Skin and Soft Tissue Infections Flashcards
Aeromonas hydrophila
Risk factor and comment
Contact w/ recreational water; Contact with medicinal leeches
minor trauma to skin usually leads to inoculation of organism
Vibrio vulnificus, other Vibrio species
Risk factor and comment
Contact w/ salt water or brackish water or raw seafood
Direct inoculation into skin or may be ingested
Hallmark is hemorrhagic bullae in area of cellulitis
Erysipelothrix rhusiopathiae
Risk factor and comment
Contact w/ saltwater marine life (also associated with freshwater fish); contact w/ infected swine and poultry
Usually involves hand or fingers i
Causes erysipeloid disease
Pasteurella multocida
Risk factor and comment
Small aerobic GnR (resist Keflex)
Contact primarily w/cats
Capnocytophaga canimorsus
Risk factor and comment
Contact w/ dogs
Cellulitis; sepsis particularly w/ functional or anatomic asplenia
Bacillus anthracis
Risk factor and comment
Contact w/ infected animals or animal products
Target of bioterrorism
Edematous pruritic lesion with central eschar; spore-forming organism
Francisella tularensis
Risk factor and comment
Contact w/ or bite from infected animal (rabbits, cats) or ticks
Ulceroglandular syndrome: ulcerative lesion with central eschar, localized tender lymphadenopathy;
Constitutional symptoms are often present
Mycobacterium marinum
Risk factor and comment
Contact with water (including fish tanks and swimming pools)
papular become ulcerative; ascending lymphatic spread can be seen (“sporotrichoid” appearance);
systemic toxicity usually absent
Mycobacterium fortuitum
Risk factor and comment
Exposure to freshwater footbaths/pedicures at nail salons;
augmentation mammoplasty and open heart surgery
Multiple boils; razor shaving strongly associated
Types of Nec Fasc and etiology
NF type I - polymycrobial
NF type II - monomycrobial: strep pyogenes, staph, Vibrio vulnificus, strep aggalactiae
NF type III - Clost perfringens
Risk factors for Vibrio Vulnificus
Liver disease
Hemochromatosis
Exposure to estuaries
_____ is a fifth-generation cephalosporin approved for treatment of SSTIs
Ceftaroline
Primary treatment of a cutaneous abscess is
Incision and drainage.
Antibiotics if: I & D is inadequate; in extensive disease; immunodeficiency/comorbidities; for very young or very old patients; areas are challenging to drain.
6 independent lab indicators that are associated with an increased likelihood of necrotizing fasciitis:
C-reactive protein (≥15.0 mg/dL, total leukocyte count (>15,000-25,000/μL, hemoglobin (<11-13.5 g/dL sodium (<135 mEq/L creatinine (>1.6 mg/dL glucose (>180 mg/dL.
Recommended abx for animal bite infections (in gral): nfected wounds require antibiotics.
β-lactam/β-lactamase inhibitor combinations,
carbapenems,
clindamycin or metronidazole and a fluoroquinolone (for allergic to β-lactam)
