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Infection > Skin and Soft Tissue Infections > Flashcards

Skin and Soft Tissue Infections Flashcards

1
Q

What is Impetigo

A

Superficial Skin infection

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2
Q

How does impetigo present

A

Multiple vesicular lesions on an erythematous base with a golden crust

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3
Q

State the possible causes of impetigo

A

Staph aureus or strep pyogenes

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4
Q

In which area of the population is impetigo present

A

2-5 years

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5
Q

Where does impetigo tend to occur

A

Face, extremities and scalp

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6
Q

List the predisposing factors of impetigo

A

Skin abrasions, minor trauma, burns, poor hygiene, insect bites etc

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7
Q

State the treatment of impetigo

A

Small areas treated with topical antibiotics alone but large areas may need flucloxacillin

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8
Q

What us erysipelas

A

Infection of the upper dermis

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9
Q

State the symptoms of erysipelas

A

Painful red area, associated fever, regional lymphadenopathy and lympgangitis, distinct elevated borders

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10
Q

What organism tends to cause erysipelas

A

Strep pyogenes

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11
Q

Where does erysipelas tend to occur

A

The face and the lower limbs. In areas of pre-existing oedema

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12
Q

State the recurrence rate of erysipelas

A

30% within 3 years

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13
Q

What is cellulitis

A

Diffuse skin infection involving the deep dermis and subcutaneous fat.

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14
Q

How does cellulitis present

A

It presents as a spreading erythematous area with no distinct borders, fever, regional lymphadenopathy

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15
Q

State the most likely organisms for causing cellulitis

A

Strep pyogenes and staph aureus

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16
Q

List the predisposing factors for cellulitis

A

Diabetes, tinea pedis and lymphoedema

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17
Q

State the treatmentof erysipelas and cellulitis

A

Combination of anti-staph and anti-strep antibiotics

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18
Q

What is folliculitis

A

Circumscribed, pustular infection of a hair follicle

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19
Q

How does folliculitis present

A

Small red papules with central area of purulence that may rupture and drain

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20
Q

Where is folliculitis often found

A

Head, back, buttocks and extremities

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21
Q

State the most common causative organism of folliculitis

A

Staph Aureus

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22
Q

What is furunculosis

A

Single hair follicle associated inflammatory nodules which extend into the dermis and subcutaneous tissue

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23
Q

Which area is mostly affected by furunculosis

A

Moist, hairy, friction prone areas of skin

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24
Q

State the most common causative organism of furunculosis

A

Staph aureus

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25
Q

List the risk factors of furunculosis

A

Obesity, diabetes, atopic dermatitis, chronic kidney disease, corticosteroid use

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26
Q

What is a carbuncle

A

Infection extending to involve multiple furuncles

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27
Q

Where are carbuncles often located

A

Back of the neck, posterior trunk or thigh

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28
Q

State the treatment of carbuncles

A

Admission to hospital, surgery and intravenous antibiotics

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29
Q

State the predisposing conditions for necrotising fascitis

A

Diabetes, surgery, trauma, peripheral vascular disease, skin popping

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30
Q

What is a type 1 necrotising fasciitis infection

A

Mixed aerobic and anaerobic infection

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31
Q

State the typical organisms that can cause nectrotising fasciitis

A

Streptococci, staphylococci, enterococci, gram negative bacteria, clostridium

32
Q

What is type 2 necrotising fasciitis

A

Monomicrobial usually with strep pyogenes

33
Q

State the clinical features of necrotising fasciitis

A

Rapid onset, sequential development of erythema, extensive oedema and severe pain. Haemorrhagic bullae, skin necrosis and crepitus may develop

