Multiloculated abscess - Spread of infection to subcutaneous tissue - Staph aureus - I and D treatment

Quiz 3 - Durrant - SSTIs Flashcards by Brennan Stringam

T/F - Intact skin is the first line of defense.

TRUE

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What permits microbial invasions?

Ducts in skin

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What is the classic presentation of an SSTI?

Erythema, warmth, edema, tenderness

Crepitus - Gas bubbles under skin

Necrosis

Fluctuate

Purpura

Bullae

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What are some other diseases that can mimic SSTIs?

Gout

Thrombosis

Drug eruption

Dermatitis

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Folliculitis can be from what?

Friction and sweat gland activity

Staph aureus, pseudomonas aeruginosa

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Acne is what? Caused by what?

Inflammation of hair follicles and associated sebaceous glands

Propionibacterium acnes - Multiplies behind/w/in sebum trapped in follicles/glands

Hormonal influences as well

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What is the most common bug associated with an abscess?

Staph aureus is the most common culprit - Including MRSA - often polymicrobial

Treatment is incision and drainage
Staph aureus is gram + cocci

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What is a furuncle?

Abscess in the area of a hair follicle

A boil

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What is a carbuncle?

Multiloculated abscess

Spread of infection to subcutaneous tissue
Staph aureus
I and D treatment

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Necrotizing fasciitis. Tell me about it.

Digest facial barriers

Rapid infection

Due to Strep progenes (Group A strep), and/or staph aureus, or clostridium - anaerobic

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What is Fournier’s gangrene?

Poly microbial infection of the genitals and perineum

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Most common pathogen in surgical wounds?

S. Aureus

Also any sort of skin/normal flora
Transmission by fomites, hands, air, or environment
Treatment is really prevention by taking antibiotics prior to surgery

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Tinea cruris, corporis, etc. is what and causes what?

FUNGI, NOT BACTERIA

Dermatophyte fungi

Ringworm, nail infections
Caused by trichophyton, microsporum, epidermophyton

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What is the most common yeast infection?

Candida albicans

-Topical antifungals

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What are some other illnesses from yeast/fungi?

Diaper rash

Intertrigo

Thrush

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What is impetigo from?

Group A strep, also S. Aureus

-Treatment is penicillin, topical antibiotic

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What is erysipelas?

Caused by group A strep

Rapid spreading

Deep layers of dermis

Treated with penicillin

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What is cellulitis?

Subcutaneous tissue

Group A Strep, S. Aureus

Systemic antibiotics

What factors would increase risk of wound infections?

Higher number of organisms

Higher virulence of organisms

Poor circulation near wound

Poor general health, poor nutrition, diabetes

S. Aureus. Tell me about it.

Champ of microbial pathogens

It is everywhere. Gut, skin, etc.

Acute, aggressive, locally destructive purulent lesions

MRSA - Methicillin-Resistant Staph Aureus

Staphylococcal toxin?

Alpha-toxin - Staph scalded skin syndrome

Exfoliatin is what?

Bullous impetigo

T/F - Certain strains of S. Aureus can cause toxic shock syndrome.

TRUE

Red, cracked hands

-Tampons, but also gauze/wound packing materials

Enterotoxins from what?

Staphylococcal food poisoning

Exotoxin - ? Endotoxins - ? Enterotoxin - ?

Exotoxin - Excreted out of the cell Endotoxin- Intracellular Enterotoxin - Causes GI issues

What is the target for beta-lactam antibiotics?

Penicillin binding proteins - PBPs

How is MRSA resistant to methicillin?

Using mecA gene - codes for the altered PBP -Makes new PBP w/ reduced affinity for beta-lactams —Resistant to all beta-lactams

MSSA

Methicillin-Sensitive S. Aureus

Risk factors for MRSA?

Skin-skin contact Crowded living - gyms, wrestling mats Poor hygiene IV drug use *Treatment: Vancomycin MRSA is a big issue and should be screened for

What is Group A Strep (Strep pyogenes)?

Gram + chains -Causes “Strep throat” - Pharyngitis

What is Post-Strep infection sequelae?

Once the body is infected, an autoimmune response could occur in the future as in rheumatic fever or glomerulonephritis

Why are Strep exotoxins so toxic?

Get thru multiple layers, break down protein, carbs, DNA, causes increased cytokine activity, and can make superantigens

Clostridium perfringens?

Anaerobic, spore forming, Gram + rod, number 1 cause of gas gangrene *HAS A LEUKOCIDIN that kills white cells Produces H2 and CO2 Rapidly fatal

Pasteurella multocida?

GRAM - rod Usually from animal bites

Pseudomonas aeruginosa?

Burn victims are very susceptible to this infection. GRAM - rod Non-fermenter, and an environmental pathogen, water, hospital rooms Causes numerous diseases, usually found on skin Green tint

Vibrio vulnificus?

Gram - rod In salt-water environments, brackish water, colonize shellfish Fever -> sepsis -> hemorrhagic bulla Associated with iron overload, cirrhosis

What is mycetoma?

Fungal Causes “warty-foot” *From Actinomyces, or Nocardia

Sporotichosis?

Rose gardener’s disease/thumb - Sporothrix schenckii *Treatment is systemic antibiotics

How to get a diagnosis?

Diagnosis is often clinical Surface cultures are often positive, rarely with the pathogen causing infection Biopsies rarely positivity, infected areas often more inflamed from immune response rather than a lot of organisms Pus is great Blood cultures are good if infection is severe

Abscess of skin - What bug?

S. Aureus

Abscess in mouth/rectum/vagina?

Polymicrobial

Cellulitis and erysipelas - what bug?

Strep pygoenes (Group A Strep)

Also, consider the situation - meaning what?

Host, exposures, etc. (Drug user, animal bite, hot tub use?