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Infection > Skin and Soft Tissue Infections > Flashcards

Skin and Soft Tissue Infections Flashcards

1
Q

What is the cause of impetigo?

A

Staph aureus

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2
Q

What does impetigo look like?

A

Multiple vesicular lesions on an erythematous base

Golden crust highly suggestive

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3
Q

What are the predisposing factors for impetigo?

A 
Skin abrasions 
Minor trauma 
Burns 
Poor hygiene 
Insect bites 
Chickenpox 
Eczema 
Atopic dermatitis
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4
Q

What is the treatment for impetigo?

A

Small areas topical antibiotics

Larger areas oral antibiotics

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5
Q

What is erysipelas?

A

Infection of the upper dermis

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6
Q

What does erysipelas look like?

A

Distinct elevated borders

Painful red area

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7
Q

What is the cause of erysipelas?

A

Strep pyogenes

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8
Q

What are the clinical signs of erysipelas?

A

Associated fever

Regional lymphadenopathy and lymphangitis

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9
Q

Where is erysipelas likely to occur on the body?

A

Lower limbs

Face

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10
Q

What is cellulitis?

A

Diffuse skin infection involving deep dermis and subcutaneous fat

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11
Q

What does cellulitis look like?

A

Spreading erythematous area with no distinct borders

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12
Q

What is the cause of cellulitis?

A

Strep pyogenes

Staph aureus

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13
Q

What are the predisposing factors for cellulitis?

A

Diabetes
Tinea pedis
Lymphoedema

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14
Q

What is the treatment for cellulitis and erysipelas?

A

Combination of anti-staphylococcal and anti-streptococcal antibiotics

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15
Q

What is folliculitis?

A

Circumscribed, pustular infection of hair follicle

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16
Q

Where is folliculitis typically found?

A

Head
Back
Buttocks
Extremities

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17
Q

What is the cause of folliculitis?

A

Staph aureus

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18
Q

What is furunculosis?

A

Single hair follicle associated inflammatory nodule, extending into the dermis and subcutaneous tissue

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19
Q

What areas are commonly affected by furunculosis?

A

Moist, hairy, friction-prone areas (face, axilla, neck, buttocks)

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20
Q

What is the cause of furunculosis?

A

Staph aureus

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21
Q

What are the risk factors for furunculosis?

A 
Obesity 
Diabetes 
Atopic dermatitis 
Chronic kidney disease 
Corticoidsteroid use
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22
Q

What is a carbuncle?

A

Occurs when infection extends to involve multiple furuncles

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23
Q

Where are carbuncles typically found?

A

Back of neck

Posterior trunk or thigh

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24
Q

What is the treatment for folliculitis?

A

No treatment of topical antibiotics

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25
Q

What is the treatment for furunculosis?

A

No treatment of topical antibiotics

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26
Q

What is the treatment for carbuncles?

A

Hospital admission, surgery, IV antibiotics

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27
Q

What are the predisposing factors for necrotising fasciitis?

A 
Diabetes 
Surgery 
Trauma 
Peripheral vascular disease 
Skin popping
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28
Q

What is type 1 necrotising fasciitis?

A

Mixed aerobic and anaerobic infection

29
Q

What organisms could be the cause of necrotising fasciitis?

A 
Streptococci 
Staphylococci 
Enterococci 
Gram negative bacilli 
Clostridium
30
Q

What is type 2 necrotising fasciitis?

A

Monomicrobial

31
Q

What is the organism which causes type 2 necrotising fasciitis?

A

Strep pyogenes

32
Q

What are the symptoms of necrotising fasciitis?

A 
Erythema 
Extensive oedema 
Severe, unremitting pain 
Haemorrhage bullae 
Skin necrosis 
Crepitus
33
Q

What are the systemic features of necrotising fasciitis?

A 
Fever 
Hypotension 
Tachycardia 
Delirium 
Multiorgan failure
34
Q

What is the treatment for necrotising fasciitis?

A

Surgical review mandatory

Broad spectrum antibiotics (flucloxacillin, gentamicin, clindamycin)

35
Q

What is pyomyositis?

A

Purulent infection deep within striated muscle, often manifesting as an abscess

36
Q

What are the common sites of pyomyositis?

A 
Thigh 
Calf 
Arms 
Gluteal region 
Chest wall 
Psoas muscle
37
Q

What are the predisposing factors for pyomysitis?

A 
Diabetes 
HIV/immunocompromised 
IV drug use 
Rheumatological disease 
Malignancy 
Liver cirrhosis
38
Q

What is the presentation of pyomyositis?

A

Fever

Pain and woody induration of affected muscle

39
Q

What is the organism that causes pyomyositis?

A

Staph aureus

Gram positives/negaitves, TB, fungi

40
Q

What is the treatment for pyomyositis?

