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Infection > Skin and Soft Tissue Infections > Flashcards

Skin and Soft Tissue Infections Flashcards

1
Q

What things should be considered when treating a skin or soft tissue infection?

A

Site, Organism, Host, Environment

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2
Q

What is impetigo?

A

Superficial skin infection, multiple vesicular lesions on an erythematous base, golden crust is highly suggestive of diagnosis, most commonly due to staph aureus

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3
Q

Who does impetigo most commonly infect?

A

Common in children 2-5 years of age

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4
Q

Where does impetigo usually occur?

A

Exposed parts of the body such as the face, extremities and scalp

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5
Q

What are the predisposing factors for impetigo?

A

Skin abrasions, burns, minor trauma, poor hygiene, insect bites, chicken pox,eczema, atopic dermatitis

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6
Q

What is the treatment for impetigo?

A

Topical antibiotics (small areas) or oral antibiotics (flucloxacillin) + topical treatment

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7
Q

What is erysipelas?

A

Infection of the upper dermis, painful red area with associated fever. Regional lymphadenopathy and lymphangitis

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8
Q

What organism causes erysipelas?

A

Strep pyogenes

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9
Q

What is cellulitis?

A

Diffuse skin infection involving deep dermis and subcutaneous fat.

Most likely to be caused by strep pyogenes and staph aureus

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10
Q

How are erysipelas and cellulitis treated?

A

Anti-staph and anti-strep antibiotics.

If disease extensive = IV antibiotics

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11
Q

What is folliculitis?

A

A circumscribed pustular infection of hair follicle up to 5mm in diameter. Present as a small red papule

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12
Q

Where on body is folliculitis common?

A

Head, back, buttocks and extremities

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13
Q

What organism causes folliculitis?

A

Staph aureus

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14
Q

What is furunculosis?

A

Commonly referred as boils. Single hair follicule associated inflammatory nodule extending into dermis and subcutaneous tissue

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15
Q

What areas of body are most likely to be affected by furunculosis?

A

Face, axilla, neck and buttocks

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16
Q

What is most likely to cause furunculosis?

A

Staph aureus

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17
Q

What are the risk factors for furunculosis?

A

Obesity, DM, Atopic dermatitis, chronic kidney disease, corticosteroid use

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18
Q

What is the presence of multiple furuncles known as?

A

Neck, posterior trunk or thigh

19
Q

How should hair associated infections be treated?

A 
Folliculitis = no treatment
Furunculosis = no treatment or topical antibiotics. Oral antibiotics may be mecessary
Carbuncles = often require admission to hospital, surgery and antibiotics
20
Q

What is necrotising fasciitis ?

A

Infectious disease emergency

Erythema, extensive oedema and severe unremitting pain. Haemorrhagic bullae, skin necrosis and crepitus may develop

21
Q

What systemic features are associated with necrotising fasciitis?

A

Fever, hypotension, tachycardia, delirium, multiorgan failure

22
Q

What is the treatment for necrotising fasciitis?

A

Flucloxacillin, gentamicin, clindamycin

23
Q

What is pyomyositis?

A

Purulent infection deep within striated muscle often manifesting as an abscess

24
Q

What are common sites of pyomyositis?

A

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

25
Q

How does pyomyositis present?

A

Fever, pain, woody induration of affected muscle and if left untreated, can lead to septic shock and death

26
Q

What are the predisposing factors for pyomyositis?

A

Diabetes mellitus, HIV/immunocompromised, IV drug use, rheumatological diseases, malignancy, liver cirrhosis

27
Q

What is the organism that causes pyomyositis?

A

Staph aureus

28
Q

What is the treatment for pyomyositis?

A

Drainage and antibiotics

29
Q

What is septic bursitis?

A

Infection of bursae, usually from adjacent skin infection

30
Q

What factors can predispose you to septic bursitis?

A

Rhematoid arthritis, alcoholism, DM, IV drug abuse, immunosuppression, renal insufficiency

31
Q

What are the symptoms of septic bursitis?

A

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

32
Q

How is septic bursitis diagnosed?

A

Aspiration of the fluid

33
Q

What is the cause of septic bursitis?

A

Staph aureus

34
Q

What is infectious tenosynovitis?

A

Infection of the synovial sheaths that surround tendons

35
Q

What causes infectious tenosynovitis?

A

Penetrating trauma

36
Q

What are the symptoms of infectious tenosynovitis?

A

Erythematous fusiform swelling of finger held in a semiflexed position. Tenderness and pain are classical

37
Q

What organisms cause TSS?

A

Staph aureus and strep pyogenes

38
Q

What is the mechanism behind TSS?

A

Superantigens attatch to T Cell receptors, activating T cells causing cytokine release which leads to endothelial leakage, haemodynamic shock, multi organ failure

39
Q

What is the diagnostic criteria for staphylococcal TSS?

A

Fever, hypotension, diffuse macular rash, 3 of either LIVER, BLOOD, RENAL, GI, CNS, MUSCULAR systems involved, isolation of staph aureus from mucosal or normally sterile sites, production of TSST1 by isolate, development of antibody to toxin during convalescence

40
Q

Which version of TSS has the highest mortality rate?

A

Streptococcal TSS

41
Q

What is the treatment of Strep TSS?

A

Surgical debridement of infected tissue

42
Q

What is treatment of TSS?

A

Removal of offending agent, IV fluids, Inotropes, Antibiotics, IV immunoglobulin

43
Q

What is Staphylococcal Scalded Skin Syndrome?

A

Infection due to a particular strain of Staph Aureus producing exfoliative toxin A/B. Bullae and skin exfoliation. Occurs in children. Treat with iv fluids and antimicrobials

44
Q

What are the causes of surgical site infections?

A 
Staph Aureus
Coagulase negative Staphylococci
Enterococcus
E. Coli
Pseudomonas Aeruginosa 
Enterobacter

Infection (12 decks)

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