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Rob's Microbiology MCD > Micro 4: skin infection > Flashcards

Micro 4: skin infection Flashcards

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1
Q

When are skin infections more commonly seen- GP or hospital

A

In GP it’s 25%

In hospital 5%

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2
Q

Where are high and low rates of skin infection seen

A
  • High rates of skin infection are seen in hot, humid and poor populations
  • Low rates are see in dry, temperate conditions, and rich populations
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3
Q

What type of bacterium is S. Aureus

A

Gram pos (cocci, from name)

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4
Q

What toxins does S. Aureus produce

A

Panton Valentine Leuocidin

Exfoliative toxin

TSST-1 (Toxic Shock Syndrome Toxin 1)

Enterotoxin

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5
Q

Is S. Aureus always harmful?

A

COMMENSAL 30% carry it, either in the nostrils or on the ski

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6
Q

Which AB is it commonly resistant to

A

MRSA

Resistant to methicillin= flucoxicillin

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7
Q

What can S. Aureus infect

A

Bone, joint, lung infections

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8
Q

What is the structure of the S. Aureus

A

Cell wall, cell membrane

Susceptible to penicillin treatment

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9
Q

What are panto valentina leucocidin

A

It is a virulence factor which makes the infection necrotising (tissue death)

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10
Q

What is the exfoliative toxin

A

Cuases cleave of the skin in the epidermis works on desmogleins so involves the same antigen as pempigus vulgaris

Causes LOCAL blisters in impertigo –> bollous impertigo

vs

auses SYSTEMIC scalded skin syndrome when the toxin gets into the blood.

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11
Q

What is TSST-1

A

Toxic shock syndrome 1 causes septicaemia type disease

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12
Q

What are enterotoxin

A

Food handler might have infected S. Aureus and an enterotoxin can get into the good and cause D and V in others

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13
Q

Where can S. Aureus cause infection

A

Bone joint lung infections

But focus of infection ften starts on the skin

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14
Q

When can staphylococcal lung infection occur

A

Often after flu (so deaths due to flue can be caused by this)

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15
Q

Manifestations of S. Aureus

A

Impetigo: subcorneal ayer

Folliculitis: mouth of hair follicle… can progress to abcess

Ecthyma: full thickness involvement of the epidermis, we see an (e.g. infected insect bite) NOT IN DERMIS

A carbuncle describes multiple abscesses next to each other, all coalescing.

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16
Q

What kind of skin infection does insect bite cause

A

Ecthyma ….

lesions look like firmly adherent crust on a background of erythema. The crust will not come off – the surface of the skin is dying. It commonly occurs after infected insect bites, or infected wounds.

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17
Q

What is it called if a folliculitis forms into abscess of hair follicle

A

Called boil

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18
Q

What is a carbuncle

A

Abscess of several adjacent hair follicles

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19
Q

Which S. Aureus infections are inthe spidermis and which in the dermis

A

Epidermis: Impetigo, folliculitis, ecthyma (might extend a tiny bit into the dermis)

Dermis: Boil and carbuncles

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20
Q

Feature of S. Aureus

A

Aureus= gold because the crust is golden

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21
Q

Common locatios for impetigo

What is bollous impetigo

A

It often occurs around the nose and mouth, but can occur anywhere (particularly groin/perineal region

Blistering with S. Aureus

Because of the exfoliative toxin
from S. Aureus (against that desmoglein antigen)

in addition to the impetigo which is just infection of the subcorneum and corneum

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22
Q

What can abscess start off as. How is it treated

A

Start as folliculitis treated with pus drainage

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23
Q

What can the exfoliative toxin from S Auerus casue

A
  1. Bollous impetigo

2. Staphylococcal scalded skin syndrome (DESQUAMATION of keratinocytes)

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24
Q

Who does Staphylococcal scalded skin syndrome occur in

A

Ages under 5

Because the immune system of children hasn’t developed properly so the infection can spread and cause widespread erythema and epithelial release

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25
Q

How can you treat Staphylococcus scalded skin syndrome

A

With emollients + ABs (systemic infection)

