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Dermatology > Microbiology of Skin Infections > Flashcards

Microbiology of Skin Infections Flashcards

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Dermatology Board Prep flashcards
1
Q

Name some competitive bacterial flora of the skin?

A

Staphylococcus epidermidis

Corynebacterium sp. (diptheroids)

Propionibacterium

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2
Q

How is diagnosis made?

A

Swab of lesion if surface is broken

Pus or tissue if deeper lesion

+/- blood cultures if appropriate

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3
Q

What is seen on the agar plate in staph aureus?

A

Golden colour (coagulase positive)

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4
Q

What is seen on the agar plate in staph epidermidis?

A

White colour (coagulase negative)

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5
Q

What are the alpha haemolytic strep ?

A

Strep pneumonia (pneumonia)

Strep viridians (commensals) (endocarditis)

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6
Q

What are the beta haemolytic strep ?

A

Group A (throat, skin infection)

Group B (neonatal infections)

Group C, G etc

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7
Q

What are the non-haemolytic strep?

A

Enterococcus sp (gut commensals, UTI)

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8
Q

What is the result of latex agglutination?

A

Only staph Aureus is positive

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9
Q

Where does staph aureus grow best?

A

Grow best in air but also can grow anaerobically

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10
Q

What are the antibiotics of choice in staph aureus infection?

A

Flucloxacillin

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11
Q

Name three toxins that staph aureus produce?

A

Enterotoxin- food poisoning

SSSST- staphylococcal scalded skin syndrome toxin

PVL- panton valentine leucocidin

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12
Q

What presentations can staph aureus cause?

A

Boils and carbuncles

Other minor skin sepsis

Cellulitis

Infected eczema

Impetigo

Wound infection

SSSST

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13
Q

What are the treatment options for MRSA?

A 
Doxycycline 
Co-trimoxazole
Clindamycin
Vancomycin 
NOT FLUCLOXACILLIN
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14
Q

why are coagulase negative staph not usually worrying?

A

Skin commensals

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15
Q

When might coagulase negatives become problematic?

A

Implanted artificial material

UTI in women of child bearing age (step saprophyticus)

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16
Q

What must you remember when prescribing topical antibiotics?

A

If there is pus it must go first

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17
Q

Where do streptococcus species grow?

A

In air and facultatively anaerobic

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18
Q

What classifies streptococcus species?

A

Haemolysis on blood agar;

B- complete haemolysis
A- partial haemolysis
Y- no haemolysis

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19
Q

What toxin produced by beta haemolytic streptococci that damages tissues?

A

Haemolysin

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20
Q

How can beta haemolytic step be further classified?

A

By antigenic structure on surface

  • Group A
  • Group B
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21
Q

What infections are caused by Group A strep?

A 
Infected eczema 
Impetigo
Cellulitis 
Erysipelas 
Necrotising fasciitis
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22
Q

What can be used to treat strep pyogenes (group A strep)?

A

Penicillin, will also be treated by flucloxacillin

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23
Q

What is the treatment for necrotising fasciitis?

A

Immediate surgical debridement as well as antibiotics

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24
Q

What is necrotising fasciitis?

A

Bacterial infection spreading along fascial planes below skin surface -> rapid tissue destruction

Little to see but SEVERE pain

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25
Q

What are the two types of necrotising fasciitis?

A

1- mixed anaerobes and coliform, usually post abdominal surgery

2- group A strep infection

26
Q

When do you take swabs of a leg ulcer and why?

A

Only if signs of clinical infection are present, you will grow lots of bacteria

27
Q

What organisms if found in leg ulcers would you treat?

A

Strep Pyogenes
Staph aureus
Strep B, C, G
Anaerobes- esp in diabetic patients

28
Q

What does dermatophyte mean?

A

Fungal

29
Q

What is a dermatophyte infection called?

A

Ringworm

30
Q

What does tinea mean?

A

Ringworm

31
Q

What is the name for ringworm of the scalp?

A

Tinea capitis

32
Q

What is the name for ringworm of the beard?

A

Tinea barbae

33
Q

What is the name for ringworm of the body?

A

Tinea corporis

34
Q

What is the name for ringworm of the hand?

A

Tinea manuum

35
Q

What is the name for ringworm of the nails?

A

Tinea unguium

36
Q

What is the name for ringworm of the groin?

A

Tinea cruris

37
Q

What is the name for ringworm of the foot?

A

Tinea pedis

38
Q

What explains the shape of ringworm?

A

Lesion grows out and heals in centre

39
Q

What tissues do ringworm infect?

A

Ketatinised tissues (skin, hair, nails)

40
Q

What causes scaling?

A

Increased epidermal turnover

41
Q

What is the most likely source of ringworm infection ?

A

Other infected humans, anthropophilic fungi

42
Q

What is fungi from animals called?

A

Zoophilic fungi

43
Q

What is fungi from soil called?

A

geophilic fungi

44
Q

How is trichophyton rubrum transferred and how much of lab isolates is it responsible for?

A

Human- human transmission

70% lab isolates

45
Q

What is the next most common isolate to trichophyton rubrum and how is it transmitted?

A

Trichophyton mentagraphytes

human-human

46
Q

What is an occasional dermatophyte isolate and how is this transmitted?

A

Microsporum canis

cats, dogs-humans

47
Q

How do you diagnose a dermatophyte infection?

A

Clinical appearance

Woods light

Skin scraping (takes 2 weeks)

48
Q

What can you treat small areas of dermatophyte infection on skin, nails with?

A

Clotrimazole (Canestan) cream or similar

Topical nail paint (amorolfine)

49
Q

What are extensive skin infections, nail and scalp infections treated with?

A

Terbinafine orally

Itraconazole orally

50
Q

Where does candida infection infect?

A

In areas of skin where it is warm and moist ‘candida intertrigo’

51
Q

How is candida diagnosed?

A

Swab for culture

52
Q

How is candida treated?

A

Clotrimazole cream, oral fluconazole

53
Q

What causes scabies?

A

Sarcoptes scabiei parasite

54
Q

What is the incubation period for scabies?

A

Up to 6 weeks

55
Q

Describe the symptoms and areas scabies affects?

A

Intensely itchy rash affecting finger webs, wrists and genital area

56
Q

What is the treatment for scabies?

A

Malathion lotion, applied overnight to whole body and washed off next day

Benzyl benzoate

57
Q

What is the name for lice of the head, body and pubic area?

A

head- Pediculus capitis
body- Pediculus corporis (vagabond disease)
pubic-Phthirus pubis

58
Q

What is the treatment for lice?

A

Malthion

59
Q

Why are gram positive infections in patients with exfoliative skin conditions a risk for other patients?

A

Exfoliative skin conditions shed huge number of skin scales and associated bacteria into the environment; gram +ve bacteria can survive in environment because of their cell wall structure

60
Q

Who needs single room isolation?

A

Group A Step infected patients

MRSA patients

Scabies patients

Dermatology (15 decks)

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