Skin and Soft Tissue Infections (SSTI) Flashcards
When would wound cultures be obtained for skin and soft tissue infections?
- purulent infections
- necrotizing infections
When would blood cultures be obtained for skin and soft tissue infections?
- severe infections
- intravenous drug use (IVDA)
When would imaging be obtained for skin and soft tissue infections?
necrotizing (deep) infections= CT scans
What is a purulent infection?
- cutaneous abscesses, collection of pus within the dermis and deeper skin tissue
- furuncles and carbuncles
- folliculitis
What is the presentation of a purulent infection?
- tender, red nodules
- signs of erythema
- systemic signs (fever, chills, malaise)- carbuncles and abscesses only
What pathogens are respondsible for purulent infections?
- staphylococcus aureus (MRSA)
- if patient has significant water exposure, pseudomonas aeruginosa
What is the empiric treatment for severe purulent infections?
- vancomycin
- daptomycin
- linezolid
- televancin
- ceftaroline
What is the empiric treatment for moderate purulent infection?
- trimethoprim/sulfamethoxole
- doxycline
What is the duration of therapy for purulent infections?
5 days (minimum)
What is a non-purulent infection?
involves epidermis and dermis, history of wound from minor trauma, abrasion, ulcer, or surgery
- cellulitis
- erysipelas
What is the presentation of non-purulent infections?
- fevers, chill, malaise
- hot and painful to the touch
- systemic symptoms common
- non-elevated lesions with poorly defined margins
- involvement of regional lymphatic system
What pathogens are respondsible for non-purulent infections?
- group A strep (streptococcus pyogenes)
- staphylococcus aureus (MRSA coverage for penetrating trauma, IV drug use, purulent drainage, MRSA infection elsewhere)
When should MRSA be empirically covered for non-purulent infections?
- penetrating trauma
- IV drug use
- purulent drainage
- MRSA infection elsewhere
When would a purulent infection be classified as severe?
- failed inscision & drainage and failed PO antibiotics
- immunocompromised
- SIRS or sepsis (2/4 of the following: temp >38C or 36C, HR > 90bpm, RR > 24bpm, WBC > 12K or <4K)
When would a non-purulent infection be classified as severe?
- failed PO antibiotics
- immunocompromised
- SIRS or sepsis (2/4 of the following: temp >38C or 36C, HR > 90bpm, RR > 24bpm, WBC > 12K or <4K)