Infections Flashcards
Classified CDC as a CAT A bioterorism agent
Bacillus anthracis
Stages of Anthrax
- purpuric macule/papule on exposed area
- vesicle forms within 48 hours
- central vesicle ulcerates
- lesion becomes depressed and hemorrhagic with painless black necrotic eschar
- escar dries and sloughs over 1-2 weeks with no scar
anthrax occurs most often in
farmers, ranchers exposed to animals or hides
how to dx anthrax
- gram stain vesicular fluid
2 punch biopsy (1 for PCR and 1 for bacteria,fungal and mycobacterial)
Debride
How to treat anthrax?
fluoroquinolones cipro 60 days
Docy 100 mg bid
levofloxacin 750
debridement
Cellulitis bacteria is most commonly
Group A strep, Staph Aureus
Child- think Haemophilus infleunza B
What should one do when they suspect cellulitis?
See patient daily, draw around cellulitis to observe treatment results
NCAA guidelines and NFHS guidelines for cellulitis
Active infections are not tolerated, all lesions must be scabbed with no purulence
Bacterial infection of the upper dermis, streaking is prominent
erysipelas
patient complaints with erysipelas
flu-like symptoms, red tender firm spots that rapidly increase in size, uniformly elvated, shining patch with raised border
-involves one hair follicle
- painful, firm fluctuant mass
-prone to friction areas
- staph aureus most common pathogen
furuncle
clinical pear for furuncle
no fever or systemic symptoms
treatment of furuncles
self limited
warm compress
i&D
antibiotics for recurrent infections
involves multiple hair follicles
deep painful mass
carbuncles
antibiotic cleansers
mupirocin inside nostrils
recurrent/resistant- treat all family member, culture for MRSA, clinda, rifampin, cephalosporins
Clinical pear for carbuncles
malaise, chills, fever precede or occur during active phase
NCAA/NFHSS return to play guidelines for impetigo
No moist exudative or draining lesion
Resembles scalded skin, large thin superficial bullae, desquamation and fissures around mouth and eyes(sad old man facies), resolves without scarring
SSSS
Positive nikolskly sign is common in what?
SSSS
oral mucosa and conjunctiva are not involved in
SSSS
Do NOT use wet dressing as they will cause drying and cracking of skin
SSSS
Spares mucous membranes, positive nikolsky, resolves without scarring
SSSS
What medication is contraindicated in SSSS
Corticosteroids
What is important to remember when treating a child with SSSS
They become dehydrated easily
Slowly progressing
granuloma formation, single erythematous hypopigmented macule or infiltrated plaque, sharply defined circinate margins, central healing, peripheral border spread, yellow red papules/nodules, ACRAL NEUROPATHY is present
Hansen’s Disease
Cannot be grown in a culture, no serologic test, non-infectious within 72 hours of beginning therapy
hansens
treatment for hansens
rifampicin, dapsone, clofazimine, thalidomide
HPV type 6 & 11 can cause what in infants?
laryngeal papillomatosis
what to do for mom with HPV?
consistent cryotherapy for 2nd trimester on
HPV vaccines guidelines
males/females age 11-16 years
Pdoflox 0.5% can be given during pregnancy yes or no?
NO
what can you treat condyloma acuminatum in pregnancy
TCA, Cryo, Laser therapy
Clinical pearl for condyloma acuminatum
application of a gauze soaked pad over suspicious lesion for 5-10 minutes reveals sharply demarcated lesions with white opacity
Papular Acrodermatitis of Childhood
giannati crosti
Self limiting dermatitis
Most often Epstein Barr
increased risk with AD
Symmetric, pink-brown papules or vesicles on buttocks and spread to face and extensors, trunk is typically spared
symptomatic tx for gianotti crosti
topical corticosteroid
monomorphic pink to brown papules
giannaticrosti resolves in 3-8 weeks, family usually frustrated as it lasts so long
Central umbillication in dome shaped papules
Palms and soles are uninvolved
Red Halo (BOTE sign)
MC
NCAA guidelines for MC
Return to play lessions are curetted or ermoved, site covered or 24 hours postcurettage with the site covered.
What is important in patients with molluscum
They need to moisturize as to not autoinoculate and continue to acquire more lesions
If lesions occur in the periocular area
refer to opthalmology
MC TX
Cantharidin
LN
Cerretage
Sal acid 2%
TCA 35-50%
