Skin and Soft Tissue Infections Flashcards
what areas of the skin does impetigo effect
the epidermis
what areas of the skin does erysipelas effect
the deep epidermis
what areas of the skin does cellulitis effect
epidermis and dermis
what areas of the skin does necrotising fasciitis effect
the epidermis, dermis, and the hypodermic
why deep infection is more likely following bite injury to the hands or feet
- Blood supply is poor in several structures
- Little subcutaneous fat
- Superficial signs of deep infection minimal or absent
The Gram film appearance of the most common bacterial causes of SSTI is
Gram positive cocci
rare causes of bacterial SSTI
Coagulase negative staphylococci
Pasteurella multocida
Zoonosis:
- Bites, septic arthritis, septicaemia, meningitis, osteomyelitis
cat bite
– deep puncture wound
– little superficial damage
dog bite
– extensive superficial injury
– crushinjury+++
human bite
– deep infection common – Adults > children – Don’t forget BBV • HIV • HepB • HepC
Management – important points
• Full history – immunodeficiency, country of exposure • Radiology – clenched fist, scalp bites children • Wound exploration – irrigate / debride = SOURCE CONTROL – delayed closure • Antibiotic therapy – prophylaxis – treatment
antimicrobial prophylaxis
High risk patients benefit most from its use.
It is given to reduce the risk of infection
Prolongeduseusually selects for drug resistance
• Prophylaxis
– all after 1° closure – puncture wounds – cat bite to hand / wrist – crush wounds – clenched fist – host risk factors • prosthetic joint, asplenia, mastectomy, diabetes mellitus – duration • 7 days
treatment / prophylaxis of an animal bite
Co-amoxyclav monotherapy
Doxycyline plus metronidazole
Ciprofloxacin plus clindamycin
Clindamycin or flucloxacillin
monotherapy DOES NOTCOVER PASTURELLA
