Skin Infections

Question 1

Warm, tender erythematous rash with raised, sharply demarcated borders
+ Rapid systemic sx (fever, chills), regional lymphadenitis

Answer 1

Erysipelas (superficial infection of dermis and lymphatics)
Mostly Group A strep

If involving external ear, more likely, since this skin does not have deeper layers (not cellulitis)

Question 2

Gas gangrene, soft tissue crepitus, shock, multiorgan failure

Answer 2

Clostridium perfringens

Question 3

Skin infection: flat edges w/ poor demarcation, indolent, localized (fever starts later)

Answer 3

Cellulitis (infection of deep dermis and subQ fat)

Enterococcus, H flu, pseudomonas, Staph aureus

Question 4

Gardener/landscaper
Skin papule -> ulcerate with nonpurulent drainage.
Proximal lesions along lymphatic chain
NO lymphadenopathy or systemic sx

Answer 4

Sporotrichosis (dimorphic fungus found in decaying vegetation and soil)

Question 5

Tx sporotrichosis

Answer 5

Oral itraconazole

Question 6

Is there prominent lymphadenopathy in cat scratch disease?

Answer 6

YES

Tender, regional lymphadenopathy and possible systemic spread

Question 7

NUMB pale patches
Painful nearby nerves with loss of sensory/motor

How to dx and tx?

Answer 7

Mycobacterium leprae
Dx: full-thickness biopsy
To: Dapsone + rifampin

Question 8

Prophylaxis after cat bite

Answer 8

Amox clav

Question 9

The rashes that involve palms and soles

Answer 9

Coxsackie
RMSF
Syphillis
Endocarditis
Measles
Meningoccemia
Reactive arthritis

Kawasaki, scarlet fever, toxic shock