SSTIs

Question 1

What pathogens usually cause folliculitis?

Answer 1

Staph aureus
Pseudomonas aeruginosa (hot tub folliculitis)

Question 2

How do you treat folliculitis?

Answer 2

soap and water and antibiotics

Question 3

What often causes acne?

Answer 3

proprionobacterium acnes (anaerobe, eats oils)

Question 4

Furuncles are

Answer 4

Boils: abscess in the area of the hair follicle. Several together make up a Carbuncle. These are usually S. Aureus

Question 5

Dermatophyte funghi

Answer 5

Tinea cruris (jock itch), corporis (ringworm)

Question 6

Yeast infections in general are caused by three things:

Answer 6

Trichophyton, Microsporum, Epidermophyton, and of course the big one: Candida albicans

Question 7

Intertrigo

Answer 7

Rash from candida under the breasts

Question 8

Impetigo

Answer 8

honey crust lesion on the epidermis. Caused by Group A strep and Staph Aureus. VERY infectious. Treat with penicillin and topical antibiotics

Question 9

Erysipelas

Answer 9

Usually group A strep. Hot, red, painful, deep in dermis, spreads rapidly. Systemic signs as well. Treat with Penicillin

Question 10

Cellulitis

Answer 10

Subcutaneous. Usually Group A strep, then sometimes Staph aureus. treat with systemic antibiotics. Sometimes blood samples are positive, sometimes not-50 50.

Question 11

Necrotizing Fascitis

Answer 11

Group A strep (flesh eating bacteria), Staph Aureus.
Look for pain out of proportion to what you see.
Can also be Clostridium perfringens: an anaerobe that makes gas gangrene.

Question 12

Fournier’s gangrene

Answer 12

polymicrobial infection, necrotizing fasciitis of the genitals and perineum

Question 13

Surgical wounds

Answer 13

Staph Aureus. Avoid by preoperative antibiotics

Question 14

What causes scalded skin syndrome?

Answer 14

Staph aureus (top layer of skin sloughs off.) 
(Alpha toxin)

Question 15

What causes bullous impetigo?

Answer 15

Exfoliatin (toxin from staph aureus)

Question 16

What causes toxic shock syndrome?

Answer 16

TSST-1 (toxin from staph aureus)

Used to happen with tampons, now happens a lot with sinus surgeries (because of the wound packing)

Question 17

An exotoxin that acts on the GI tract is called an

Answer 17

enterotoxin

Question 18

What makes a MRSA strain MR?

Answer 18

It has acquired a mecA gene, which alters PBPs (penicillin binding proteins,) and become resistant to ALL B-lactams.
(they will need an IV of trimethoprim or linezolid, daptomycin etc) Don’t use vancomycin!!

Question 19

If you have MSSA, treat it with

Answer 19

nafcillin, and oxacillin
and cephalosporins
(Orally and send them home)

Question 20

What sequelae follow Group A strep?

Answer 20

Pharyngitis–to rheumatic fever (attacks heart valves)

Pharyngitis OR soft tissue– to glomerulonephritis

Question 21

Strep A makes what exotoxins?

Answer 21

Strepolysin O and S (lyse leukocytes, platelets, tissue cells)
-Pyrogenic exotoxins A and B (superantigens)

Question 22

Clostridium perfringes

Answer 22

anaerobic, form spores, gram positive rod, causes gas gangrene

Question 23

Pasteurella multocida

Answer 23

cat and dog bites. Gram negative rods

Question 24

Pseudomonas auruginosa

Answer 24

Gram negative rod
non-glucose fermenter
environmental (water, hospital rooms)
Colorful secondary infections on burns

Question 25

Vibrio vunificus

Answer 25

gram negative rod
loves salt water and shellfish
Iron overload,
fever, sepsis, hemorrhagic bull