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26
Q

What is the treatment for S. Auerus

A

Give flucoxicillin/clindamycin/erythromycin

Topic for impetigo

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27
Q

What infection causes symphylis

A

Treponema pallidum

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28
Q

What type of bacterium is Treponema pallidum

A

Gram neg spirochete

Syph Spiro

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29
Q

What is coinfection with Treponema pallidum bad

A

Co-infection with syphilis increases the transmission of HIV

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30
Q

Phases of syphilis

A 
Primary (3-8 weeks) 
Secondary (6-12) 
Latent 
Tertiary 
Congenital
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31
Q

Outline primary syphilis

A

Painless ulcer at inoculation site (Genital or oral) = chancre

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32
Q

Outline secondary syphilis

A

Disseminated infection

Generalised rash and lymphadenopathy

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33
Q

Outline latent syph

A

(no clinical signs)

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34
Q

Outline teriary syph

A

Skin, neurological and vascular manifestations

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35
Q

Outline congenital syph

A

Acquired perinatally

Early and late manifestations

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36
Q

What happens to the baby in congenital syph

A 
Miscarriage
Still birth
Prematurity
Rashes
Brain and neurological problems
Bone disease
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37
Q

Does syph involve palms and hands

A

Yes

38
Q

What is a chancre

A

An ulcer…. primary syph often genital region

Lasts a few weeks then disappears

Can take a swap

39
Q

What type of rash is seen in syph

A

In econdary syph

Macropapular rash (can be just a few)

Involves palms and soles

40
Q

Why do brothels have red lights

A

Can’t see the macropapular rash under it

41
Q

What is Condyloma lata

A

NOT A WART

But a wart type lesion seen in secondary syph

Axilla and groin

42
Q

Tertiary syphylis

A

Bone lesions
Gummatous skin lesions
Thoracic aneurysm
Neurosyphilis

43
Q

T/F Mother can pass syph onto the baby in a latent phase

A

T

44
Q

Diagnosis of syph and treatment

A

For the chancre it’ll be microscopy

Otherwise look for antibody against syph

Penicillin

45
Q

How many human herpes viruses

A

8

46
Q

What is HHV1, HHV2 and HHV3

What is the target cell

A

HHV1: HSV1
HHV2: HSV2
and
HHV3: VZV

macro-epithelial

47
Q

What is the disease caused by HHV1, HHV2 and HHV3

A

1 &2: Oro-genital herpes

Chickenpox shingles

48
Q

Site of latency for HHV1, HHV2 and HHV3

A

NEURONS

49
Q

What is HSV4. What is the target cell, and what is it also known as.

Where is the latency

A

EBV

Infection of B cell

Infectious mono nucelosis

B cell

50
Q

What is HHV8

What is the target cell, and what is the site of latency

A

Karposi sarcoma associated herpes virus

Target cell is lymphocyte

Latency in B cells

51
Q

What does HV1 and HV2 usually cause

A

General

HSV 1= Oral coldsores

HSV 2: Genital herpes

52
Q

What does HHV5 cause, what is the target cell, disease and latency

A

CMV, Monocyte, epithelial cell, infectious mononucleosis type sndome

Lymphocyte latency

53
Q

What is HHV6

Target cell? disease? latency?

A

Roseola virus

Lymphocyte latency and target cell

Roseola

54
Q

What is HHV 7 target cell and latency

A

T cell is target cell

Pityriasis rosea is the disease

Lymphocyte site of latency

55
Q

What does KS affect and which patients

A

Endothelial cells of the lymphatics and affects HIV patients in partivular

56
Q

Clinical presentation of Herpes simplex

A

Vesicular rash lasting two weeks on erythmatous base

groups of vesicles which break up to form ulcers2 weeks then clears up

57
Q

What can happen with primary HSV

A

Can be worse and form stomatitis (who mouth not just lips) hard to eat

58
Q

What is stephen-hojnsons syndrom

A

Often cause by drug reaction

can also get inflammation of mouth

59
Q

What are herpetic lesions

A

Can be seen in eczema herpeticum, little punched out ulcers in the skin following the vesicle formation

