Skin & Soft Tissue Infxns

Question 1

what is the #1 drug for purulent cellulitis?

Answer 1

TMP/SMX PO (septra)

Question 2

what is considered a 2nd line drug for purulent cellulitis?

Answer 2

clindamycin

save for more serious infxns, or when you need to cover both strep & staph

Question 3

2 other drugs that may be used to tx purulent cellulitis?

Answer 3

vancomycin IV

doxycycline PO

Question 4

what bug is the major culprit for purulent cellulitis?

Answer 4

S. aureus (causes 1/2 of the MRSA infxns)

Question 5

what are the main bugs for nonpurulent cellulitis?

Answer 5

beta hemolytic strep- S. pyogenes (GAS), group B, G, C strep

S. aureus is uncommon

Question 6

what is the best drug choice for non-purulent cellulitis?

Answer 6

1st generation cephalosporins

• Cefazolin (Ancef) IV
• Cephalexin (Keflex) PO

Question 7

what are some of the anti-staph PCN’s you can use to tx non-purulent cellulitis?

Answer 7

Nafcillin IV

Dicloxacillin PO

Question 8

erysipelas

Answer 8

superficial, non-purulent cellulitis, typically toxic

• commonly on face, more often in LE in assoc. w/ pedal edema
• more often in elderly population

Question 9

what are the 4 infection patterns that should always make you think of NSTI?

Answer 9

1. diabetic foot ulcer
2. perineal infxns (Fourniers gangrene)
3. any SSTI in an IDU
4. unexplained MS pain

Question 10

who is called a flesh eating bacteria?

Answer 10

S. pyogenes

Question 11

what is the definitive diagnostic test & tx in NSTI?

Answer 11

surgery

Question 12

name 4 bugs that may be found in a monomicrobial NSTI

Answer 12

S. pyogenes (GAS)
Clostridium-perfringens, novyi, sordelli
Vibrio vulnificus
CA-MRSA

Question 13

name 4 types of bugs that may be responsible for polymicrobial/synergistic NSTI

Answer 13

Staph of all kinds
Strep of all kinds
Anaerobes of all kinds
Gram negatives

Question 14

drugs used for NSTI

Answer 14

perpercillin/tazobactam (Zosyn) +

vancomycin + clindamycin

Question 15

true target lesions are usually only seen in?

Answer 15

erythema multiforme minor

Question 16

name 2 severe & life threatening rashes associated w/ systemic bacterial infxn

Answer 16

meningococcemia

staph scalded skin

Question 17

bullous pemphigoid

Answer 17

more mild form of bullous dz

Question 18

pemphigus vulgaris

Answer 18

higher mortality & pop very easily- form of bullous dz which is assoc. w/ old age & the immune system attacking skin

Question 19

allergic rxn rash + oral involvement think?

Answer 19

SJS

Question 20

MC drugs that causes SJS?

Answer 20

anti-convulsants (CBZ)
sulfa drugs
clindamycin
any Abx
*often occurs 3-20 after starting