Skin Infections Flashcards
Dermis
Connective tissue Blood vessels Lymphatics Sensory nerve endings, sweat and SubQ gland Hair Smooth muscle fibers
Skin layers
Epidermis, dermis, fat layer
SSTI INVOLVES
Any or all layers of skin, fascia, muscle
Skin MOA
Dry, acidic pH, colonizing bacteria,
Frequent desquamation, sweat
Conditions for predispose pt to SSTIs
High bacterial load
Excessive skin moisture
Decrease skin perfusion
Damage corneal layer of skin
Primary bacteria
Previous health skin
1 or 2 pathogens
2nd infection
Previous damaged skin
Polymicrobial
Complicated infection
Deeper skin layer (fascia or muscle)
Require significant intervention
Compromised immune system
Major cause of SSTIs
Gram +
S. Aureus
S. Pyogenes (GAS, flesh-eating bacteria)
Primary infection list
Erysipelas
Impetigo
Cellulitis
Necrotizing fasciitis
Secondary infection list
Diabetic foot infection
Bite wounds by animals
Bite wounds by human
Burn wounds
Erysipelas
Superficial and sub Q layer
S. Pyogenes
Red color and burn pain
Likely to recur
Impetigo
Superficial skin infection
S. Aureus,
group A strep (80%)
Less common now replace by MRSA
Cellulitis
Group A Strep, S. Aureus,
Painful, tender, with rapidly spreading signs of redness, edema, and heat
Poorly defined margins and not raised
Necrotizing fasciitis
Clostridium perfringens, group A Strep
Impetigo sign and symptoms
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
Impetigo treatment
Soaking w/ soap and water
Skin emollients
Antibiotic for 7-10 days
DOC FOR impetigo
Penicillin
Systematic treatment of impetigo
PO PRP &BLIC
1st gen PO cephalosporin
Macrolide for penicillin allergic
MRSA: Clindamycin, bectrim, macrolide
Topical for impetigo
Mupirocin
Retapamulin
Retapamulin
1st bacteria protein synthesis inhibitor
Independent of other antibiotic susceptibilities
Erysipelas presentation
Clearly demarcated raised margins
Bright red and edematous, painful
Lymphatic streaking,
Treatment erysipelas
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
Non-pharm for cellulitis
Elevating and immobilizing the limb to decrease swelling
Sterile saline place on open lesion
Surgical debridement for severe infection
Abscess drainage
