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Infectious Diseases > Lecture 13 Skin and Soft Tissue Infections > Flashcards

Lecture 13 Skin and Soft Tissue Infections Flashcards

1
Q

What are clinical features of Impetigo

A

Golden crust lesion

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2
Q

What organisms commonly cause Impetigo

A

Staph aureus

Less commonly Strep Pyogenes

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3
Q

What age group os common affected by impetigo

A

2-5 years

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4
Q

What are predisposing factors of impetigo

A 
o	Skin abrasions
o	Minor trauma
o	Burns
o	Poor hygiene
o	Insect bites
o	Chickenpox
o	Eczema
o	Atopic dermatitis
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5
Q

How is impetigo treated

A 
Topical antibiotics (small areas)
Oral antibiotics (Flucloxacillin)
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6
Q

What is Erysipelas

A

Infection of the upper dermis

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7
Q

What are the clinical features of Erysipelas

A

Painful red area
Fever
Regional Lymphadenopathy and lymphangitis
Lower limbs

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8
Q

What organism is commonly associated with Erysipelas

A

Strep pyogenes

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9
Q

What pre-existing conditions increase the risk of Erysipelas

A

pre-existing lymphoedema, venous stasis, obesity, paraparesis, diabetes mellitus

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10
Q

What is cellulitis

A

Diffuse skin infection involving deep dermis and subcutaneous fat

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11
Q

What is the clinical presentation of cellulitis

A

Spreading erythematous with no distinct border
Fever
Regional lymphadenopathy and lymphangitis

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12
Q

What are the most likely causes of Cellulitis

A

Strep pyogenes
Staph aureus
Diabetes
Febrile neutropeanics

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13
Q

What are predisposing factors of Cellulitis

A

DM
Tinea pedis
Lymphoedema

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14
Q

How is Erysipelas and Cellulitis treated

A

Combination of anti-staphylococcal and anti-streptococcal antibiotics
In extensive disease, admission for intravenous antibiotics and rest

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15
Q

What is folliculitis

A

o Circumscribed, pustular infection of a hair follicle

o Up to 5mm in diameter

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16
Q

What are the clinical features of folliculitis

A

o Present as small red papules
o Central area of purulence that may rupture and drain
o Typically found on head, back, buttocks and extremities

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17
Q

What is the common causative agent of folliculitis

A

Staph aureus

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18
Q

What is Furunculosis

A

Boils

Single hair follicle-associated inflammatory nodule

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19
Q

What areas to Furunculosis occur

A

Usually affected moist, hairy, friction-prone areas of body (face, axilla, neck, buttocks)

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20
Q

What is a carbuncle

A

Occurs when infection extends to involve multiple furuncles

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21
Q

Where are the common locations of carbuncles

A

neck, posterior trunk, or thigh

22
Q

How are hair-associated infections treated

A

Folliculitis- no treatment or topical antibiotics
Furunculosis- no treatment or topical antibiotics
Carbuncles- often require hospital admission, surgery and IV antibiotics

23
Q

What is type 1 Necrotising fasciitis

A

Mixed aerobic and anaerobic infection (diabetic foot infection, Fornier’s gangrene)

24
Q

Typical organisms that cause type 1 necrotising fasciitis

A 
o	Streptococci
o	Staphylococci
o	Enterococci
o	Gram negative bacilli
o	Clostridium
25
Q

What is type 2 necrotising fasciitis

A

Mono-microbial

Normally associated with strep pyogenes

26
Q

What are the clinical features of necrotising fasciitis

A 
Erythema
extensive oedema
haemorrhagic bullae
Skin necrosis and crepitus
Fever
Hypotension
tachycardia
Delirium
Multi-organ failure
27
Q

How is necrotising fasciitis treated

A

Antibiotics should be broad spectrum
o Flucloxacillin
o Gentamicin
o Clindamycin

28
Q

What is pyomyositis

A

Purulent infection deep within striated muscle, often manifesting as an abscess
Secondary to damaged muscle

29
Q

Common sites of Pyomyositis

A 
o	Thigh
o	Calf
o	Arms
o	Gluteal region
o	Chest wall
30
Q

What are the clinical features of pyomyositis

A

fever, pain and woody induration of affected muscle

If untreated can lead to septic shock and death

31
Q

What is the common causative organism of pyomyositis

A

Staph aureus

32
Q

How is pyomyositis diagnosed

A

CT/MRI

33
Q

How is Pyomyositis treated

A

Drainage with antibiotic cover depending on gram stain and culture

34
Q

What is septic bursitis

A

Infection of bursae -small sac-like cavities that contain fluid and are lined by synovial membrane
Located subcutaneously between bony prominences or tendons

35
Q

Predisposing factors of septic bursitis

A 
o	Alcoholism
o	RA
o	DM
o	IV drug abuse
o	Immunosuppression
o	Renal insufficiency
36
Q

What are clinical features of septic bursitis

A

fever and pain in movement

37
Q

How is septic bursitis diagnosed

A

Aspiration of fluid

Staph aureus

38
Q

What is infectious tenosynovitis

A

Infection of the synovial sheaths that surround tendons

39
Q

What are the common causes of infectious tenosynovitis

A

Staph aureus and streptococci

Penetrating trauma

40
Q

What are the clinical features of infectious tenosynovitis

A
  • Tenderness over the length of the tendon sheath and pain with extension of finger are classical
  • Present with erythematous fusiform swelling of finger
41
Q

How is infectious tenosynovitis treated

A

Empiric antibiotics, hand surgeon to review ASAP

42
Q

What are the causative agents of Toxin-mediated syndromes

A

Staph aureus- TSST1, ETA and ETB

Strep pyogenes- TSST1

43
Q

What are the diagnostic criteria for staphylococcal TSS

A 
•	Fever
•	Hypotension
•	Diffuse macular rash
•	Three of the following organs involved
o	Liver
o	Blood
o	Renal
o	GI
o	CNS
o	Muscular
44
Q

How is TSS treated

A
  • Remove offending agent (ex-tampon)
  • IV fluids
  • Inotropes
  • Antibiotics
  • IV immunoglobulins
45
Q

What is Staphylococcal scalded skin syndrome

A

• Infection due to a particular strain of Staph aureus producing the exfoliate toxin A or B

46
Q

What are the clinical features of staphylococcal scalded skin syndrome

A

Widespread bullae and skin exfoliation

47
Q

How is staphylococcal scalded skin syndrome treated

A

IV fluids and antimicrobials

48
Q

Causes of surgical site infections

A
  • Staph aureus
  • Coagulase negative Staphylococci
  • Enterococcus
  • E. coli
  • P. aeruginosa
  • Enterobacter
  • Streptococci
  • Fungi
  • Anaerobes
49
Q

Risk factors for surgical site infections

A
  • DM
  • Smoking
  • Obesity
  • Malnutrition
  • Concurrent steroid use
  • Colonisation with Staph aureus
  • Procedural factors
50
Q

How are surgical site infections diagnosed

A
  • Importance of sending pus/infected tissue for cultures especially with clean wound infections
  • Avoid superficial swabs- aim for deep structures
  • Consider an unlikely pathogen as a cause if obtained from a sterile site (ex bone infection)
  • Antibiotics to target likely organisms

Infectious Diseases (13 decks)

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