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Infection > Skin and Soft Tissue Infections > Flashcards

Skin and Soft Tissue Infections Flashcards

1
Q

What are the features of impetigo?

A
  • Superficial skin infection
  • Highly infectious
  • Multiple vesicular lesions on an erythematous base
  • Golden crust
  • Usually on exposed parts of the body
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2
Q

Which organisms can cause impetigo?

A
  • Staph aureus (common)

- Strep pyogenes (less common)

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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

How can impetigo be treated?

A
  • Small areas: topical antibiotics

- Large areas topical treatment and oral antibiotics

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5
Q

What are the features of erysipelas?

A
  • Infection of the upper dermis
  • Painful, red area
  • Fever, lymphadenopathy and lymphangitis
  • Mostly affects the lower limbs
  • Distinct elevated borders
  • Tends to occur in areas of pre-existing lymphoedema, venous stasis, obesity, paraparesis and diabetes
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6
Q

Which organism commonly causes erysipelas?

A

Strep pyogenes

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7
Q

What are the features of cellulitis?

A
  • Skin infection involvin deep dermis and subcut fat
  • Spreading erythematous area
  • Fever
  • Regional lymphadenopathy and lymphangitis
  • Predisposing factors: diabetes, tinea pedis and lymphoedema
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8
Q

Which organisms commonly cause cellulitis?

A
  • Strep pyogenes
  • Staph aureus
  • Gram negatives in diabetics and febrile neutropaenics
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9
Q

How can erysipelas and cellulitis be treated?

A
  • Combination of anti-staph and anti-strep antibiotics

- Extensive disease: IV antibiotics and rest

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10
Q

What is folliculitis and how does it present?

A
  • Circumscribed, pustular infection of a hair follicle
  • Small red papules
  • Central area may rupture and drain
  • Head, back, buttocks and extremities
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11
Q

Which organism commonly causes folliculitis?

A

Staph aureus

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12
Q

What are the features of furunculosis?

A
  • Boils
  • Single hair follicle associated inflamm. nodule
  • Extends into dermis and subcut tissue
  • Affects moist, hairy, friction prone areas
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13
Q

Which organism commonly causes furunculosis?

A

Staph aureus

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14
Q

What are the risk factors for furunculosis?

A
  • Obesity
  • Diabetes
  • Atopic dermatitis
  • Chronic kidney disease
  • Corticosteroid use
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15
Q

What is a carbuncle and what are the features of them?

A
  • Infection which has extended to involve multiple furuncles
  • Multiseptated abscesses
  • Purulent material
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16
Q

How are hair-associated infections treated?

A
  • Folliculitis: no treatment
  • Furunculosis: if not improving then oral antibiotics
  • Carbuncles: may require admission, surgery and IV antibiotics
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17
Q

What are the predisposing conditions for necrotising fasciitis?

A
  • Diabetes
  • Surgery
  • Trauma
  • Peripheral vascular disease
  • Skin popping
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18
Q

What is type 1 necrotising fasciitis and which organisms typically cause it?

A
  • Mixed aerobic and anaetobiv infection (diabetic foot infection and Fournier’s gangrene)
  • Strep, staph, enterococci, gram negative bacilli and clostridium
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19
Q

What is type 2 necrotising fasciitis and which organism typically causes it?

A
  • Monomicrobial

- Strep pyogenes

20
Q

What are the features of necrotising fasciitis?

A
  • Rapid onset
  • Erythema, oedema and severe pain
  • Haemorrhagic bullae, skin necrosis and crepitus
  • Fever, hypotension, tachycardia, delirium and multiorgan failure
  • Anaesthesia at site of infection
21
Q

How is necrotising fasciitis managed?

A
  • Surgical review

- Broad spectrum antibiotics: fluclox, gentamicin and clindamycin

22
Q

What is pyomyositis?

A

Purulent infection deep within striated muscle often as an abscess

23
Q

What are the common sites for pyomyositis?

A
  • Thigh
  • Calf
  • Arms
  • Gluteal region
  • Chest wall
  • Psoas muscle
24
Q

How does pyomyositis present?

A
  • Fever
  • Pain
  • Woody induration of affected muscle
  • Can lead to septic shock and death
25
Q

What are the predisposing factors for pyomyositis?

