Sec 29 Bacterial Disease Flashcards
Sites of colonisation in carriers of Staphylococcus aureus
Anterior nares Throat Axillae, perineum Hands Involved skin in individuals with atopic dermatitis
Sites of colonisation in neonates of Staphylococcus aureus
Skin
Umbilicus
Circumcision site
Conjunctivae
Primary pyoderma of skin
Impetigo
Bullous impetigo
Erythema
Botryomycosis
Primary pyoderma of hair follicles
Superficial folliculitis (follicular or Bockhart impetigo)
Folliculitis (sycosis barbae)
Furuncle (boil)
Carbuncle
Secondary pyoderma
Impetiginization of dermatoses such as atopic dermatitis, herpes simplex (superinfection)
Pyodermas associated with systemic disease Job syndrome
Chédiak–Higashi syndrome
Chronic granulomatous disease
First line topical therapy for Impetigo
Mupirocin BID
Retapamulin BID
Fusidic acid BID (not available in United States)
First line systemic therapy for Impetigo
Dicloxacillin 250–500 mg PO qid for 5–7 days
Amoxicillin plus clavulanic acid 25 mg/kg tid
Cephalexin 250–500 mg qid
Second line systemic therapy for Impetigo (if with penicillin allergy)
Azithromycin 500 mg × 1, then 250 mg daily for 4 days
Clindamycin 15 mg/kg/day TID
Erythromycin 250–500 mg PO qid for 5–7 days
Bacterial folliculitis
Staphylococcus aureus folliculitis
Periporitis staphylogenes
Superficial (follicular or Bockhart impetigo)
Deep (sycosis) [may progress to furuncle (boil) or carbuncle]
Pseudomonas aeruginosa folliculitis (“hot tub” folliculitis)
Gram-negative folliculitis (occurs at the site of acne vulgaris, usually the face, with long-term antibiotic therapy)
Syphilitic folliculitis (secondary; acneiform)
First line topical treatment for Streptococcal Pyoderma
Mupirocin BID
First line systemic treatment for Streptococcal Pyoderma
Penicillin V 250–500 mg PO qid for 5–7 days
Dicloxacillin 250–500 mg qid for 5–7 days
Second line topical treatment for Streptococcal Pyoderma
Retapamulin BID
Second line systemic treatment for Streptococcal Pyoderma
Azithromycin 500 mg × 1 then 250 mg daily for 4 days
Clindamycin 15 mg/kg/day tid
Erythromycin 250–500 mg PO qid for 5–7 days
Toxins: Staphylococcus aureus
Exfoliatin type A - Epidermolytic - Bullous impetigo, SSSS
Exfoliatin type B - Epidermolytic - SSSS, Bullous impetigo
TSS toxin 1 - Superantigen - TSS (menstrual > nonmenstrual), food poisoning
Staphylococcal enterotoxins A–C - Superantigen - TSS (nonmenstrual > menstrual), food poisoning
Toxin: Streptococcus pyogenes
Streptococcal pyrogenic exotoxins A, C - Superantigen - TSS (nonmenstrual), scarlet fever
Major Criteria: Staphylococcal Toxic Shock Syndrome
Fever - Temperature >38.9°C (102°F)
Rash - Diffuse macular erythroderma
Desquamation - 1–2 week after onset of illness, particularly on palms/soles
Hypotension - Systolic blood pressure <95 mm
Hg for adults, or less than 5th percentile by age for children <16 years of age, or orthostatic syncope
MCC: Erysipelas
Group A Streptococcus
MCC: Cellulitis
S. aureus
Group A Streptococcus