Pneumonia
Meningitis
Develop rapidly with fatal termination

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30
Q

Tx and management impetigo

A

Lesions sprinkled with penicillin -dangerous because hypersensitivity rxn may develop

Moist, weeping lesions - cream
Dry - ointment

Keep injured area clean
1. Gentle washing
2. Antibacterial soap
3. Soaks or compresses (PNSS)
Gentle debridement with fingers or gauze after soak
Topical antibiotic - Mupirocin, Gentamicin

widespread and resistant - cloxacillin

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31
Q

Tx widespread and resistant cases impetigo

A

Cloxacillin

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32
Q

Impetigo of Bockhart

A

Superficial pustular folliculitis

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33
Q

Superficial pustular folliculitis

A

Impetigo of Bockhart

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34
Q

Superficial folliculitis with thin-walled pustules at the follicle orifices

A

Superficial pustular folliculitis

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35
Q

Favorite locations of Superficial pustular folliculitis

A

Extremities
Scalp
Face (periorally)

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36
Q

Fragile, yellow-white, domes pustules develops in crops and heal in a few days

A

Superficial pustular folliculitis

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37
Q

Most frequent cause of Superficial pustular folliculitis

A

S. Aureus

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38
Q

Superficial pustular folliculitis secondarily arises in

A

Scratches, insect bites, other skin injuries

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39
Q

Sycosis barbae

A

Sycosis vulgaris

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40
Q

Formerly known as barber’s itch

A

Sycosis barbae

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41
Q

A perifollicular, chronic, pustular staphylococcal infection of the bearded region

A

Sycosis vulgaris

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42
Q

Inflammatory papules and pustules and tendency to recurrence
Begins with erythema and burning or itching usually on the upper lip near the nose
In a 1-2 days, one or more pinhead-sozed pustules pierced by hairs develop

A

Sycosis vulgaris

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43
Q

There pustules rupture after shaving and leave a crop of erythematous spot, which is later the site of fresh crop of pustules, in this manner the infection persists and gradually spreads

A

Sycosis vulgaris

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44
Q

With severe cases of sycosis barbae, what other disease is usually present

A

Marginal blepharitis with conjunctivitis

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45
Q

Inflammation of eyelids in which they become red, irritated, and itchy, and dandruff-like scales form on the eyelashes

A

Blepharitis

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46
Q

Diffrential diagnosis for sycosis vulgaris

A

Tinea barbae
Acne vulgaris
Pseudofolliculitis barbae
Hepetic sycosis

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47
Q

Common location for sycosis

Not usually affected by tinea barbae

A

Sycosis barbae

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48
Q

Usual area affected by tinea barbae

A

Submaxillary region, or on the chin (beard area)

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49
Q

Spores and hyphae are found in the hairs

A

Tinea barbae

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50
Q

Manifests topid papules at the sites of ingrowing beard hairs in black men

A

Pseudofolliculitis barbae

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51
Q

Differential diagnosis for sycosis barbae caused by herpes simplex type 1

A

Herpetic sycosis

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52
Q

Herpetic sycosis caused by

A

HSV-1

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53
Q

Vesicles that lasts for a few days in the beard area

A

Herpetic sycosis

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54
Q

Tx sycosis vulgaris

A

Oral and topical antibiotics
Corticosteroids
Antifungal agents

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55
Q

Diagnosis sycosis barbae

A

Request gram stain

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56
Q

Inflammation of hair follicles

Caused by bacterial infection, chemical irritation, physical injury

A

Folliculitis

57
Q

Does folliculitis heal without scarring?

A

Depends on its depth of infection

58
Q

Painless or tender pustule that heals without scarring

A

Folliculitis

59
Q

Painless or tender pustule that heals without scarring

Dirty yellow or gray erythema

A

Folliculitis

60
Q

Pustule is confined to the ostium of the hair follicle

A

Folliculitis

61
Q

Involves the sweat ducts

Folliculitis

A

Milliaria

62
Q

Folliculitis

Involves the sebaceous glands wherin secretions come off the hair follicles

A

Millia

63
Q

The pustule is not associated with hair follicle

A

Milliaria pustulosa

64
Q

Folliculitis infection with Staphylococcus in the face

A

Folliculitis barbae

65
Q

Folliculitis in the scalp of legs

A

Follicular impetigo

66
Q

It causes red sores that can break open, ooze fluid, and develop a yellow-brown crust. These sores can occur anywhere on the body.

A

Impetigo

67
Q

Impetigo affects this age group very often

A

Impetigo

68
Q

Folliculitis in the trunk caused by pseudomonas aeroginosa

A

Hot tub folliculitis

69
Q

Hot tub folliculits is caused by

A

Pseudomans aeroginosa

70
Q

Back folliculitis
reaches young children and usually follows the miliaria, with inflammatory nodules or superficial pustules that eventually drain pus.

A

Periporitis suppurativa

71
Q

in this case the infectious process leads to atrophy of the hair, leaving bald patches that extend due to peripheral progression of the disease.

