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Infections > skin and soft tissue infections > Flashcards

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
Q

What commonly causes folliculitis

A

most common - staph aureus

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26
Q

What is furunculosis

A

Single hair follicle -associated inflammatory nodule which extends down the shaft of the hair follicle and slightly further

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27
Q

Where is furunculosis most commonly located

A

Friction associated places - face, axilla, neck and buttocks

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28
Q

What commonly causes furunculosis

A

Staph aureus

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29
Q

What are the risk factors of furunculosis

A

Obesity
diabetes mellitus
atopic dermatitis
CKD
corticosteroid use

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30
Q

What is carbuncle

A

When infection extends to involve multilpe furuncles

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31
Q

Where are the common locations of carbuncles

A

back of neck and posterior aspect of thigh

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32
Q

What is commonly seen in patients with carbuncle

A

Multiseptated abscess - multiple chambers of abscess

They present quite unwell

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33
Q

What is the treatment for folliculitis

A

No treatment or topical antibiotics

34
Q

What is the treatment for furunculosis

A

No treatment
topical antibiotics
Or if they do not work, oral antibiotics

35
Q

What is the treatment for carbuncles

A

Hospital admission, surgery and IV antibiotics

36
Q

What is necrotising fasciitis

A

An agressive infection that causes necrosis

37
Q

What are predisposing conditions of necrotising fasciitis

A

Diabetes mellitus
surgery
trauma
Peripheral vascular disease
skin popping
IV drugs

38
Q

What is type 1 necrotising fasciitis

A

mixed aerobic and anaerobic infection - caused by multiple organisms

39
Q

What are the typical organisms in necrotising fasciitis

A

Streptococci
staphylococci
enterococci
gram negative bacilli
clostridium

40
Q

What is type 2 necrotising fasciitis

A

Monomicrobial

41
Q

What is necrotising fasciitis commonly caused by

A

Strep pyogenes

42
Q

How does necrotising fasciitis present

A

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
Q

What is the treatment for necrotising fasciitis

A

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
Q

What is pyomyositis

A

plurulent infection deep within striated muscle - manifests as an abscess

45
Q

What are common sites of pyomyositis

A

thigh
calf
arms
gluteal region
chest wall
psoas muscle

46
Q

What pathogen commonly causes pyomyositis

A

staph aureus

47
Q

What is the treatment for pyomyositis

A

drainage with antibiotic cover depending on the gram stain and culture

48
Q

What is septic bursitis

A

Infection of the bursae often coming from an adjacent skin infection

49
Q

What are the common sites of septic bursitis

A

Olecranon bursa and patellar bursa

50
Q

What are common presentation of septic bursitis

A

Peribursal cellulitis, swelling and warmth are common
fever
pain on movement

51
Q

What is used to diagnose septic bursitis

A

Aspiration of the fluid in the bursae

52
Q

What is the common bacteria that causes septic bursitis

A

staph aureus

53
Q

What is infections tenosynovitis

A

Infection of the synovial sheats that surround tendons

54
Q

What is the most common site of infectious tenosynovitis

A

Flexor muscle associated tendons and tendon sheaths of the hand

55
Q

What pathogens commonly cause infectious tenosynovitis

A

Staph aureus and streptococci

56
Q

How does infectious tenosynovitis present

A

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
Q

What is the treatment of infectious tenosynovitis

A

Empiric antibiotics

58
Q

What are toxin mediated syndromes caused by

A

superantigens
group of pyrogenic exotoxins

59
Q

How do toxin mediated syndromes work

A

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
Q

What commonly causes toxin mediated syndromes

A

staph aureus and strep pyogenes - TSST-1 - toxic shock syndrome toxin 1- both release TSST1

61
Q

What are the symptoms of staphylococcal Toxic shock syndrome

A

Diffuse macular rash
fever
hypotension
\Liver, blood, renal, GI, CNS and muscular - at least 3 of these systems involved

62
Q

What is streptococcal Toxic shock syndrome commonly associated with

A

streptococci in deep seated infections such as erysipelas and necrotising fasciitis

63
Q

What is treatment of toxic shock syndrome

A

urgent surgical debridement of the infected tissues
IV fluids
inotropes - fix hypotension
antibiotics

64
Q

What is staphylococcal scalded skin syndrome

A

Infection due to staph aureus producing exfoliative toxin A or B

65
Q

What is staphylococcal scalded syndrome characterised by

A

Widespread bullae and skin exfoliation

66
Q

Who is most at risk of staphylococcal scalded syndrome

A

children

67
Q

What is the treatment of staphylococcal scalded syndrome

A

IV fluids and antimicrobials

68
Q

What does the panton-valentine leucocidin toxin cause

A

Skin and soft tissue unfection

69
Q

What is the treatment for panton-valentine leucocidin toxin

A

Clindamycin

70
Q

What is the presentation of panton-valentine leucocidin toxin

A

Recurrent boils which are hard to treat - most commonly in children and young adults

71
Q

What happens IV catheter associated infections

A

starts as a SST infection but progresses deeper into cellulitis and necrotising fasciitis

72
Q

Where should cannulas not be put into

A

Lower limb due to infection risk

73
Q

What common pathogen causes IV catheter associated infections

A

staph aureus

74
Q

How is IV catheter associated infections diagnosed

A

Blood cultures

75
Q

What is the treatment of IV catheter associated infections

A

removal of cannula and then antibiotics for 14 days

76
Q

What is a class 1 surgical wound

A

clean wound

77
Q

What is a class 2 surgical wound

A

clean - contaminated wound

78
Q

What is a class 3 surgical wound

A

Contaminated wound

79
Q

What is a class 4 surgical wound

A

Infected wound

80
Q

What are the pathogens that cause surgical site infections

A

staph aureus
coagulase negative staphylococci
enterococcus
e.coli
streptococci

81
Q

What are risk factors for surgical site infections

A

diabetes
smoking
obesity
malnutrition
steroid use
staph aureus colonisation

82
Q

How are surgical site infections diagnosed

A

sending pus / infected tissue for culture

Infections (13 decks)

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