Skin & Soft Tissue Infections

Question 1

What are the types of infections that occur after animal bites?

Answer 1

1. Nonpurulent wound with cellulitis, lymphangitis, or both
2. Purulent wound without abscess
3. Abscess

Question 2

What organisms are associated with cat bites? 11 listed

Answer 2

1. Pasteurella 2. Strep 3. Staph 4. Fusobacterium 5. Porphyromonas 6. Bacteroides 7. Neisseria 8. Moraxella 9. Corynebacterium 10. Enterococcus
2. Bacillus

Question 3

Which Pasteurella species is present in > 90% of cats’ saliva

Answer 3

P. multocida

Question 4

Which Pasteurella species is present in 50% of dog saliva

Answer 4

P. canis

Question 5

Shape and classification of Pasteurella species

Answer 5

Gram negative bacillus

Question 6

First line treatment for Pasteurella

Answer 6

Amoxicillin susceptible

Question 7

6 pathogens that can cause infection from cat bites

Answer 7

1. Pasteurella
2. Anaerobic bacteria-Fusobacterium
3. Bartonella henselae
4. Rabies virus
5. Staph aureus
6. Strep species

Question 8

What are the potential pathogens from a dog bite?

Answer 8

Pasteurella and Capnocytophaga canimorsus
Staph aureus, Strep pyogenes

Question 9

What is risk factor for capnocytophaga infection getting worse?

Answer 9

Splenectomy

Question 10

What abx work against Capnocytophaga

Answer 10

1. Amox/Clav
2. Pip/Tazo
3. PCN G
4. Clindamycin

Question 11

What abx is Capnocytophaga resistant to?

Answer 11

Bactrim, Vancomycin

Question 12

Classification of Eikenella corrodens

Answer 12

Small anaerobic gram negative coccobacilli

Question 13

Treatment of Eikenella corrodens (5 listed)

Answer 13

1. PCN’s
2. Fluoroquinolones
3. Bactrim
4. Doxycycline
5. Extended spectrum cephalosporins (2nd, 3rd generation cephalosporins)

Question 14

What kind of injury is associated with Eikenella corrodens and why?

Answer 14

Closed fist or clenched fist injury because Eikenella is part of normal human flora.

Question 15

Which organism is found in the mouth of a leech?

Answer 15

Aeromonas hydrophila

Question 16

What kind of water can Aeromonas be found in?

Answer 16

Fresh, brackish or marine water

Question 17

Name the 3 different Aeromonas species

Answer 17

1. hydrophila-most common
2. veronii
3. shubertii

Question 18

List 3 different infections caused by Aeromonas

Answer 18

1. Gastroenteritis (most common)
2. Wound infection (after trauma/exposure to leeches)
3. Bacteremia (after exposure to fresh, brackish or marine water)

Question 19

What is the treatment for Aeromonas?

Answer 19

Lots of variability. Need culture and susceptibility testing done for wound, stool and blood.
Always resistant to Ampicillin, Penicillin and Cefazolin

Question 20

Honeycrust lesion near the mouth

Answer 20

Streptococcal impetigo

Question 21

Streptococcal impetigo-which bacteria cause it? Where is it more common?

Answer 21

Bacteria-Strep Groups A, B, C, G
More common in warm, humid environments; especially in children

Question 22

Risk factors for skin infections? 7 listed

Answer 22

1. Trauma to normal skin
2. Immune deficiency
3. Disrupted venous or lymphatic drainage
4. Local inflammatory disorders
5. Presence of foreign body
6. Vascular insufficiency
7. Obesity/poor hygeine

Question 22

Describe superficial folliculitis

Answer 22

Purulence (can be mixed with blood) where hair follicles exit skin

Question 22

Organisms that cause superficial folliculitis? 5 listed

Answer 22

1. Staph aureus 2. P. aeruginosa (hot tub) 3. C. albicans (esp. in obese pt) 4. Malassezia furfur 5. Idiopathic eosinophilic pustular folliculitis in AIDS pt

Question 22

Folliculitis under swim trunks is which organism?

Answer 22

Pseudomonas