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skin and soft tissue infections Flashcards

1
Q

What is impetigo

A

A superficial skin infection that does not go under the epidermis

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2
Q

What is the characteristic feature of impetigo

A

Golden crust

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3
Q

What pathogens cause impetigo

A

Staph aureus - most common

Strep pyogens

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4
Q

Which age group is impetigo most common in

A

2-5 year olds

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5
Q

Which parts of the body does impetigo most commonly occur on

A

exposed parts of the body such as the scalp, extremities and face

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6
Q

What is the treatment for impetigo

A

topical antibiotics but if it is a large area of impetigo oral flucloxacillin will need to be given as well

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7
Q

What is erysipelas

A

Infection of the upper dermis

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8
Q

What is commonly seen in erysipelas

A

Painful red area with distinct elevated borders with associated fever

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9
Q

What is the pathogen that most commonly causes erysipelas

A

Strep pyogens

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10
Q

What part of the body most commonly has erysipelas

A

the legs

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11
Q

What is cellulitis

A

Diffuse skin infection that affects the deep dermis and subcutaneous fat

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12
Q

How does cellulitis present

A

Spreading erythematous area with no distinct borders - fever is common

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13
Q

What organisms cause cellulitis

A

strep pyogenes and staph aureus are most common

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14
Q

What is the correlation between gram negatives and immunosupression

A

When you are immunosuppressed, the risk of gram negative invasion increases

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15
Q

What are predisposing factors in cellulitis

A

diabetes mellitus
tinea pedis. athletes foot
lymphoedema

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16
Q

What is lymphangitis

A

Swelling of the lymph glands - seen as tracking and redness

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17
Q

What is the treatment of cellulitis and erysipelas

A

anti staphylococcus and anti streptococcal antibiotics

In extensive cases - IV antibiotics are used

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18
Q

What is superficial folliculitis

A

Inflammation of the top of the hair follicle as it leaves the skin

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19
Q

What is deep folliculitis

A

Inflammation that goes down the shaft of the follicle

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20
Q

What is a foruncle (boil)

A

Inflammation goes further down then the shaft of the follicle

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21
Q

What is a carbuncle (abscess)

