SSTIs

Question 1

Cellulitis Definition

Answer 1

infection of dermis and epidermis may spread to superficial fascia

Question 2

Cellulitis Presentation

Answer 2

redness, warmth, poorly defined margins; possible systemic - AMS, hypotension, fever, chills

Question 3

Cellulitis Common Pathogens

Answer 3

Group A strep and S. aureus (CA-MRSA)

Question 4

Moderate Cellulitis S/S

Answer 4

systemic s/s or immunocomp

Question 5

Severe Cellulitis S/S

Answer 5

failed I/D + PO abx, deeper infection, organ dysfunction

Question 6

Mild Cellulitis Tx

Answer 6

Dicloxacillin, cephalexin, clindamycin, augmentin, pen vk

Question 7

Moderate Cellulitis Tx

Answer 7

IV PCN, cefazolin, clindamycin, ceftriaxone,

Question 8

Severe Cellulitis Tx

Answer 8

Unasyn, vanco + Zosyn

Question 9

Cellulitis Tx Duration

Answer 9

5-7 days

Question 10

Erysipelas Definition

Answer 10

Infection of the superficial skin layers and cutaneous lymphatics

Question 11

Erysipelas Presentation

Answer 11

Intense redness and painful plaque w/ demarcated edges usually w/ fever

Question 12

Erysipelas Common Pathogens

Answer 12

Group A Strept (pyogenes) or S. aureus

Question 13

Erysipelas Tx

Answer 13

Mild-mod: IM PCN, clindamycin; Severe: IV PCN

Question 14

Erysipelas Tx Duration

Answer 14

7 days

Question 15

Necrotizing Fasciitis Definition

Answer 15

infection resulting in destruction of superficial fascia & subcutaneous fat

Question 16

Necrotizing Fasciitis Presentation

Answer 16

Systemic toxicity, painful, shiny, tender area w/ bullae

Question 17

Necrotizing Fasciitis Type I Common Pathogens

Answer 17

trauma or surg; anaerobes (bacteriodes, clostridium, ppetostrept) and facultative (strept, entrobacteriaceae)

Question 18

Necrotizing Fasciitis Type II Common Pathogens

Answer 18

gangrene: strept (pyogenes)

Question 19

Necrotizing Fasciitis Empiric Tx

Answer 19

Vanco + (Zosyn or meropenem) +/- clindamycin

Question 20

Necrotizing Fasciitis Definitive Tx

Answer 20

S. pyogenes or Clostridium: pcn + clindamycin; Aeromonas: doxycyline + cipro; Vibrio: doxycycline + ceftazidime

Question 21

Necrotizing Fasciitis Tx Duration

Answer 21

10-14 days or more

Question 22

Carbuncles Presentation

Answer 22

Swollen follicular mass accompanied w/ fever and chills

Question 23

Folliculitis Presentation

Answer 23

Pruritic, erythema surrounding hair follicle

Question 24

Furuncle Presentation

Answer 24

Erythematous, painful nodule surrounding hair follicle

Question 25

Impetigo Presentation

Answer 25

Contagious (non)bullous pus-filled blisters that form a golden crust

Question 26

Carbuncles, Folliculitis, Furuncles Common Pathogens

Answer 26

S. aureus (CA-MRSA), P. aeruginosa

Question 27

Impetigo Common Pathogens

Answer 27

S. aureus and group A strep

Question 28

Carbuncles, Folliculitis, Furuncles Mild Tx

Answer 28

local infection erythema 0.5-2 cm around ulcer; I/D no abx needed

Question 29

Carbuncles, Folliculitis, Furuncles Moderate Tx

Answer 29

local infection erythema > 2 cm or deeper than skin, no systemic s/s; abx: bactrim (MRSA), dicloxacillin, doxycycline or cephalexin

Question 30

Carbuncles, Folliculitis, Furuncles Severe Tx

Answer 30

local infection w/ systemic s/s; MRSA abx: vanco, daptomycin, telavancin, ceftaroline, bactrim (if suspectible); MSSA abx: nafcillin, clindamycin

Question 31

Carbuncles, Folliculitis, Furuncles Tx Duration

Answer 31

5-7 days

Question 32

Impetigo Tx

Answer 32

Dicloxacillin, cephalexin, clindamycin PO, mupirocin TOP

Question 33

Impetigo Tx Duration

Answer 33

7 days