Skin and Soft Tissue Infections Flashcards
List 6 types of infections commonly caused by water exposure.
Aeromonas Edwardsiella tarda Erysipelothrix rhusiopathiae Vibrio vulnificus Mycobacterium marinarum Vibrio parahaemolyticus
Define cellulitis.
Infection of the deeper dermis and fat layers after bacteria breach the skin barrier
What are the most common causes of cellulitis? (2)
Staph. aureus
Beta haemolytic streptococci, e.g.
-Strep. pyogenes
Describe the clinical features of cellulitis. (5)
What is the cellulitis triad? (3)
CELLULITIS TRIAD:
Oedema
Erythema
Warmth
OTHER FEATURES:
Skin changes
Fever
List 6 differential diagnoses for cellulitis.
Stasis dermatitis Acute arthritis Pyoderma gangrenosum Hypersensitivity/drug reactions DVT Necrotising fasciitis
List 4 general risk factors for cellulitis.
List 8 local risk factors for cellulitis.
GENERAL RISK FACTORS: Venous insufficiency Lymphoedema Pregnancy White Caucasian
LOCAL RISK FACTORS: Ulcers Eczema Athlete's foot Burns Surgical wounds IVDUs Trauma Tattoos
Describe the classification of cellulitis.
HINT: there are 4 classes.
CLASS 1:
No sepsis
No co-morbidities
CLASS 2: Possible systemic illness At least one of: -Peripheral vascular disease -Obesity -Venous insufficiency
CLASS 3:
Significant systemic illness
Unstable co-morbidities
CLASS 4:
Sepsis
Necrotising fasciitis
Unstable co-morbidities
In cellulitis, what can cause failure to respond to antibiotics? (3)
Resistant organisms (e.g. MRSA) Underlying conditions (e.g. bone infection, abscess) Incorrect diagnosis
When would you consider hospital admission in cellulitis patients? (4)
Severe, localised pain
Rapidly evolving skin lesions
SIRS:
- HR 100+
- RR 20+
- Temp <36 or 38+
- WCC <4 or 12+
Sepsis:
- SIRS
- Organ dysfunction (confusion, hypotension or RR 22+)
How would you treat cellulitis? Consider:
a) Mild cellulitis
b) Moderate cellulitis
c) Severe cellulitis
MILD CELLULITIS:
Flucloxacillin (oral)
-Duration: 7 days
MODERATE CELLULITIS:
Flucloxacillin (oral)
-Duration: 10 days
SEVERE CELLULITIS: Flucloxacillin (IV) Gentamicin (IV) Clindamycin (IV) -Duration: 10 days
Define erysipelas.
Infection of the upper dermis and superficial lymphatics in the skin
Define impetigo.
Superficial bacterial infection of the skin
Define necrotising fasciitis.
Severe inflammation and infection of the muscle sheath that leads to necrosis of the subcutaneous tissue and adjacent fascia
Define tinea.
A superficial dermatophyte infection of the epidermis, characterised by scaly, inflammatory or non-inflammatory patches
Define dermatophyte.
A pathogenic fungus that grows on skin, mucous membranes, hair, nails and other body surfaces
