Lecture 12: Skin and Soft Tissue Infections Flashcards
What do skin and soft tissue infections involve?
Invastion of the skin and soft tissue
Cardinal sign of a SSTI?
Host inflammatory response followed by the manifestations including fever and rapid progression of lesions
How do we classify SSTI?
Depth of infection
List some risk factors for SSTI’s
DM, cirrhosis, bite wounds, neutropenia, reptiles, hot tubs, fish tank, water, drug abuse
A patient presents with a eruption of flaccid pustules which form a honey-coloured crust. These lesions are highly contagious and it is seen in children. What is this?
Epidemic impetigo
What organisms cause epidemic impetigo?
Group A strep, staph aureus
How is epidemic impetigo treated?
Antibiotic therapy
What is a rapid spreading infection of deep skin layers that involves superficial dermal lymphatics that lead to swelling?
Erysipelas
What can erysipelas be a a source of?
Bacteremia and has the potential for a systemic infection
What causes erysipelas?
Streptococcus progenies (group A strep)
What does cellulitis mean?
Refers to a deeper infection with acute spreading in the subcutaneous layer
What does cellulitis tend to follow?
Local infection or trauma
List the organisms which may cause cellulitis?
Staph aureus, streptococcus progenies, pseudomonas aeruginosa, gram negative bacilli- organisms depend on the sire of the wound
Furuncles
Boil
What causes boils?
ALWAYS staphylococcus aureus
Carbuncle
Multiple furuncles
How is a furuncle treated?
Cloxacillin
Decubitus ulcers
Bed wound
What type of organisms lead to bed wounds?
COlonozied with mixed potential pathogens or non-pathogens
How are bed wounds treated?
Nursing care
Clean
No significant contamination (i.e. heart surgery)
Clean contaminated
Through mucous membrane, GU, Resp tract
Contaminated
Colon, accident
Dirty/infected
Greatest risk of infection
What should you tell the lab if a client suffers from a bite wound?
The details of the situation
What can bites lead to?
Cellulitis, abscess, deep tissue infections
If a client has a clenched fist and is bitten here….
Do not ignore this as there is a high risk of deep infection as the skin over the knuckles is tight and there is a TON of bacteria in a human’s mouth
What is fasciitis?
A rapidly progressing cellulitis with extensive necrosis of the subcutaneous tissue as a result of toxin producing agents
What is the most common agent of flesh eating disease?
Streptococcus progenies (group A strep)
How do you diagnose flesh eating disease?
Rapid clinical followed by gram stain and culture confirmation
Give an example of a dermatophyte
Tinea or ringworm, infections in the hair nails, and skin
Where can infections pop up in the body in dermatophytes?
Anywhere in the body
What causes tinea/rignworm?
Yeast infection of dermatophytic fungi
How is this diagnosed in the lab?
Skin/nail scrapping sent to the lab, calcoflour stain and a +/- fungal culture is performed
What do dermatophytes produce?
Keratinase which breaks down keratin
Which sex of scabies burrow into the skin and lay eggs?
Females
What are we able to see on the skin’s surface with a scabies infestation?
The tracks from this microscopic mite
What are the three “easy’s” of lice?
Spreads, diagnosed, controlled
How many types of herpes simplex virus are there?
Two
Facial (cold sores) herpes
Type 1
Genital herpes
Type 1 or 2
How does transmission happen in herpes?
Direct contact
How is herpes diagnosed
Clinical but with genital it may require the virus culture or molecular detection
How is herpes treated?
With antiviral drugs which can shorten healing time if taken early
Talk about recurrence and herpes viruses
Common, with genital this will usually diminish in a year and some people never have recurrences
Varicella Zoster Virus
Chicken pox and shingles
Vaccine for VSZ
Vaccine is safe and effective, live vaccine which has led to decreased hospitalizations and death by 95%
What is shingles?
Varicella zoster reactivated which is diagnosed clinically
How does the VSZ virus persist?
In a latent state in the nerve ganglia in the face and trunk
List the microbes found: in mild infections (above the waist)
Staph Aureus, strep pyogenes
List the microbes found: Infections of hand and head
S. Aureus
S. Pyogenes
Haemophilus influenzae
List the microbes found: severe infections (above the waist) without special considerations
S aureus, S pyogenes
List the microbes found: Mild infections below the waist
S aureus, S pyogenes, coliform species possible
List the microbes found: Severe infections below the waist
Escherichia coli, Enterococcus species, other coliform species, S aureus, S pyogenes
