soft tissue infection Flashcards
what is cellulitis
red deep infection
what is ecythema
crusty deep lesion
what is impetigo
superifical crusty lesion
what is erysipelas
superficial red patch that has very clear boundaries
what causes impetigo
either s.aureus or s.pyogenes
-very contaigous
what causes ecthyma
also s.aurues and s.pyogenes but deeper form into dermis
what causes ecthyma gangrenosum
pseudomonas aeruginosa
causes of cellulitis
s.aureus or beta haem strep
what is erysipelas caused by
group a beta haem strep pyogenes
- lypmatics
- distinct borders
what is a furuncle
deep folliculitis of one hair follicle also called a boile
what causes furuncles
s.aurues
what is a carbuncle
multiple hair follicles infected and systemic upset possible
what is erysipeloid
dermatitis of the hand due to a bacterial infection
what causes necrotising fasciitis
monomicrobial usually s.pyogenes
polymicrobial with s.aureus
clinical features of nec fasciitis
- pain that is out of proportion or unrequitting
skin necrosis
multi-organ failure
treatment nec fasci
- ben pen
- fluxoc
- clinda
- metro
- genta
what causes gas gangrene
clostridium perfringens
what is fournier’s gangrene
type of necrotising fasciitis affecting external genitalia or perineum
what causes toxic shock
s. pyogenes
s. aureus
what causes myonecrosis
clostridium perfringens
risk factors for clostridium ssti
- wound contaminantion
- IVDU spores
risk factor for ecthyma gangrene
water or hot tub
what does virbrio vulnificus cause and risk factor
-gas ganrene
due to saltwater, fish handling
where is aeromonas hydrophila infection
fresh water
what causes pasteruella infection
dog, cat bite or wound
what causes erysipelothix rhysopathiae infection
puncture wound
shrimp or crab
what is sirs
systemic inflammatory response
what is septic shock
SIRS plus infection
SIRS criteria
two or more of temp >38 or <36 hr >90 rr>20 wcc >12 or <4
how does cellulitis go to nec fasciitis
o Hyperinflammation
o Bacterial burden-intracellular survival-bacterial enzymes/ exotoxin- direct tissue destruction
o Neutrophil predominant
o Pro-inflammatory cytokine millieu (IL-1, TNFb, IFN Y)-neutrophil degranulation
o Microvascular thrombosis
o T cell migration-further amplification
o Dysregulation of the immune response
o Overwhelming sepsis-immune regulatory mechanisms overpowered
-inappropriate response
test for nec fasciitis
if run finger over produces immense pain woody tissue
imetigo treatment
fluxoc
erysipelas (strep_ treat
fluxoc
amoxi
mssa cellulitis
flucox
mrsa cellulitis
vancomycin
how long isolation for group a strep
minimum 24 hours
difference recurrent cellulitis in strep and s.aureus
strep=previous site
s.aureus=different site
