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Infections > Skin and soft tissue infections > Flashcards

Skin and soft tissue infections Flashcards

1
Q

What is impetigo?

A

Superficial skin infection - multiple vesicular lesions on an erythematous base

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2
Q

What is the peak age for impetigo?

A

2-5 years age

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3
Q

What are predisposing factors for impetigo?

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

How is impetigo treated?

A

Topical antibiotics

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5
Q

What is erysipelas?

A

Infection of the upper dermis - painful red area, associated fever, regional lymphadenopathy, elevated borders

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6
Q

What is the most common causative organism for erysipelas?

A

Strep pyogenes

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7
Q

What is cellulitis?

A

Diffuse skin infection involving deep dermis and subcutaneous fat

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8
Q

What are features of cellulitis?

A

Presents as spreading erythematous area with no distinct borders
Fever
Regional lymphadenopathy
Possible source of bacteraemia

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9
Q

What are common causative organisms of cellulitis?

A

Strep pyogenes

Staph aureus

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10
Q

What are predisposing factors for cellulitis?

A

Diabetes mellitus
Tinea pedis
Lymphoedema

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11
Q

How is cellulitis treated?

A

Combination of anti-staphylococcal and anti-streptococcal antibiotics

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12
Q

What are hair-associated infections?

A

Folliculitis
Furunculosis
Carbuncles

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13
Q

What is folliculitis?

A

Circumscribed pustular infection of a hair follicle

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14
Q

Where is folliculitis typically found?

A

Head
Back
Buttocks
Extremities

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15
Q

What is the most common causative organism for folliculitis?

A

Staph aureus

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16
Q

What is furunculosis?

A

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

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17
Q

What are common affected areas of furunculosis?

A

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

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18
Q

What are risk factors for furunculosis?

A 
Obesity
Diabetes mellitus
Atopic dermatitis
Chronic kidney disease
Corticosteroid use
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19
Q

What is carbuncle?

A

When infection extends to multiple furuncles

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20
Q

Where are carbuncles located?

A

Back of neck
Posterior trunk
Thigh

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21
Q

How are hair associated infections treated?

A

Folliculitis - none/topical antibiotics
Furunculosis - none/topical antibiotics, if no improvement oral antibiotics
Carbuncles - hospital admission, surgery, IV antibiotics

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22
Q

What are predisposing factors for necrotising fasciitis?

A 
Diabetes mellitus
Surgery
Trauma
Peripheral vascular disease
Skin popping
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23
Q

What is type I necrotising fasciitis?

A

Mixed aerobic and anaerobic infection

24
Q

What are typical organisms causing necrotising fasciitis?

A 
Streptococci
Staphylococci
Enterococci
Gram negative bacilli
Clostridium
25
Q

What is type II necrotising fasciitis?

A

Monomicrobial

26
Q

What is the most common causative organism of type II necrotising fasciitis?

A

Strep pyogenes

27
Q

What are features of necrotising fasciitis?

A

Rapid onset
Sequential development of erythema, extensive oedema, severe unremitting pain
Haemorrhagic bullae, skin necrosis
Anaesthesia at site is highly suggestive
Systemic features - fever, hypotension, tachycardia, delirium, multiorgan failure

28
Q

How is necrotising fasciitis treated?

A

Surgical review mandatory

Broad spectrum antibiotics - flucloxacillin, gentamicin, clindamycin

29
Q

What is pyomyositis?

A

Purulent infection deep within striated muscle - abscess

30
Q

What are common sites for pyomyositis?

A 
Thigh
Calf
Arms
Gluteal region
Chest wall
Psoas muscle
31
Q

What are predisposing factors for pyomyositis?

A 
Diabetes mellitus
HIV/immunocompromised
IV drug use
Rheumatological disease
Malignancy
Liver cirrhosis
32
Q

What is the most common causative organism of pyomyositis?

A

Staph aureus

33
Q

What investigation is done for pyomyositis?

A

CT/MRI

34
Q

How is pyomyositis treated?

A

Drainage with antibiotic cover dependent on gram stain and culture results

35
Q

What are the most common sites of septic bursitis?

A

Patella

Olecranon

36
Q

What causes septic bursitis?

A

Adjacent skin infection

37
Q

What are predisposing factors for septic bursitis?

A 
Rheumatoid arthritis
Alcoholism
Diabetes mellitus
IV drug abuse
Immunosuppresion
Renal insufficiency
38
Q

What are features of septic bursitis?

A

Peribursal cellulitis, swelling, warmth
Fever
Pain on movement

39
Q

How is septic bursitis diagnosed?

A

Aspiration of fluid

40
Q

What is the most common causative organism of septic bursitis?

A

Staph aureus

41
Q

What is infectious tenosynovitis?

A

Infection of synovial sheets around tendons

42
Q

What tendons are most commonly involved in infectious tenosynovitis?

A

Flexor muscle-associated tendons

Tendon sheets of the hand

43
Q

What are the most common causative organisms of infectious tenosynovitis?

A

Staph aureus

Streptococci

44
Q

How does infectious tenosynovitis present?

A

Erythematous fusiform swelling of finger
Held in semiflexed position
Tenderness over length of tendon sheet
Pain with extension of finger

45
Q

How is infectious tenosynovitis treated?

A

Empiric antibiotics

Hand surgeon review

46
Q

What is diagnostic criteria for staph aureus toxic shock syndrome?

A

Fever
Hypotension
Diffuse macular rash
Three of the following involved - liver, blood, renal, GI, CNS, muscular
Isolation of staph aureus from normally sterile sites
Production of TSST1 by isolate
Development of antibody to toxin during convalescence

47
Q

How is streptococcal toxic shock syndrome treated?

A 
Remove offending agent
IV fluids
Inotropes
Antibiotics
IV immunoglobulins
48
Q

What is staphylococcal scalded skin syndrome?

A

Infection with particular strain of staph aureus producing exfoliative toxin A or B
Characterised by widespread bullae and skin exfoliation

49
Q

How is staphylococcal scalded skin syndrome treated?

A

IV fluids and antimicrobials

50
Q

What are risk factors for IV catheter associated infection?

A

Continuous infusion >24 hours
Cannula in situ >72 hours
Cannula in lower limb
Patients with neuro problems

51
Q

What is the most common causative organism of IV catheter associated infection?

A

Staph aureus

52
Q

How is IV catheter associated infection prevented?

A

Do not leave unused canula
Do not insert canula unless using them
Change canula ever 72 hours
Use aseptic technique when inserting cannula

53
Q

What are patient associated risk factors for surgical site infections?

A 
Diabetes
Smoking
Obesity
Malnutrition
Concurrent steroid use
Colonisation with staph aureus
54
Q

What are procedural risk factors for surgical site infection?

A 
Shaving of the site the night prior to procedure
Improper preoperative skin preparation
Improper antimicrobial prophylaxis
Break in sterile technique
Inadequate theatre ventilation
Perioperative hypoxia
55
Q

How is surgical site infection diagnosed?

A

Pus/infected tissue culture

Avoid superficial swab - aim for deep structures

Infections (14 decks)

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