SSTI Flashcards
What is the outermost layer of the skin?
Epidermis
What are the two innate immune system cells present in the outermost layer of the skin?
Keratinocytes and Langerhans’ cells
3 main organisms on the skin
.Staphylococcus species
.Corynebacterium species
.Propionibacterium species
The skin is mostly colonized by gram (positive/negative) bacteria
Positive
What is dysbiosis?
An imbalance in a microbial community. Overgrowth of certain organisms
Which of the following is not a common colonizer of the skin?
a. Streptococcus mitis
b. Pseudomonas aeruginosa
c. Staphylococcus epidermidis
d. Candida albicans
b. Pseudomonas aeruginosa
(Purulent/nonpurulent) SSTIs require incision and drainage (I and D)
Purulent
Impetigo is commonly associated with which organism?
Group A streptococcus (pyogenes)
True or false: Impetigo penetrates dermis &
infects keratinocytes
False. Impetigo penetrates epidermis &
infects keratinocytes
Duration of treatment for impetigo
.5-7 days
.Mild: 5 days
.Extensive: 7 days
A 65yo M presents with complaints on LLE pain, swelling,
redness after scraping his leg on an end table in his home.
* Vitals: HR 90, RR 22, BP 156/98, Tmax 99.1 F
* Physical exam: no open lesions identified, there is clear
demarcation of the erythema, no purulence or pain out of
proportion identified
* Allergies: NKDA PMH: HTN, HLD, obesity
23
Which of the following SSTIs does this patient likely have?
a. Impetigo
b. Ecthyma
c. Cellulitis
d. One we haven’t discussed yet
c. Cellulitis
A 65yo M presents with complaints on LLE pain, swelling,
redness after scraping his leg on an end table in his home.
* Vitals: HR 90, RR 22, BP 156/98, Tmax 99.1 F
* Physical exam: no open lesions identified, there is clear
demarcation of the erythema, no purulence or pain out of
proportion identified
* Allergies: NKDA PMH: HTN, HLD, obesity
23
Which of the following is the most appropriate to treat this
patient?
a. Cephalexin 250-500mg PO Q6H
b. Vancomycin 15mg/kg Q12H IV
c. Clindamycin 300mg Q6H PO
d. Topical mupirocin applied to the affected areas BID
a. Cephalexin 250-500mg PO Q6H
Mild, can use PO
A 65yo M presents with complaints on LLE pain, swelling,
redness after scraping his leg on an end table in his home.
* Vitals: HR 90, RR 22, BP 156/98, Tmax 99.1 F
* Physical exam: no open lesions identified, there is clear
demarcation of the erythema, no purulence or pain out of
proportion identified
* Allergies: NKDA PMH: HTN, HLD, obesity
23
What is the most appropriate duration of therapy for this
patient?
a. 3 days
b. 5 days
c. 7 days
d. 14 days
b. 5 days
Mild therapy is 5 days
Folliculitis is (purulent/nonpurulent) and occurs at the _______ ________
Purulent. Hair follicle.
Treatment for non-severe and severe folliculitis
Non-severe: Mupirocin or retapamulin topical BID
Severe: Cefepime, zosyn, meropenem
Furuncle and carbuncle treatment duration of treatment
7-14 days from I and D (7 days for milder disease)
A 25yo F presents with a large pustule under her arm that is
inflamed and indurated. She has been living with the pain for
the past week but she began to feel feverish so she presents to
the ER
* Vitals: HR 99, RR 24, BP 102/68, Tmax 102.7 F
* Physical exam: appears to be a collection of underarm lesions
with frank pus
* Allergies: sulfa drugs PMH: none
* Blood cultures: negative
Which of the following treatment plans is most appropriate for
this patient?
a. I&D followed by piperacillin-tazobactam 3.375g IV Q6H
b. I&D followed by cefepime 1g IV Q8H
c. I&D followed by vancomycin 15mg/kg IV Q12H targeting an
AUC of 400-600
d. I&D followed by SMX/TMP 1 DS tablet PO Q12H
c. I&D followed by vancomycin 15mg/kg IV Q12H targeting an
AUC of 400-600