Soft tissue infections and abscesses

Question 1

Clinical presentations local to the source (5):

Answer 1

Pain/tenderness
Swelling
Redness
Temperature (increase)
Loss of function

Question 2

Give 3 systemic clinical presentations you might expect to find:

Answer 2

Fever
Sweats
Rigors

Question 3

What is the most common site for soft tissue skin infection?

Answer 3

Lower leg (though any area can be affected)

Question 4

What is erysipelas?

Answer 4

An intradermal infection

Question 5

What are the 2 organisms likely responsible for causing erysipelas?

Answer 5

Group A beta haemolytic streptococcus

+/- Staphylococcus aureus

Question 6

What are the 2 organisms likely responsible for causing cellulitis?

Answer 6

Group A beta haemolytic streptococcus

+/- Staphylococcus aureus

Question 7

What are the 2 typical organisms that cause skin sepsis?

Answer 7

Group A beta haemolytic streptococcus

+/- Staphylococcus aureus

Question 8

What groups of people may be more likely to develop an atypical skin sepsis?

Answer 8

Drug users

Immunocompromised people

Question 9

Why/how are drug users more vulnerable to atypical infections?

Answer 9

Due to contaminated needles

Question 10

Why/how are immunocompromised people more vulnerable to atypical infections?

Answer 10

As they have a lowered immune system leaving them vulnerable to infections by atypical or low virulence organisms - including fungi

Question 11

What is cellulitis?

Answer 11

A subcutaneous infection

Question 12

How is a subcutaneous infection acquired?

Answer 12

1) By a breach in the body defences (eczema, ulcers, insect bites, athlete’s foot, etc.)
2) Or by bloodstream spread (less likely)

Question 13

What is an abscess?

Answer 13

A localised collection of infection

Question 14

Name a microorganism that is known to cause skin and soft tissue abscesses?

Answer 14

Staphylococcus aureus

Question 15

Name 4 microorganisms that are known to cause lung abscesses?

Answer 15

1) Staphylococcus aureus
2) Klebsiella pneumoniae
3) Anaerobic organisms
4) Mycobacterium tuberculosis

Question 16

Name 4 microorganisms that are known to cause liver abscesses?

Answer 16

1) Gram negative bacteria (e.g. E.coli)
2) Streptococcus milleri
3) Anaerobes
4) Entamoeba histolytica (tropics)

Question 17

Name 2 microorganisms that are known to cause kidney abscesses?

Answer 17

1) E.coli

2) Klebsiella

Question 18

Name 2 microorganisms that are known to cause bowel abscesses?

Answer 18

1) Gram negative bacteria (e.g. E.coli)
2) Streptococcus milleri
3) Anaerobes

Question 19

What investigations should be done for patients with suspected soft tissue infections?

Answer 19

Full blood count
Microbiological samples
Blood cultures

IF portal of infection is identified then swabs
IF abscess is present then pus sample (if possible)