Skin Infections

Question 0

Dermis

Answer 0

Connective tissue
Blood vessels
Lymphatics
Sensory nerve endings, 
sweat and SubQ gland
Hair
Smooth muscle fibers

Question 1

Skin layers

Answer 1

Epidermis, dermis, fat layer

Question 2

SSTI INVOLVES

Answer 2

Any or all layers of skin, fascia, muscle

Question 3

Skin MOA

Answer 3

Dry, acidic pH, colonizing bacteria,

Frequent desquamation, sweat

Question 4

Conditions for predispose pt to SSTIs

Answer 4

High bacterial load
Excessive skin moisture
Decrease skin perfusion
Damage corneal layer of skin

Question 5

Primary bacteria

Answer 5

Previous health skin

1 or 2 pathogens

Question 6

2nd infection

Answer 6

Previous damaged skin

Polymicrobial

Question 7

Complicated infection

Answer 7

Deeper skin layer (fascia or muscle)
Require significant intervention
Compromised immune system

Question 8

Major cause of SSTIs

Answer 8

Gram +
S. Aureus
S. Pyogenes (GAS, flesh-eating bacteria)

Question 9

Primary infection list

Answer 9

Erysipelas
Impetigo
Cellulitis
Necrotizing fasciitis

Question 10

Secondary infection list

Answer 10

Diabetic foot infection
Bite wounds by animals
Bite wounds by human
Burn wounds

Question 11

Erysipelas

Answer 11

Superficial and sub Q layer
S. Pyogenes

Red color and burn pain
Likely to recur

Question 12

Impetigo

Answer 12

Superficial skin infection
S. Aureus,
group A strep (80%)
Less common now replace by MRSA

Question 13

Cellulitis

Answer 13

Group A Strep, S. Aureus,

Painful, tender, with rapidly spreading signs of redness, edema, and heat
Poorly defined margins and not raised

Question 14

Necrotizing fasciitis

Answer 14

Clostridium perfringens, group A Strep

Question 15

Impetigo sign and symptoms

Answer 15

Children, summer, poor hygiene
Numerous, well localized, erythmatous
Small and large blister that rupture,
Crust reminiscent cornflakes
Rarely painful, but pruritic
Crust become darker brown and harder

Question 16

Impetigo treatment

Answer 16

Soaking w/ soap and water
Skin emollients
Antibiotic for 7-10 days

Question 17

DOC FOR impetigo

Answer 17

Penicillin

Question 18

Systematic treatment of impetigo

Answer 18

PO PRP &BLIC
1st gen PO cephalosporin

Macrolide for penicillin allergic

MRSA: Clindamycin, bectrim, macrolide

Question 19

Topical for impetigo

Answer 19

Mupirocin

Retapamulin

Question 20

Retapamulin

Answer 20

1st bacteria protein synthesis inhibitor

Independent of other antibiotic susceptibilities

Question 21

Erysipelas presentation

Answer 21

Clearly demarcated raised margins
Bright red and edematous, painful
Lymphatic streaking,

Question 22

Treatment erysipelas

Answer 22

7-10 days
Pen V 500mg q6hr
Pen IM 600000 units BID/Daily

alternative
Erythromycin 250-500 PO q6hr
Macrolide

Severe: pen G2000000 unit q6hr
PRP IV
1st gen IV

Question 23

Non-pharm for cellulitis

Answer 23

Elevating and immobilizing the limb to decrease swelling
Sterile saline place on open lesion
Surgical debridement for severe infection
Abscess drainage

Question 24

Pharm for cellulitis

Answer 24

BL,
Cephalosporin for lower extremity
Monitor by mark boarder

IV FOR SEVERE 
cefazolin
Nafcillin 
Vanco
Linezolid
Daptomycin