34
Q

State the systemic features of necrotising fasciitis

A

Fever, hypotension, tachycardia, delirium and multiorgan failure

35
Q

What feature is highly suggestive of necrotising fasciitis

A

Anaesthesia at the site of infection

36
Q

State the treatment of necrotising fasciitis

A

Flucloxacillin, gentamicin, clindamycin

37
Q

State the mortality rates of necrotising fasciitis

A

17-40%

38
Q

What is pyomyositis

A

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

39
Q

State the common sites of pyomyositis

A

Thigh, calf, arms, gluteal region, chest wall and psoas muscle

40
Q

State the presentation of pyomyositis

A

Fever, pain and woody induration of affected muscle

41
Q

List the predisposing factors of pyomyositis

A

Diabetes, HIV, IV drug use, malignancy, liver cirrhosis

42
Q

State the organism most likely to cause pyomyositis

A

Staph aureus

43
Q

State how pyomyositis should be investigated

A

CT/MRI

44
Q

How is pyomyositis treated

A

Drainage with antibiotic cover

45
Q

What is septic bursitis

A

Infection of bursae within joints

46
Q

State the predisposing factors for septic bursitis

A

Rheumatoid arthritis, alcoholism, diabetes mellitus, IV drug abuse, immunosuppression, renal insufficiency

47
Q

State the clinical features of septic bursitis

A

Cellulitis, swelling, warmth, fever, pain on movement

48
Q

How is septic bursitis diagnosed

A

Aspiration of fluid

49
Q

State the most common causative organism of septic bursitis

A

Staph aureus

50
Q

What is infectious tenosynovitis

A

Infection of the synovial sheats that surround tendons

51
Q

Which tendons are most commonly involved in infectious tenosynovitis

A

Flexor muscle associated tendons of the hand

52
Q

What is commonly the inciting event in infectious tenosynovitis

A

Penetrating trauma

53
Q

State the most common causative bacteria of tenosynovitis

A

Staph aureus and streptococci

54
Q

What is the symptoms of infectious tenosynovitis

A

Erythematous fusiform swelling of finger, tenderness over the length of the tendon sheath and pain with extension of the finger classical

55
Q

State the treatment of infectious tenosynovitis

A

Empiric antibiotics and hand surgeon review

56
Q

How do toxic mediated infections cause such a response

A

Bypass normal immune system and attach directly to T cell receptors activating up to 20% of the total pool of T cells. This results in a massive burst of cytokines leading to endothelial leakage etc

57
Q

What organisms tend to cause Toxin Mediated Syndrome

A

Staphylococcus aureus and Streptococcus pyogenes

58
Q

State the toxins released by Staph aureus

A

TSST1, ETA and ETB

59
Q

State the toxins released by strep pyogenes

A

TSST1

60
Q

State the diagnostic criteria for staphylococcal TSS

A

Fever, hypotension, diffuse macular rash, involvement of three of liver, blood, renal GI, CNS, muscular, isolation of Staph Aureus from mucosal sites, production of TSST1 by isolate, development of antibody to toxin during convalescence

61
Q

Where does streptococcal TSS usually come from

A

Deep seated infections such as erysipelas or necrotising fasciitis

62
Q

State the treatment of TSS

A

Remove offending agent, IV fluids, inotropes, antibiotics, IV immunoglobulins

63
Q

What is Panton-Valentine Leucocidin Toxin

A

Gamma Haemolysin

64
Q

What can Panton-Valentine Leucocidin Toxin cause

A

SSTI and haemorrhagic pneumonia

65
Q

Patients with Panton-Valentine Leucocidin Toxin present with

A

Recurrent boils which are difficult to treat

66
Q

How is Panton-Valentine Leucocidin Toxin treated

A

Antibiotics that reduce toxin production

67
Q

How do Intravenous Catheter associated infections usually presenht

A

SST inflammation, progressing to cellulitis and even tissue necrosis

68
Q

State the risk factors of IV catheter associated infections

A

Continuous infusion>24 hours, Cannula in situ >72 hours, cannula in lower limb

69
Q

State the most common organism causing IV catheter infections

A

Staph aureus

70
Q

State the treatment if IV catheter associated infections

A

Remove cannula, express pus, antibiotics for 14 days and Echo

71
Q

Class 1 surgical site infection

A

Clean wound

72
Q

Class 2 surgical site infection

A

Clean-contaminated wound

73
Q

Class 3 surgical site infection

A

Contaminated wound

74
Q

Class 4 surgical site infection

A

Infected wound

75
Q

List the possible causes of surgical site infections

A

Staph aureus, coagulase negative staph, enterococcus, E.coli, psuedomonas aeruginosa, enterobacter, streptococci, fungi, anaerobes

76
Q

How are surgical site infections diagnosed

A

Cultures

Infection (24 decks)

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