Superficial/Deep skin tissue infection Flashcards
What is the order of skin anatomy from surface to the inside?
Epidermis»Dermis»Subcutaneous layer»Fascia layer»muscle
When are skin infections considered superficial?
What are the possible example of such infections?
- Superficial skin and soft tissue infections (SSTIs) are superficial if they present only on epidermis and dermis:
-Impetigo
-Focullitis
-Erysipelas
When are skin infections considered deep?
What are the possible examples of such infections?
-SSTI are considered deep if they expand through the subcutaneous layer:
-cellulitis
-Necrotizing fasciitis
-clostridial/non-clostridial myonecrosis
What is the clinical manifestations of impetigo? How does it present or look like?
- Presents as vesicular pustules which rapture»producing purulent discharge (pus)»which dries to form characteristic ‘golden-yellow crusts’
*Pruritis-itchy sensation is common. Scratching spreads the disease
Provide the epidemiology if impetigo. Population most prone to the infection? When is the disease mostly seen? (seasons)
- Common in children
- Peaks in hot and humid summer months.
What is the clinical manifestation of folliculitis? How does it present or look like?
- Pyoderma (pus) located within and around hair follicle.
What bacteria species causes impetigo?
Group A Streptococcus (GAS)
- staphylococcus aureus causes bullous impetigo
What other 2 conditions extend from folliculitis?
- Furuncle: usually smaller than carbuncles and involve a single hair follicle. (Are superficial)
- Carbuncle: larger and more severe form of skin abscess that involves multiple interconnected furuncles. (Are deeper)
What bacteria causes folliculitis?
Staphyloccoccus eureus
What are the clinical presentations of facial erysipelas?
- Tender erythematosus
- demarcated boarder
- Indurated plaque
What are the 2 types/forms of erysipelas and their causative organisms?
- Erysipelas in the face: Streptococccus pyogenes
- Lower extremities: Staphylococcus aerues
What happens in the site of infection when you are having erysipelas, and what symptoms do you present with?
“St. Anthony’s fire”- originated from the intense burning sensation and fiery red appearance of the affected skin
- Regional lymph node swelling
*Symps: malaise, aches, fever, nausea
What’ the treatment for erysipelas?
- spontaneous resolution
What bacterial organisms cause celllulitis?
- Staphylococcus aureus.
- GAS
- Vibro vulnificus(gram- bacteria) -through contact with brackish waters
What’s the prominent characteristic of cellulitis?
- Non-necrotizing inflammation of the skin and subcutaneous tissue
What are the symptoms of cellulitis?
- Erythema(redness)
- Pain
- Warmth
- Swelling
*inflammatory symptoms coz naye uyi inflammation vele
When do we suspect a sever infection with cellulitis?
- When patient is presenting with:
-circumferential cellulitis
-Lymphangitic spread
-Pain disproportionate to examination finding
-malaise, chills, fever, and toxicity
What antibiotics are used to treat cellulitis?
- co-amoxyclav
- Clindamycin
- Cefazolin
- ciprofloaxicin
*IV for severe infection
What is fournier gangrene?
A form of necrotising fasciitis localised to scrotum and perineal area
What is a signs of necrotising fasciitis heard beneath the skin on the early ages of the skin infection where the infection has not yet presented to the surface?
- Crepitus
*grating/crackling sound under the skin
Other signs seen within 3-5 days following crepitus:
-Skin breakdown with Blisters
-foul smelling discharge
-Frank cutaneous necrosis and gangrene.
-discolouration
What are the 3 types of necrotising fasciitis?
- Type 1- Caused by a mixture of pathogens: 1 anaerobe, facultative anaerobe, and an enterobacteriaceae. Common in diabetic patients
- Type 2- Caused by GAS/S pyogenes alone, or with S aerus
- Type 3- Cuased by rare pathogens
What bacterial species cause ‘clostridial gangrenous myonecrosis’?
- Clostridium perfringens
- novyii
At what setting should 1 expect to see ‘clostridial gangrenous myonecrosis’?
- Traumatic injuries
- Penetrating wounds
- surgical wounds
- vascular insufficiency in extremity (inadequate blood flow to extremities)
What bacterial species cause non-clostridial gangrenous myositis?
- streptococcus pyogenes