A

Folliculitis decalvans

72
Q

Gram + cocci in clusters

A

Staphylococcus

73
Q

Gram + cocci in pairs/chains

A

Streptococcus

74
Q

Folliculitis considerd to be a sexually transmitted disase

A

Miniepidemics of folliculitis nd

Furunculosis of genital and gluteal areas

75
Q

Tx of folliculitis

A

Heal with drainage (deep lesions of folliculitis) and topical tx
Removal of exciting agents 3 times a day with antibacterial soaps
Topical antibiotics
Systemic antibiotics

76
Q

Topical antibiotics used for folliculitis

A

Mupirocin (Bactroban)
Retapamulin - non responsive to mupirocin
Fusidic acid

77
Q

Folliculitis
If drainage fail/ soft tissue infections
Tx

A

Systemic antibiotic

78
Q

Systemic antibiotic for Folliculitis

A

1st generation cephalosporin ( IV cephazolin, cephalothin; Oral: Cephalexin, cephradine, cefadroxil)
Penicillinase resistant penicillin
(Cloxacillin, dicloxacillin)

79
Q

Aqueous solution of aluminium triacetate. It jas astringent and antibacterial properties.

A

Burrow’s solution

80
Q

When folliculitis is acute and wet tx

A

Soak with burrow’s solution diluted 1:20

81
Q

Chronic folliculitis esp. for buttocks

A

Anhydrous formulation of aluminium chloride (can be used once a night)

82
Q

Pigsa

A

Furuncle

83
Q

Acute, deep-seated, erythematous, hot, very tender inflammatory nodule

A

Furuncle

84
Q

Evolves from staphylococcal folliculitis

Deeper lesion

A

Furuncle

85
Q

Boil

A

Furuncle

86
Q

Acute, round, tender, circumscribed, perifollicular staphycoccal abscess that generally ends in central suppuration

A

Furuncle, boil

87
Q

2 or more confluent furuncles, with separate heads

A

Carbuncle

88
Q

PR for furuncle

A

Chronic staphyloccocal carrier states in nares or perineum
Intergrity of the skin surface - irritation, pressure, friction, hyperhidrosis, dermatitis, dermatophytosis (tinea), shaving
Systemic disorders- alcholism, manutrition, blood dyscrasias, disorder neutrophil function, iatrogenic or other immunosuppression, AIDS, diabetes
Obesity
Bactericidal defects
Scabies, pediculosis, abrasions

89
Q

hard nodule -> fluctuant abscess with central necrotic plug -> rupture -> ulceration -> scarring

A

Furuncle

90
Q

Bright red, indurated round plaque
Isolated single lesions or few multiple lesions (Scattered discrete)
Occurs only where there are hair follicles and in areas subject to friction and sweating

A

Furuncles

91
Q

Areas commonly affected by furuncles

A 
Nose
Neck
Face 
Axilla
Buttocks
92
Q

Lab examination for a suspected furuncle

A

Incision and drainage of abscess (gram stain, culture, antibiotic sensitivity)
Blood culture - fever, constitutional symptoms

93
Q

Tx of simple furunculosis

A

Local application of heat (15-20 mins)

Incision and drainage (if antibiotics failed)

94
Q

Tx furunculosis with surrounding cellulitis or fever

A

Systemic antibiotics for 1-2 weeks
Penicillinase- resistant penicillin (cloxacillin, dicloxacillin) or
1st generation cephalosporin orally dose of 1-2 g/day according to severity of case

95
Q

Type of furunculosis difficult to tx

A

Recurrent furunculosis

96
Q

May be related to persistent staphylococcus in the nares, perineum, and body folds
Type of furunculosis

A

Recurrent furunculosis

97
Q

Tx for Recurrent furunculosis

A

Frequent bathing, germicidal soap
Antibacterial ointments
(Bactroban - anterior nares daily or 5 days, bleach baths prevent recurrence)
Oral antibiotic until all lesions have resolved, and as a OD prophylactic dose for many months

98
Q

Bakokang / piso piso

A

Ecthyma

99
Q

Uncerative impetigo

A

Ecthyma

100
Q

Ulcerative staphylococcal or streptococcal pyoderma, (usually) of the shins and dorsal feet

A

Ecthyma

101
Q

Lesion of neglect

A

Ecthyma

102
Q

Ecthyma develops in

A

Minor trauma
Insect bites
Excoriations

103
Q

Etiology ecthyma

A

Group A beta-hemolytic streptococci (GAHBS)
Staphylococci
Both

104
Q

Disease begins with a vesicle, or vesicopustule which enlarges in a few days becomes thickly crusted.
When crust is removed, there is a suprficial saucer-shaped ulcer with a raw base and elevated edges

A

Ecthyma

105
Q

PF for ecthyma

A

Uncleanliness
Malnutrition
Trauma

106
Q 
Round, oval 0.5 to 0.3 cm
Indurated ulcer
Dirty yellowish-gray crust
Pruritus and tenderness
Located on the lower extremities
Last for weeks
A

