Skin Infections Flashcards

1
Q

Steps of skin infections

A
  1. exposure to pathogens
  2. Adherence to skin or mucosa
  3. invasion thru epithelium
  4. Colonization and growth
  5. Toxicity effects or invasiveness
  6. Tissue damage
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2
Q

Factors that could contribute to wound becoming infected..

A
  1. dose of bacteria
  2. virulence of the organism
  3. Vascular integrity
  4. Immune system strength
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3
Q

Bacteria on skin that prevent pathogen attachment and outcompete

A

Staphylococcus epidermis

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4
Q

Skin disease resistance mechanisms (5)

A
  1. dry layer regenerating with keratinocytes
  2. cell secrete antimicrobial peptides and lysozyme
  3. lactic acid and fatty acids produced by sebaceous glands
  4. Lots of salt
  5. Sweat glands cool off the body
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5
Q

Keritinocytes (skin cells)

A

sentinels detecting pathogens and damage associated molecular patterns

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6
Q

What parts of the skin can become infected?

A

epidermis, dermis, and hypodermis

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7
Q

Folliculitis

A

Hair follicle infection

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8
Q

Abscess

A

localized collection of pus created by host defense to prevent spreading

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9
Q

Cellulitis

A

involves all layers of skin, leads to fever, and occassionally causes bacteremia

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10
Q

Gangrene

A

advanced cellulitis with significant tissue necrosis & death

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11
Q

Osteomyelitis

A

bone infection often due to contamination of open fractures

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12
Q

Most common skin condition

A

Acne vulgaris

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13
Q

How is acne caused?

A

follicles trap sebum and dead epithelial cells which clogs pore. Lipases digest the surplus of trapped oil, which leads to inflammation.

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14
Q

How do we treat acne?

A

Doxycline which is a ribosome inhibitor

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15
Q

Impetigo

A

superficial bacerial infection common in children causing the skin to flake off

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16
Q

Bacteria that cause impetigo

A

streptococcus pyogenes

Staph aureus

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17
Q

How can we distinguish between staph bacteria types?

A

Coagulase

Staph aureus is coagulase positive

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18
Q

How can we distinguish between staph and strept?

A

Staph is catalase positive and strept is catalase negativeq

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19
Q

What type of hemolysis is streptococcus pyogenes?

A

beta, group A

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20
Q

How is strept pyogenes spread?

A

fomites (normally on skin or respiratory)

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21
Q

How does strept pyogenes penetrate into deeper layers?

A

proteases like hyalurondiase and exotoxin B

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22
Q

How do we treat streptococcus pyogenes

A

penicillin

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23
Q

Necrotizing fasciitis

A

flesh eating infection

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24
Q

What causes necrotizing fasciitis?

A

many microbes
Group A streptococcus
Clostridium perferinges (gas gangrene)

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25
Bacteremia
widespread desquamation of skin, shock, multiorgan failure, and death caused by exotoxins
26
Where is Staph aureus found?
in your nose
27
How is staph aureus transmitted?
through air droplets and on skin
28
How do hospitals prevent staph aureus infection before surgery?
chlorhexidine
29
What people are more at risk for a staph aureus infection?
Chediak-Higashi disease (defect in lysosomal enzyme)
30
Staph aureus causes infection by...
1. Protein A 2. Coagulase 3. Hemolsisn and leukocidins 4. Salt tolerance and toxins
31
Protein A
prevents antibodies from tagging the protein
32
Coagulase
forms fibrin coat around the organism
33
Hemolysins and leukocidins
destroy RBCs and WBCs
34
Staphylococcal scaled skin syndrome
Exfoliatin disrupts desmoglein 1, the epidermis then splits away
35
How is staph scaled skin syndrome treated?
Mupirocin (inhibits tRNA synthesis) | Systemic antibiotics
36
1st mechanism of resistance to staph aureus
Expression of beta lactamases (cuts the beta lacatam ring so the drug doesn't work as well)
37
2nd mechanism of resistance to staph aureus
change in the structure of penicillin binding proteins
38
Drug that treats bacteria that changed their PBP
vancomycin
39
Vancomycin characteristics
Gram positive | bactericidal
40
How does vanco work?
Peptidoglycan synthesis is prevented (transglycosylase is inhibited)
41
Dermatophytoses
caused by fungi (ringworm, tinea, jock itch, athletes foot)
42
Types of bacteria that cause dermatophytoses (3)
1. trichophyton 2. microsporum 3. epidermophyton
43
How are fungal skin infections transferred?
human to human, fomites, or zoophilic
44
Why do fungal infections rarely invade?
they grow best at 25 C and are unable to survive at 37 C
45
fungal infection associated with rose thorns
Sporothrix schenckii
46
Tinea capitis
scalp
47
Tinea barabe
beard
48
Tinea axillaris
armpit
49
Tinea corporis
body
50
tinea cruris
groin
51
tinea pedis
feet
52
tinea unguium
nail
53
How are fungal infections diagnosed?
collect skin, nail, or hair dissolve in 10% KOH Stain with calcofluor white or grow on sabaroud media
54
What causes most tinea pedis (athletes foot) infections?
Trichophyton rubrum
55
How do we treat fungal infections?
``` topical itraconazole (AZOLE) 1 month oral for nail infections ```
56
How does azole work?
blcocks the production of membrane protein ergosterol and causes the accumulation of lanosterol fungistatic
57
How does hook worm enter the skin?
1. Contact with soil 2. Enters break in the skin (larva) 3. Goes into the small intestine and becomes an adult 4. Eggs are released in feces
58
What drug do we use to treat worm infections?
Albendazole
59
How does albendazole work?
inhibits microtubules that affect glucose transport
60
Symptoms of worm infection
itching & localized rash Weight loss Anemia and protein deficiency cognitive and physical developmental delays
61
How do you diagnose hookworm infections?
eggs in stool