Soft Skin Tissue Infections

Question 1

1. Peginterferon alfa-2a 180mcg sq q week

CrCl

Answer 1

questionable efficacy , limited use in mild infections only like impetigo

Question 2

for skin infections, when do you use the oral antibiotics?

Answer 2

outpatient treatment

mild to moderate disease

Question 3

for skin infections, when do you use the IV antibiotics?

Answer 3

inpatient therapy,
moderate to severe disease
signs and symptoms of systemic infection exists

Question 4

what is impetigo ?

Answer 4

localized purulent infection of the epidermis

Question 5

what are the risk factors for impetigo?

Answer 5

poor hygiene
minor trauma
insect bite
scabies
herpes
eczema
more common during hot and humid weather

Question 6

what organism are likely causing impetigo?

Answer 6

S. Aureus

S. Pyogenes

Question 7

what are the signs and symptoms of non-bollous impetigo?

Answer 7

small vesicles which rapidly pustulate and rupture

characteristic thick, golden yellow curst (honey crusted)

Question 8

what are the signs and symptoms of bollous impetigo?

Answer 8

lesions 1-2 cm in diameter initially filled with clear fluid that turns cloudy yellow over several days
after 1-3 days, the lesions rupture and leave a thin light brown varnish like crust
lesions are painless, pruritis is common

Question 9

how long is empiric treatment of impetigo?

Answer 9

7-10 days

Question 10

what are the PO choices for impetigo?

Answer 10

cephalexin
dicloxacillin
erythromycin
SMX/TMP
Clindamycin

Question 11

what are the Skin options for impetigo?

Answer 11

mupirocin 2% (bactroban) ointment
Retapamulin 1% (altabax)ointment
only for limited skin involvement

Question 12

what is the most common cause for abscess skin infections?

Answer 12

S. aureus

Question 13

when should you use antibiotics to treat abscess skin infections?

Answer 13

1. abscess is >5cm or incompletely drain
2. significant surrounding cellulitis
3. systemic signs and symptoms of infection are present
4. patient is immunocompromised

Question 14

what are the risk factors for acquiring CA- MRSA?

Answer 14

prior history of mrs a infection
close contact with person with similar infection
recent antibiotic use
reported “spider bite”

Question 15

what are the treatment options for CA MRSA?

Answer 15

PO
1. TMP/SMX
2. Doxycycline
3. Clindamycin
4. linezolid 
IV
Vancomycin
Daptomycin
Linezolid
Telavancin

Question 16

what is cellulitis?

Answer 16

acute speeding infection of the skin that spans the dermis and involves deep subcutaneous tissue

Question 17

what are some risk factors for cellulitis?

Answer 17

trauma, laceration, puncture
underlying skin lesion: furuncle, carbuncle
post operative wound infection
chronic edema (lower extremity edema)
hematogenous spread (are)

Question 18

what are the signs and symptoms of cellulitis?

Answer 18

local pain, tenderness, warmth, erythema
red hot swollen
regional lymphadonpath
+/- fever chills malaise, bacteremia