Skin and soft tissue infection Flashcards

1
Q

why is the skin intrinsically resistant to infection

A
  • low water content
  • low pH
  • low temp
  • high salt
  • fats and FAs have antimicrobial properites
  • microbiota
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2
Q

what are the common skin microbiota

A
  • staph epidermidis
  • staph aureus
  • diptheroids
  • streptococci
  • some gram bacilli (pseudomonas)
  • anaerobes
  • yeasts
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3
Q

what are the main bacteria that cause skin and soft tissue infections

A
Staph aureus
strep pygogenes
clostridia
psuedomonas sp.
other gram -ves
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4
Q

what are the main fungi that cause skin and soft tissue infections

A

candida and filamentous fungi

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5
Q

what are the main parasites that cause skin and soft tissue infections

A

Leishmania
schistosomes
hookworms

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6
Q

what are the main antrhopods that cause skin and soft tissue infections

A

insects, ticks, mites

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7
Q

what are the main viruses that cause skin and soft tissue infections

A
  • HSV
  • VZV
  • HPV
  • measles
  • rubella
  • enteroviruses
  • parvovirus
    molluscum contagiosum
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8
Q

what are the bacterial localised infections of soft tissue and skin

A

folliculitis

abscess

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9
Q

what are the bacterial spreading infections of soft tissue and skin

A

impetigo

cellulitis

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10
Q

what are the bacteria necrotising infections of soft tissue and skin

A

fasciitis

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11
Q

most common cause of folliculitis

A

staph aureus

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12
Q

what is the proper name of a boil

A

furuncle

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13
Q

what is the important staph species that causes UTI

A

staph saphrophyticus

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14
Q

how can you tell the difference in culture of staph aureus and staph epidermidis

A

aureus - coagulase positive

epidermidis - coagulase negative

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15
Q

primary defense against staph aureus is via which arm of the immune system

A

innate - neutrophils

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16
Q

explain the pathogenesis of staph aureus

A
  • binds via adhesins
  • inhibits chemotaxis via CHIPS
  • inhibits phagocytosis
  • if ingested - can resist killing
  • biofim formation
  • abscess formation
17
Q

what substances does staph aureus make that allows it to inhibit phagocytosis

A
  • capsule
  • protein A (binds Fc end of Ab)
  • staphylokinase
  • complement inhibitors
  • haemolysins and leukocidins - kill neutrophils
18
Q

community acquired MRSA is commonly associated with which virulence factor

A

Panton-Valentine leukocidin

19
Q

what is impetigo

A

an infection of the epidermis characterised by bullous, crusted or pustular lesions

20
Q

impetigo is caused by…

A

staph aureus or Strep pyogenes

staph aureus = bullous impetigo

21
Q

what is erysipelas

A

a rapidly spreading superficial erythematous infection with well defined borders, plus pain and fever

22
Q

what is the difference between erysipelas and cellulitis

A

cellulitis also involves the subcutaneous fat

23
Q

what is the main cause of erysipelas and cellulitis

A

Strep pyogenes

24
Q

most common causes of necrotising

A

strep pyogenes and anaerobes (including Clostridium)

25
most common cause of gas gangrene
Clostridia
26
what are the substances produced by strep pyogenes that help it evade the innate immune system
- M protein, capsule = antiphagocytic - leukocidal toxins - DNAse - overcomes NETS - C5a peptidase - evades C'
27
how does strep pyogenes cause damage
- direct cytolethal toxins and enzymes - superantigens - activation of autoimmunity
28
explain structure of clostridia
gram positive rods, anaerobe, spore-forming
29
what things would you perform on a skin swab of someone with a skin/soft tissue infection
- nucleic acid testing (viruses) - microscopy (gram stain - bacteria) - culture and identification - antimicrobial susceptibility testing (bacteria)
30
treatment of impetigo
soap and water + mupirocin (if mild) or flucloxacillin/dicloxacillin (if more severe) - (unless strep pyogenes alone)
31
treatment of cellulitis
flucloxacillin or dicloxacillin (unless Strep pyogenes alone)
32
treatment of gas gangrene
surgery + penicillin G +/- hyperbaric oxygen
33
treatment of diabetic foot ulcer
co-amoxyclav + metronidazole