Infections of Skin & Soft Tissues Flashcards
Infection of obstructed hair follicles - clinically manifested as series of raised, painful, reddish lesions centered on a follicle
Folliculitis
Deep-seated infections around hair follicles
Furuncles
Deep-seated infections around hair follicles that result from coalescence of furuncles
Carbuncles
Form of cellulitis characterized by diffuse lymphangitis of skin, with redness & pain at advancing margins
Erysipelas
What should women who have had mastectomies with ispilateral LN dissections wear to decrease swelling & edema?
Arm compression sleeves
Soft-tissue swelling, erythema, warmth & tenderness, frequently in association with ulcer
MCC?
Vast majority of cellulitis due to what organism?
Cellulitis
S. pyogenes
(or S. aureus)
Rapidly progressing necrotizing soft tissue infections (crepitant & gangrenous) - top 5 causes.
- Group A strep
- Vibrio
- Aeromonas
- Clostridium
- Rarely, S. aureus
What is anaerobic cellulitis characterized by?
Foul discharge & gas in the wound
What species of Clostridium is frequently associated with underlying systemic malignancy? Wound feels like rice krispies. What do you treat with?
Clostridium septicum
Treat with penicillin
Therapy of Clostridial gangrene/myonecrosis?
Surgical debridement/amputation, high dose penicillin, hyperbaric O2, clindamycin to decrease toxin production
Poor killing activity of penicillin against slow growing (or dormant) organisms when they exist in a high inoculum.
Eagle effect
Individuals with necrotizing soft tissue infections due to Vibrio are usually compromised by what? Often results after exposure to what?
cirrhosis, AIDS, or malignancy
Brackish or salty water
Soft tissue infections due to Aeromonas hydrophila occurs after exposure to what?
Fresh water exposure or use of leeches in surgical procedures
Necrotizing perineal infections that occur most frequently in diabetics and patients with granulocytopenia - microbiology reflects mixed bowel flora
Fournier’s gangrene
Post-surgical mixed infection - microbiology reflects site of surgery
Meleney’s gangrene
Polymicrobial infection of submandibular and submental spaces - bacteriology reflects complex oral flora
Ludwig’s angina
Acronym for management of bite wounds.
H History E Examination of wound L Liberal cleansing & I Irrigation C Closure, culture purulent material O Operative debridement & closure P Prophylactic/therapeutic antimicrobials T Tetanus immunization status E Elevation & immobilization R Rabies risk assessment & radiology
Diabetic foot infections in diabetecs due to vascular disease
Microangiopathy
What does gangrene in diabetic feet result from?
thrombosis of digital arteries, due to inflammation around ulcerated bunions OR
from inflammation around web space and subsequent thrombosis of small arteries
How does diabetic neuropathy lead to foot infections?
Parasthesias and numbness - can’t feel trauma if occurring
Wasting of lumbrical and interosseous muscles results in collapse of arch, loss of stability, claw or hammer toe which predispose to ulceration from abnormal pressure (motor neuropathy)
Wasting of intrinsic foot muscles - plantar fat pad pulled away from metatarsal heads
Autonomic neuropathy in diabetic feet results in what?
Loss of perspiration –> drying of feet with cracking, increases risk of ulceration
Ulcer that occurs over sites of bony protrusions, like over metatarsal heads in diabetics
Mal perforans ulcer
Abnormal perfusion to bones causes bony fragmentation and collapse of arch with bony protrusions - “rocker bottom feet”
Charcot’s foot - autonomic neuropathy
Dermatophyte infections (Athlete’s foot) often caused by___
Candida albicans