A

Multiple hair follicles affected

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22
Q

What is folliculitis

A

Circumscribed, pustular infection of a hair follicle

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23
Q

How does folliculitis present

A

Small red papules

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24
Q

Where are the common site of folliculitis

A

head, back, buttocks and extremities

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25
What commonly causes folliculitis
most common - staph aureus
26
What is furunculosis
Single hair follicle -associated inflammatory nodule which extends down the shaft of the hair follicle and slightly further
27
Where is furunculosis most commonly located
Friction associated places - face, axilla, neck and buttocks
28
What commonly causes furunculosis
Staph aureus
29
What are the risk factors of furunculosis
Obesity diabetes mellitus atopic dermatitis CKD corticosteroid use
30
What is carbuncle
When infection extends to involve multilpe furuncles
31
Where are the common locations of carbuncles
back of neck and posterior aspect of thigh
32
What is commonly seen in patients with carbuncle
Multiseptated abscess - multiple chambers of abscess They present quite unwell
33
What is the treatment for folliculitis
No treatment or topical antibiotics
34
What is the treatment for furunculosis
No treatment topical antibiotics Or if they do not work, oral antibiotics
35
What is the treatment for carbuncles
Hospital admission, surgery and IV antibiotics
36
What is necrotising fasciitis
An agressive infection that causes necrosis
37
What are predisposing conditions of necrotising fasciitis
Diabetes mellitus surgery trauma Peripheral vascular disease skin popping IV drugs
38
What is type 1 necrotising fasciitis
mixed aerobic and anaerobic infection - caused by multiple organisms
39
What are the typical organisms in necrotising fasciitis
Streptococci staphylococci enterococci gram negative bacilli clostridium
40
What is type 2 necrotising fasciitis
Monomicrobial
41
What is necrotising fasciitis commonly caused by
Strep pyogenes
42
How does necrotising fasciitis present
SUDDEN ONSET Not as red as cellulitis but blood blisters (haemorrhagic bullae) tend to form It is extremely painful Systemic features such as fever, hypotension, tachycardia, delirium and multiorgan failure Anaesthesia at site of infection is suggestive of diagnosis
43
What is the treatment for necrotising fasciitis
Broad spectrum antibiotics because you cannot tell the difference between type 1 and 2 flucloxacillin - covers staph aureus Gentamicin - covers gram negatives Clindamycin - covers anaerobes and gram positives
44
What is pyomyositis
plurulent infection deep within striated muscle - manifests as an abscess
45
What are common sites of pyomyositis
thigh calf arms gluteal region chest wall psoas muscle
46
What pathogen commonly causes pyomyositis
staph aureus
47
What is the treatment for pyomyositis
drainage with antibiotic cover depending on the gram stain and culture
48
What is septic bursitis
Infection of the bursae often coming from an adjacent skin infection
49
What are the common sites of septic bursitis
Olecranon bursa and patellar bursa
50
What are common presentation of septic bursitis
Peribursal cellulitis, swelling and warmth are common fever pain on movement
51
What is used to diagnose septic bursitis
Aspiration of the fluid in the bursae
52
What is the common bacteria that causes septic bursitis
staph aureus
53
What is infections tenosynovitis
Infection of the synovial sheats that surround tendons
54
What is the most common site of infectious tenosynovitis
Flexor muscle associated tendons and tendon sheaths of the hand
55
What pathogens commonly cause infectious tenosynovitis
Staph aureus and streptococci
56
How does infectious tenosynovitis present
Erythematous fusiform swelling of the finger Hand in a semiflexed position because that is where the sheath is under least tension Tenderness over the length of the tendon
57
What is the treatment of infectious tenosynovitis
Empiric antibiotics
58
What are toxin mediated syndromes caused by
superantigens group of pyrogenic exotoxins
59
How do toxin mediated syndromes work
Superantigens bypass the immune systems normal contact and directly attach to T cell receptors and activate a large proportion of them which causes large cytokine release This leads to endothelial leakage, haemodynamic shock and multiorgan failure
60
What commonly causes toxin mediated syndromes
staph aureus and strep pyogenes - TSST-1 - toxic shock syndrome toxin 1- both release TSST1
61
What are the symptoms of staphylococcal Toxic shock syndrome
Diffuse macular rash fever hypotension \Liver, blood, renal, GI, CNS and muscular - at least 3 of these systems involved
62
What is streptococcal Toxic shock syndrome commonly associated with
streptococci in deep seated infections such as erysipelas and necrotising fasciitis
63
What is treatment of toxic shock syndrome
urgent surgical debridement of the infected tissues IV fluids inotropes - fix hypotension antibiotics
64
What is staphylococcal scalded skin syndrome
Infection due to staph aureus producing exfoliative toxin A or B
65
What is staphylococcal scalded syndrome characterised by
Widespread bullae and skin exfoliation
66
Who is most at risk of staphylococcal scalded syndrome
children
67
What is the treatment of staphylococcal scalded syndrome
IV fluids and antimicrobials
68
What does the panton-valentine leucocidin toxin cause
Skin and soft tissue unfection
69
What is the treatment for panton-valentine leucocidin toxin
Clindamycin
70
What is the presentation of panton-valentine leucocidin toxin
Recurrent boils which are hard to treat - most commonly in children and young adults
71
What happens IV catheter associated infections
starts as a SST infection but progresses deeper into cellulitis and necrotising fasciitis
72
Where should cannulas not be put into
Lower limb due to infection risk
73
What common pathogen causes IV catheter associated infections
staph aureus
74
How is IV catheter associated infections diagnosed
Blood cultures
75
What is the treatment of IV catheter associated infections
removal of cannula and then antibiotics for 14 days
76
What is a class 1 surgical wound
clean wound
77
What is a class 2 surgical wound
clean - contaminated wound
78
What is a class 3 surgical wound
Contaminated wound
79
What is a class 4 surgical wound
Infected wound
80
What are the pathogens that cause surgical site infections
staph aureus coagulase negative staphylococci enterococcus e.coli streptococci
81
What are risk factors for surgical site infections
diabetes smoking obesity malnutrition steroid use staph aureus colonisation
82
How are surgical site infections diagnosed
sending pus / infected tissue for culture

Infections (13 decks)

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