A

Drainage with antibiotic cover depending on gram stain and culture results

41
Q

What is septic bursitis?

A

Infection of bursar found between bony prominences or tendons

42
Q

What are the predisposing factors for septic bursitis?

A 
Rheumatoid arthritis 
Diabetes 
Alcoholism 
IV drug use 
Immunosuppression 
Renal insufficiency
43
Q

What are the features of septic bursitis?

A

Peribursal cellulitis
Swelling and warmth
Fever
Pain on movement

44
Q

What is the organism that causes septic bursitis?

A

Staph aureus

Rarer (gram negatives, mycobacteria, brucella)

45
Q

What is infectious tenosynovitis?

A

Infection of the synovial sheaths that surround tendons

46
Q

What areas are typically affected by infectious tenosynovitis?

A

Flexor muscle associated tendons

Tendon sheaths of the hand

47
Q

What is the organism that causes infectious tenosynovitis?

A

Staph aureus

Streptococci

48
Q

What is the presentation of infectious tenosynovitis?

A

Erythematous fusiform swelling of finger
Held in semiflexed position
Tenderness over the length of the tendon sheath and pain with extension of finger

49
Q

What is the treatment for infectious tenosynovitis?

A

Empiric antibiotics

Hand surgeon review

50
Q

What is the organism that causes toxin-mediated syndromes?

A

Staph aureus

Strep pyogenes

51
Q

What is a toxin-mediated syndrome?

A

Superantigens bypass APC and T cell activation and attach directly to T cell receptors causing a massive burst in cytokine release

52
Q

What is the diagnostic criteria for staphylococcal toxic shock syndrome?

A

Fever
Hypotension
Diffuse macular rash
3 of the flooring involved (liver, blood, renal, gastrointestinal, CNS, muscular)
Isolation of staph aureus from mucosal or normally sterile sites
Production of TSST1 by isolate
Development of antibody to toxin during convalescence

53
Q

What is the treatment for streptococcal toxic shock syndrome?

A 
Urgent surgical debridement of the infected tissues 
Remove offending agent (tampon) 
IV fluids 
Inotropes
Antibiotics 
IV immunoglobulins
54
Q

What is staphylococcal scalded skin syndrome?

A

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

55
Q

How is staphylococcal scalded skin syndrome characterised?

A

Widespread bullae

Skin exfoliation

56
Q

What is the treatment for staphylococcal scalded skin syndrome?

A

IV fluids and antimicrobials

57
Q

What is Panton-Valentine leucocidin toxin?

A

Gamma haemolysin which can be transferred from one strain of staph aureus to another including MRSA

58
Q

What is the presentation of Panton-Valentine leucocidin toxin?

A

Recurrent boils which are difficult to treat

59
Q

What is the treatment for Panton-Valentine leucocidin toxin?

A

Antibiotics that reduce toxin production

60
Q

What are the risk factors for intravenous-catheter associated infections?

A

Continuous infusions >24hrs
Cannula in situ >72hours
Cannula in lower limb
Patients with neurological/ neurosurgical problems

61
Q

What is the treatment for intravenous-catheter associated infections?

A

Remove cannula
Express any pus from the thrombophlebitis
Antibiotics 14 days
Echocardiogram

62
Q

What are the preventative measures for intravenous-catheter associated infections?

A 
Don't leave unused cannula 
Don't insert cannula unless using it 
Change cannula every 72 hours 
Monitor for thrombophlebitis 
Use aseptic technique when inserting cannulae
63
Q

What is a class 1 surgical site infection?

A

Clean wound (respiratory, alimentary, genital or infected urinary systems not entered)

64
Q

What is a class 2 surgical site infection?

A

Clean-contaminated wound (tracts entered but no unusual contamination)

65
Q

What is a class 3 surgical site infection?

A

Contaminated wound (open, fresh, accidental wounds or gross spillage from the GI tract)

66
Q

What is a class 4 surgical site infection?

A

Infected wound (existing clinical infection, infection present before operation)

67
Q

What are the causes of surgical site infections?

A 
Staph aureus (incl MRSA and MSSA) 
Coagulase negative staphylococci 
Enterococcus 
Escherichia coli 
Pseudomonas aeroginosa 
Enterobacter 
Streptococci
68
Q

What are the patient associated risk factors for surgical site infections?

A 
Diabetes 
Smoking 
Obesity 
Malnutrition 
Concurrent steroid use 
Colonisation with staph aureus
69
Q

What are the procedural risk factors for surgical site infections?

A 
Shaving of site the night prior to procedure 
Improper preoperative skin preparation 
Improper antimicrobial prophylaxis 
Break in sterile technique 
Inadequate theatre ventilation 
Preoperative hypoxia

Infection (12 decks)

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