Ecthyma

107
Q

Tx ecthyma

A

Cleansing with soap, water, followed by application of mupirocin, retapamulin, bacitracin ointment twice a day

Systemic tx is usually indicated
Cloxacillin
Dicloxacillin
Erythromycin ( for sensitive S. Aureus)
Clindamycin (MRSA)
108
Q

Ecthyma MRSA tx

A

Clindamycin

109
Q

Ecthyma same supportive management as

A

Impetigo

Gentle washing, antibacterial soap
Soaks or compresses
Gentle debridement with fingers or gauze after soak

Moist lesions - use cream
Dry lesions - ointment

110
Q

Acute spreading infection of the dermis and subcutaneous tissue

A

Cellulitis

111
Q

Cellulitis

Caused most frequently by

A

S. Pyogenes or S. Aureus

112
Q

Most common portal of entry of cellulitis

A

Tinea pedis

113
Q

Cellulitis accompanying sx and signs

A

Mild local erythema and tenderness, malaise, chilly sensations,sudden chill and fever may be present at onset

114
Q 
Erythematous, hot edematous
Very tender
Vary in size nad shape
Borders are usually sharply defined, irregular, slightly elevated
Associated with lymphangitis
A

Cellulitis

115
Q

Can form on the plaques and primary lesions of cellulitis

A

Vesicles, bullae, erosions, abscesses, hemorrhage, necrosis

116
Q

Kolebra

A

Erisypelas

117
Q

Also known as St. Anthony;s fire and ignis sacer

A

Erysipelas

118
Q

Acute, superficial inflammatory form of cellulitis
Involves superficial dermal lymphatics (streaking prominent)
Painful
Margins more clearly demarcated than normal skin
More superficial

A

Erysipelas

119
Q

What makes erysipelas differ from other types of cellulitis

A

Involves superficial dermal lymphatics (streaking prominent)
Margins more clearly demarcated than normal skin
More superficial

120
Q

Cause of erysipelas

A

Acute beta hemolytic group A streptococcal infection

Group B in newborn, abdominal or perineal erysipelas in postpartum women

121
Q

Characterized by local redness, heat, swelling, highly characteristic raised indurated border

A

Erysipelas

122
Q

Erysipelas often preceded by prodromal sx of

A

Malaise for several hours

Severe constitutional rxn with chills, high fever, headache, vomiting, joint pains

123
Q

Early stages Erysipelas, affected skin is

A

Scarlet
Hot to touch
Branny and swollen

124
Q

Distinctive feature of the inflammation is the advancing edge of the patch
This is raised and sharply demarcated, feels like a wall to the palpating finger
Often painful

A

Erysipelas

125
Q

Sites of predilection

Erysipelas

A

Lower legs -edema and bullous lesions, spreads centrally
Face - cheek, near the nose, in front of the lobe of the ear and spreads upward toward the scalp, hairline (usually) acts as a barrier against further extension
Ears
Umbilical stump
Areas of pre-existin lymphedema

126
Q

PR

Erysipelas

A 
Operative wounds
fissures - nares, auditory meatus, under the lobes of the ears, anus, penus, between an under toes (little toe usually) 
Abrasions or scratches
Venous insufficiency
Obesity
Lymphedema
Chronic leg ulcers
127
Q

Tx Erysipelas

A

Systemic penicillin - rapidly effective (24-48 hours)
Vigorous tx with antibiotics - continued 10 days
Locally, ice bags, cold compresses may be used
Leg involvement - likely require hospitalization with IV antibiotics

128
Q

H. Influenza cellulitis mainly in (age)

A

Young children <3 years old

129
Q

Most common sites of H. Influenza cellulitis

A

Most common : cheek, periorbital area, head and neck

130
Q

Ecthyma gangrenosum caused by

A

P. Aeuroginosa

131
Q

Most common site of Ecthyma gangrenosum

A

Extremity

132
Q

Ecthyma that rapidly becomes necrotic, leads to ulcer

A

Ecthyma gangrenosum

133
Q

Rapidly progressive

Extensive necrosis of subq tissue and overlying skin

A

Infectious gangrene

134
Q

Etiology infectious gangrene

A

Group A beta-hemolytic Streptococcus pyogenes

S. Aureus

135
Q

Etiology of infectious gangrene

Adults with underlying disease

A 
Clostridium septicum
P. Aeruginosa
E. Coli
Acinetobacter
Pasteurella multocida
H. Influenza
enterobacter
Proteus mirabilis
136
Q

Etiology of infectious gangrene

Children

A

H. Influenza
Group A streptococci
S. Aureus

137
Q

Transmission infectious gangrene

A

Break in the skin (puncture, abrasion, laceration, surgical site)
Underlying dermatosis (tinea pedis, stasis dermatitis/ ulcer)
Nasal fissures

138
Q

RF infectious gangrene

A 
Diabetes mellitus
Hematologic malignancies
IV drug use
Immunocompromise
Chronic lymphedema
139
Q

Tx infectious gangrene

A

Oral antibiotics

Wound care - debridement

Medicine (29 decks)

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