Skin infections Flashcards
What is the common pathogen associated with folliculitis?
Staph
2nd- pseudomonas
What is the initial empiric therapy for folliculitis?
Dicloxacillin/keflex
What is a non-necrotizing inflammation of the skin and subcutaneous tissue that does not involve fascia or muscles?
cellulitis
What bacteria is most commonly associated with pus/abscess infection? Cellulitic infections?
Abcess= staph aureus Cellulitis = strep
What organism is most likely to present with purulent drainage trauma or eschar?
staph
What infection is characterized by the UPPER DERMIS and superficial lymphatics ?
Erysipelas
Of all the skin infections which one has sharply demarcated red borders?
Erysipelas
Signs of potentially severe infections that might need debridement:
Violaceous bullae sloughing rapid progression hemmorrhage skin anesthesia gas in the tissue
How do you treat cellulitis in the outpatient setting?
dicloxicillin
amoxicillin
cephalexin/keflex
In PCN allergy:
Clindamycin
Azithromycin/Zythromax
Clarithromycin/Biaxin
How is purulent cellulitis treated?
Bactrim
Doxycycline- doesn’t cover strep well though
When should patients be seen after their first outpatient appointment for cellulitis?
48-72 hours
When should a patient be hospitalized for cellulitis?
Hypotensive/systemically ill
Large area affected
Comorbidities
Failure with outpatient care
How would you treat the following scenarios in inpatient setting:
Uncomplicated cellulitis
Cellulitis with purulence
Aquatic environment infections
IV
Uncomplicated cellulitis: Cefazolin/Ancef or PCN
Cellulitis with purulence: Vanco
Aquatic: think pseudomonas… Ceftazidime or a quinolone :cipro/levo
What can you discharge a patient home on after the patient has been afebrile in the hospital with a cellulitis infection?
Oral whatever their IV was or augmenting/cephalexin/cephazolin
10 days of therapy!!!
What are the 2 most common pathogens in DM foot ulcers?
anaerobes from lack of oxygen perfusion
gram - rods from the gut because poop just keeps moving down that way
What are the surgical options for DM foot ulcers?
Debridement
Revascularization
What inpatient treatment of DM foot ulcers?
Ampicillin/sulbactam - Unasyn or Pip/tazo
What is outpatient treatment for DM ulcers?
Strep: Cephalexin/Keflex
Strep: Dicloxacillin
Staph: Bactrim Doxycycin
What is a deep infection of the subQ tissues that rapidly spreads along the fascial plane
necrotizing fasciitis
What organism causes N.F?
beta hemolytic strep or staph and is ofter poly microbial
What are 3 risk factors for N.F?
recent sx
Trauma
DM
Cirrhosis
What disease should be suspected if there pain is out of proportion to the the physical signs?
NF
What empiric antibiotic is used to treat necrotizing fasciitis?
PNC G, CLINDAMYCIN AND AN AMINOGLYCOSIDE
What is the drug of choice for animal bites?
Augementin(Amor/Clauv)
