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B2: microbiology > 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, fro 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 (it causes tissue death)

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10
Q

What is the exfoliative toxin

A

Cuases cleavage of the skin within the epidermis . involves the same antigen as bullous pemphigus. Causes skin to flake off

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11
Q

What is TSST-1

A

Toxic shock dynfrome 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 layer(i.e. very superficial) 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 boil: An abcess that often starts in the hair follicle. A carbuncle describes multiple abscesses next to each other, all coalescing( an abcess of multiple ajoining hair follicles.)

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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
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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 confirm it

A

Send away for lab

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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)

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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 ( can cause miscarraiges|)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(blood test). 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 3: Chickenpox shingles

48
Q

Site of latency for HHV1, HHV2 and HHV3

A

NEURONS

49
Q

What disease does HHC-4 vauses What is the target cell, and what is it also known as. Where is the latency

A

also known as EBV. The target cell is B cells. Cuases Infectious mono nucelosis(gladular fever) . Site of latency :B cells.

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

Can cause Vesicular rash: grouped vesicles( these can break up to form an ulcer) on an erythematous base, then clears up .

Can cause eczema herpeticum: igf the patient has eczema.

Can cause herpes encephalitis: where it has a global effect on the brain.

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

Candida 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

91
Q

Terminology:

explain tinea and candida terminology

A

the tinea teminology is to describe disease. tinea means fungal( and it is usually for dermatophytes , but can also include yeast sometimes) and the next part of the word describes where it occurs in. Candida is always for yeast.

B2: microbiology (35 decks)

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