Mehlman/UW. Skin inf bacterial 11-14 (2)

Question 1

M. Impetigo types?

Answer 1

bullous and non-bullous

Question 2

M. Impetigo is highly present in pediatrics

Answer 2

Usually in kids between 2-6 ages
Higly contagious

Question 3

M. Most likely cause of NON-bullous impetigo?

Answer 3

Staph aureus
80 proc of time

Question 4

M. NON-bullous impetigo, what other m/o?

Answer 4

It can be cause by streptococcus pyogenes (group a beta hemolytic strep)
10 proc of time

Question 5

M. NON-bullous impetigo - BOTH bacteria at the time can also cause, accounts for 10 proc.

Answer 5

.

Question 6

M. Bullous impetigo, causative m/o?

Answer 6

Staph aureus

Question 7

M. Bullous impetigo, population?

Answer 7

more common in infants
ages <2 y/o accounts for 90 proc.

Question 8

M. Bullous impetigo. CP?

Answer 8

Superficial infection characterized by inflamed and infected epidermis. Bullous is characterized by fragile fluid-filled vesicles and flaccid blisters.

Question 9

M. Impetigo treatment. TOPICAL HY? 3

Answer 9

Mupirocin!!! HY
Retapamulin, fusicid acid

Question 10

M. Impetigo treatment. ORAL? 3

Answer 10

Dicloxacillin, caphalexin, amoxiclav

Question 11

M. Impetigo treatment. HY fact about oral?

Answer 11

if you give penicillin or amoxicillin alone, they WILL NOT cover Staph aureus due to its beta-lactamase production

Question 12

Abs coverage: penicilin, amoxicillin/ampicillin?

Answer 12

covers streptococcus, do not cover staphylococus

Question 13

Abs coverage: dicloxacillin, caphalexin, amoxiclav (cia sities prie impetigo gydymo as per oral buvo nurodyti)

add: nafcillin, cefazolin

Answer 13

All five covers staph aureus, ALSO they all covers streptococcus

Question 14

M. Erysipelas (roze). definition?

Answer 14

infection involving the upper dermis with CHARACTERISTIC extension to the SUPERFICIAL cutaneous lymphatics

Question 15

M. Erysipelas (roze). skirtymas?

Answer 15

nonbullous/non-purulent
and
bullous/purulent

Question 16

M. Erysipelas (roze). nonbullous/non-purulent cause?

Answer 16

Strep pyogenes>staph aureus

Question 17

M. Erysipelas (roze). bullous/purulent cause?

Answer 17

staph aureus>strep pyogenes

Question 18

M. Erysipelas (roze). CP?

WELL DEFINED BORDERS!!! vs cellulitis

Answer 18

abrupt onset of a fiery red, tender, intensely erythematous, indurated plaque WITH sharply demarcated border.

Question 19

M. Cellulitis. definition?

Answer 19

Extends to subcutaneous tissues, which may explain its more diffuse margins and lighter, pinkish color.

Question 20

M. Cellulitis. Cause?

Answer 20

Staph aureus>Strep pyogenes

Question 21

M. Tx erysipelas/cellulitis.
no systemic symptoms?

Answer 21

ORAL dicloxacilin, cephalexin, clindamycin

Question 22

M. Tx erysipelas/cellulitis.
If severe/systemic symptoms?

Answer 22

IV flucloxacilin, cephazolin

Question 23

M. Tx ORAL dicloxacilin, cephalexin, clindamycin?

Answer 23

erysipelas/cellulitis.
no systemic symptoms

Question 24

Tx IV flucloxacilin, cephazolin?

Answer 24

erysipelas/cellulitis.
If severe/systemic symptoms

Question 25

M. Tx erysipelas. when consider other agent than penicillin in erysipelas?

Answer 25

It should be considered in patients that do not respond to penicillin treatment –> suspect staph aureus

Question 26

M. Tx erysipelas. When many clinicians choose penicillin?

Answer 26

if presentation is subjectively ,,classic” erysipelas.

Question 27

M. MCC of erysipelas?

Answer 27

strep pyogenes

Question 28

M. Tx erysipelas. When many clinicians choose staph covering agent? 4

Answer 28

1. No improvement with penicillin
2. Systemic features or underlying trauma
3. There are characteristic features of staph infection (ie bullae or purulence)
4. the diagnosis is more sujectively equivocal (ie one believes it may or may not potentially be cellulitis)

Question 29

M. Tx erysipelas. In half of cases, an antibiotic effective againt staph aureus is chosen instead penicillin.

Answer 29

.

Question 30

M. Tx erysipelas/cellulitis.
Exceedingly HY abs fact?

Answer 30

dicloxacillin and cephalexin –> can treat staph (MSSA)
BUT penicillin CANNOT

Question 31

UW table. erysipelas manifestation?

Answer 31

Superficial dermis and lymphatics
Raised, DEMARCATED edges
Rapid spread
Fever early in course

Question 32

UW table. Cellulitis (nonpurulent) manifestation?

Answer 32

Deep dermis and subcutaneous fat
Flat edges with POOR demarcation
Indolent course
Localized (fever later)

Question 33

UW table. Cellulitis (purulent) manifestation? MSSA/MRSA
what forms of this type?

Answer 33

Purulent drainage

Folliculitis: infected hair follicle
Furuncles: Folliculitis ->dermis -> abscess
Carbuncule: multiple furuncules

Question 34

In UW. Purulent cellulitis cause?

Answer 34

Staph aureus

Question 35

In UW. NON-purulent cellulitis cause?

Answer 35

beta hemolyhtic strep (s. pyogenes)