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infection > skin and soft tissue infection > Flashcards

skin and soft tissue infection Flashcards

1
Q

things to consider

A

organism
host: diabetes, immunosuppression, predisposing factors e.g. atopic dermatitis
site:
environment: drug resistant strains, drug allergies

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2
Q

impetigo

A

superficial skin infection
highly infectious
kids 2-5yrs

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3
Q

impetigo organisms

A

staph aureus mostly

strep pyogenes

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4
Q

impetigo features

A

multiple vesicular lesions on erythematous base
golden crust
usually exposed parts of body: face, extremeties

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5
Q

impetigo predisposing factors

A 
skin abrasions 
poor hygiene
atopic dermatitis
insect bites
chicken pox
minor trauma
burns
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6
Q

erysipelas

A

infection of upper dermis

most commonly strep pyogenes

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7
Q

erysipelas features

A

painful, red areas
distinct elevated borders
assoc fever
regional lymphadenopathy + lymphangitis

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8
Q

erysipelas risk factors

A 
pre-existing lymphodema
venous stasis 
obesity 
paraparesis 
DM
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9
Q

cellulitis

A

diffuse skin infection involving dermis and epidermis

staph a and strep pyogenes
possible source bacteraemia

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10
Q

cellulitis features

A

spreading erythematous area with no distinct borders
fever
regional lymphadenopathy and lymphangitis

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11
Q

cellulitis predisposing factors

A

DM
lymphadema
tinea pedis

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12
Q

cellulitis and erysipelas Mx

A

combination anti-staph and anti-strep antibiotic

extensive disease: admission for IV antib and rest

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13
Q

hair assoc infections

A

Folliculitis
Furunculosis
Carbuncles

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14
Q

folliculitis

A

circumscribed pustular infection of hair follicle
up to 5mm diameter
staph aureus

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15
Q

folliculitis presentation

A

small red papules
central area of purulence may rupture and drain
typically found head, back, buttocks

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16
Q

folliculitis Rx

A

none

topical antibiotics

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17
Q

furuncolosis

A

single hair follicle-associated inflammatory nodules
boils
staph aureus

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18
Q

furunculosis features

A

extends into dermis and subcut tissue
may drain purulent material
usually affects moist, hairy, friction prone areas: face, axilla, buttocks

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19
Q

furunculosis Rx

A

none
topical antib
oral antib

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20
Q

furunculosis risk factors

A 
DM 
atopic dermatitis
obesity 
kidney disease
corticosteroid use
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21
Q

carbuncle

A

infections extends to involve multiple furuncles

multi-sepatated abscess

22
Q

carbuncle features

A

purulent material multiple sites
fever
multi-septated abscess
often back, neck

23
Q

carbuncle Rx

A

hospital
surgery
IV antib

24
Q

necrotising fasciitis predisposing factors

A 
DM
surgery 
trauma 
peripheral vascular disease
skin popping
25
Q

necrotising fasciitis T1

A

mixed aerobic and anaerobic infection
diabetic foot infection, Fournier’s gangrene

strep 
staph
enterococci
gram = bacilli
clostridium
26
Q

necrotising fasciitis T2

A

mono-microbial

strep pyogenes

27
Q

necrotising fasciitis features

A 
rapid onset
erythema
extensive oedema 
pain 
anaesthesia over infection 
skin necrosis, heamorrhagic bullae
systemic: fever, hypotension, tachycardia
28
Q

necrotising fasciitis management

A

urgent surgical review - plastics for fasciotomy

29
Q

necrotising fasciitis antibiotics

A

broad spectrum

flucloxacilin
gentamicin
clindamycin
benzyl penicillin

30
Q

pyomyositis

A

purulent infection within striated muscle
often forms abscess
infection often 2ry to seeding damaged muscle

31
Q

pyomyositis features

A

fever
pain
woody induration of affected muscle

32
Q

pyomyositis organism and common sites

A

staph aureus

common sites: thigh, calf, arms, gluteal region, psoas muscle

33
Q

pyomyositis predisposing factors

A 
DM
HIV
IVDU
rheumatological disease
malignancy 
liver cirrhosis
34
Q

septic bursitis

A

infection often from adjacent skin infection

most common s.aureus

35
Q

septic bursitis risks

A 
alchohilism
RA
DM
IVDU
immunosupressino 
renal insufficiency
36
Q

septic bursitis features

A

peribursal cellulitis
swelling, warmth
fever
pain on movement

37
Q

infection tenosynovitis

A

infection of synovial sheaths surrounding tendons

staph a
streptococci

38
Q

infection tenosynovitis: presentation

A

erythematous fusiform swelling finger
held in semiflexed position
pain finger extension
tenderness over length tendon sheath

39
Q

infection tenosynovitis Mx

A

empiric antib

hand surgeon review

40
Q

what are toxin mediated syndromes often due to

A

superantigens - group pyrogenic exotoxins

41
Q

toxin mediated syndromes pathophys

A

superantigens bypass APC and bind directly to T cells

massive burst cytokine release: endothelial leakage, haemodynamic shock, multi-organ failure

42
Q

toxin mediated syndormes: organisms

A

staph a: TSST1, ETA, ETB

strep pyogenes: TSST1

43
Q

which TSS organism is assoc w tampons

A

staphylococcal TSS

44
Q

staphylococcal TSS diagnostic criteria

A 
fever
hypotension 
diffuse macular rash
3+ involved: liver, muscular, blood, renal, GI, CNS
isolation staph a 
production TSST1 by isolate
45
Q

streptococcal TSS

A

usually assoc w prescence of strep in deep seated infection e.g. erysipelas, necrotising fasciitis

urgent surgical debridement

46
Q

TSS Rx

A 
IV fluids
remove offending agent e.g. tampon
inotropes
IV Ig
antib - clindamycin, vancomycin
47
Q

panton-valentine leucocidin toxin

A

staph a

recurrent boils, heamorrhagic pneumonia

48
Q

panton-valentine leucocidin toxin antibiotica

A

vancomycin, linezolid

49
Q

staphylococcal scalded skin syndrome

A

Infection due to a particular strain of staph aureus producing the exfoliative toxin A or B

50
Q

cellulitis antibiotics

A
  1. fluclocacillin
  2. clarithromycin (penicillin allergy)

if pregnant - erythromicin

infection (36 decks)

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