Mehlman/UW. Skin inf bacterial 04-08 (3) Flashcards
Impetigo, erysipelas, cellulitis - MC skin infections
M. Impetigo types?
bullous and non-bullous
M. Impetigo is highly present in pediatrics
Usually in kids between 2-6 ages
Higly contagious
M. Most likely cause of NON-bullous impetigo?
Staph aureus
80 proc of time
M. NON-bullous impetigo, what other m/o?
It can be cause by streptococcus pyogenes (group a beta hemolytic strep)
10 proc of time
M. NON-bullous impetigo - BOTH bacteria at the time can also cause, accounts for 10 proc.
.
M. Bullous impetigo, causative m/o?
Staph aureus
M. Bullous impetigo, population?
more common in infants
ages <2 y/o accounts for 90 proc.
M. Bullous impetigo. CP?
Superficial infection characterized by inflamed and infected epidermis. Bullous is characterized by fragile fluid-filled vesicles and flaccid blisters.
M. Impetigo treatment. TOPICAL HY? 3
Mupirocin!!! HY
Retapamulin, fusicid acid
M. Impetigo treatment. ORAL? 3
Dicloxacillin, caphalexin, amoxiclav
M. Impetigo treatment. HY fact about oral?
if you give penicillin or amoxicillin alone, they WILL NOT cover Staph aureus due to its beta-lactamase production
Abs coverage: penicilin, amoxicillin/ampicillin?
covers streptococcus, do not cover staphylococus
Abs coverage: dicloxacillin, caphalexin, amoxiclav (cia sities prie impetigo gydymo as per oral buvo nurodyti)
add: nafcillin, cefazolin
All five covers staph aureus, ALSO they all covers streptococcus
M. Erysipelas (roze). definition?
infection involving the upper dermis with CHARACTERISTIC extension to the SUPERFICIAL cutaneous lymphatics
M. Erysipelas (roze). skirtymas?
nonbullous/non-purulent
and
bullous/purulent
M. Erysipelas (roze). nonbullous/non-purulent cause?
Strep pyogenes>staph aureus
M. Erysipelas (roze). bullous/purulent cause?
staph aureus>strep pyogenes
M. Erysipelas (roze). CP?
WELL DEFINED BORDERS!!! vs cellulitis
abrupt onset of a fiery red, tender, intensely erythematous, indurated plaque WITH sharply demarcated border.
M. Cellulitis. definition?
Extends to subcutaneous tissues, which may explain its more diffuse margins and lighter, pinkish color.
M. Cellulitis. Cause?
Staph aureus>Strep pyogenes
M. Tx erysipelas/cellulitis.
no systemic symptoms?
ORAL dicloxacilin, cephalexin, clindamycin
M. Tx erysipelas/cellulitis.
If severe/systemic symptoms?
IV flucloxacilin, cephazolin
M. Tx ORAL dicloxacilin, cephalexin, clindamycin?
erysipelas/cellulitis.
no systemic symptoms
Tx IV flucloxacilin, cephazolin?
erysipelas/cellulitis.
If severe/systemic symptoms
M. Tx erysipelas. when consider other agent than penicillin in erysipelas?
It should be considered in patients that do not respond to penicillin treatment –> suspect staph aureus
M. Tx erysipelas. When many clinicians choose penicillin?
if presentation is subjectively ,,classic” erysipelas.
M. MCC of erysipelas?
strep pyogenes
M. Tx erysipelas. When many clinicians choose staph covering agent? 4
- No improvement with penicillin
- Systemic features or underlying trauma
- There are characteristic features of staph infection (ie bullae or purulence)
- the diagnosis is more sujectively equivocal (ie one believes it may or may not potentially be cellulitis)
M. Tx erysipelas. In half of cases, an antibiotic effective againt staph aureus is chosen instead penicillin.
.
M. Tx erysipelas/cellulitis.
Exceedingly HY abs fact?
dicloxacillin and cephalexin –> can treat staph (MSSA)
BUT penicillin CANNOT
UW table. erysipelas manifestation?
Superficial dermis and lymphatics
Raised, DEMARCATED edges
Rapid spread
Fever early in course
UW table. Cellulitis (nonpurulent) manifestation?
Deep dermis and subcutaneous fat
Flat edges with POOR demarcation
Indolent course
Localized (fever later)
UW table. Cellulitis (purulent) manifestation? MSSA/MRSA
what forms of this type?
Purulent drainage
Folliculitis: infected hair follicle
Furuncles: Folliculitis ->dermis -> abscess
Carbuncule: multiple furuncules
In UW. Purulent cellulitis cause?
Staph aureus
In UW. NON-purulent cellulitis cause?
beta hemolyhtic strep (s. pyogenes)