60
Q

What can latent HSV reactivate

A

Times of stress, sun exposure, other infection etc

61
Q

HHV3 causes whatt

A

Chickenpox/ singles

62
Q

What type of rash in chicken pox VCV

A

Looks like vesicles on erthymatous base scattered all ofver the body, most concentrated on the face, ess concentrated on the body and least concentrated on arms and legs

Ask if they are feeling unwell if they are adults…

found in mouth

63
Q

Treatment for chikcen pox

A

Normally will get better by itself…

can cause encephalitis

64
Q

What is Herpes Zoster

A

This is shingles (i.e like chicken pox and herpes zoster both caused by VZV HHV3)

65
Q

Distribution of rash in VZV

A

Comes after latency at times of stress or low immune function and spreads along 1 dermatome

Vesicular

66
Q

How do people feel with shingles

A

Can feel nothing or terrible

67
Q

Does the rash in shingles cross the midline?

A

No ,because it’s in dermatome

68
Q

Can herpes zoster cross dermatomes

A

Yes it can partocilarly in immunosuppressed people like HIV

69
Q

Why is involvement of the tip of the nose bad in herpes zoster

A

Because it can inidcate involvement of the nasociliary branch of V1

This could mean that the back of the eye is involved, and this needs more serious treatment to prevent blindness

Acyclovir

70
Q

Types of fungal infections

A

Superficial and deep (deep is in ID)

71
Q

Types of superficial skin fungal infections

A

Dermatophytes

Yeasts

72
Q

Example of dermatophytes, where they grow

A

eg Trichophyton rubrum (often causes athletes foot)

Grow in keratin

Skin hair and nails

73
Q

How do dermatophytes grow

A

Long hyphae, grow from tip

74
Q

Example of yeast and where they grow and how they grow

A

eg Candida

Grow on warm wet surfaces

single cell and bud

Groin genitals under breast, axilla and groins

75
Q

What is tinea unguium and what is it usually caused by

What does it look like

A

This is the disease not the fungus

Funal infection of the nails

Usually caused by dermatophytes but sometimes yeast

Yellow and crumbly

76
Q

How to treat tinea unguium

A

Anti-fungal IV

Topical probably won’t work because it’s deep in the nail

77
Q

Cause of tinea capitis

A

Funal infection on the head

78
Q

Who does tinea capitis occur on

A

Kids not adults

At around puberty sebum produces antifungals

Agro-caribbean kids due to shape of hair shaft makes suceptible to fungal infection

79
Q

Types of lesion in tinea capitis

A

Kerion (abscess type lesion, well defined) … dermatophyte

Diffuse across scalp

80
Q

Waht is fungal superficial infection of the hadn called

A

Tinea mannum

Vets get it and kids with pets. Fungus transferred from the pet to the kid

81
Q

What is tinea curis

A

Fungal infection of skin around the groin

Not involving scrotum

82
Q

Tinea facei

A

Funal infection of the face (on chin may be pet related)

83
Q

Dandida intertrigo

A

Yeast infection often on top of somme eczema

Some satellite regions

Wet rash

Intertrigo means inflammation within a body crease

84
Q

Tinea pedis

A

Between toes (usually due to Trichophyton rubrum (athletes foot)

85
Q

An area that tinea doesn’t appear on

A

The scrotum, only the groin

86
Q

Treamtnet of the superficial fungal infections

A

SKIN only -> topical cream (clotrimazole antidngal)

HAIR OR NAIL –> the infection has gone deeper and needs tablet… it goes down the hair follice

87
Q

Latin name for scabies

A

Sarcoptes scabei

A mite

88
Q

Where do scabies burrow

A

Deep in surface off epidermis

Finger, axillae, genital area, insteps of the feet

Widepsread itchy rash

89
Q

What happens after the scabies infectin

A

After the burrows, two weeks later eczema reaction ot the eggs and faeces

90
Q

Does tinea infection include yeast

A

Strictly speaking no, just dermatophyte

General fungal nail infection (ie yeast or dermatophyte= onchynychhya mycosis)

Dermatophyte infection nail= tinea unguium

Rob's Microbiology MCD (6 decks)

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