A
  • Diabetes
  • HIV/ immunocompromised
  • IVDA
  • Rheumatological diseases
  • Malignancy
  • Liver cirrhosis
26
Q

Which organisms can cause pyomyositis?

A
  • Staph aureus

- Gram positives/negatives, TB and fungi

27
Q

How is pyomyositis investigated and how is it treated?

A
  • CT/MRI, gram stain and culture

- Specific antibiotics

28
Q

What are the predisposing factors for septic bursitis?

A
  • Rheumatoid arthritis
  • Alcoholism
  • Diabetes mellitus
  • IVDA
  • Immunosuppression
  • Renal insufficiency
29
Q

What are the features of septic bursitis?

A
  • Peribursal cellulitis
  • Swelling
  • Warmth
  • Fever
  • Pain on movement
30
Q

How is septic bursitis diagnosed and which organisms are involved?

A
  • Aspiration
  • Most common is staph aureus
  • Gram negative, mycobacteria and brucella
31
Q

Which organisms cause infectious tenosynovitis?

A
  • Staph aureus and strep
  • Chronic infections due to mycobacteria and fungi
  • Disseminated gonococcal infection
32
Q

How does infectious tenosynovitis present?

A
  • Erythematous fusiform swellling of the finger
  • Finger held in semiflexed position
  • Tenderness over the length of the tendon sheet and pain with extension of the finger
33
Q

How is infectious tenosynovitis treated?

A
  • Empiric antibiotics

- Hand surgeon review ASAP

34
Q

Which organisms cause toxin mediated syndromes?

A
  • Staph aureus

- Strep pyogenes

35
Q

What are the diagnostic criteria for staph TSS?

A
  • Fever
  • Hypotension
  • Diffuse macular rash
  • Three of the following organs involved: liver, blood, renal, GI, CNS and muscular
  • Isolation of staph aureus from mucosal or normally sterile sites
  • Production of TSSTq
  • Development of antibody to toxin
36
Q

What additional treatment does strep TSS need?

A

Urgent surgical debridement of the infected tissues

37
Q

How is TSS treated?

A
  • Remove offending agent
  • IV fluids
  • Inotropes
  • Antibiotics
  • IV immunoglobulins
38
Q

What are the features of staph scalded skin syndrome?

A
  • Infection by staph
  • Widespread bullae and skin exfoliation
  • Usually in children
39
Q

How is scalded skin syndrome treated?

A
  • IV fluids

- Antimicrobials

40
Q

What does the panton valentine leucocidin toxin cause and how is it treated?

A
  • SSTI and haemorrhagic pneumonia
  • Recurrent boils that are difficult to treat
  • Treated with antibiotics
41
Q

Which organism most commonly causes intravenous catheter associated infections?

A

Staph aureus (MSSA and MRSA)

42
Q

How are intravenous catheter associated infections diagnosed and how are they treated?

A
  • Clinically or positive blood cultures
  • Remove cannular
  • Express any pus
  • Antibiotics for 14 days
  • ECHO
43
Q

How can IV catheter infections be prevented?

A
  • Remove unsued cannulas
  • Only insert cannulas when in use
  • Change cannulae every 72hrs
  • Monitor for thrombophlebitis
  • Aseptic technique for insertion
44
Q

How are surgical wounds classified?

A
  • Class 1: clean wound (resp, GI, genital and urinary systems not entered)
  • Class 2: clean contaminated wound (above tracts entered but no unusual contamination
  • Class 3: contaminated wound
  • Class 4: infected wound
45
Q

Which organisms cause surgical site infections?

A
  • Staph aureus
  • Coagulase negative staph
  • Enterococci
  • E coli
  • Pseudomonas
  • Enterobacter
  • Strep
  • Fungi
  • Anaerobes
46
Q

What are the risk factors for surgical site infections?

A
  • Diabetes
  • Smoking
  • Obesity
  • Malnutrition
  • Concurrent steroid use
  • Colonisation with staph aureus
  • Shaving of site night prior
  • Improper skin prep
  • Improper antimicrobial prophylaxis
  • Break in sterile technique
  • Inadequate theatre ventilation
  • Perioperative hypoxia
47
Q

How can surgical site infections be diagnosed and how are they treated?

A
  • Pus/infected tissue for cultures (deep swabs)

- Antibiotics to target likely organisms

Infection (15 decks)

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