Topic I/8) Diseases due to Staphylococci and their therapy:

Question 1

diseases of staphylococci

Answer 1

1. impetigo
2. folliculitis
3. furuncles
4. carbuncles
5. staphylococci scalded skin syndrome

Question 2

impetigo

Answer 2

in the face and on limbs,

weeping, exudative areas, with a typical honey-colored crust on the surface.
begins as red macules, then develops into pustules.
When the pustule bursts, the crusting develops secondarily on top.
It is caused by S.aureus or S.pyogene

Question 3

Ecthyma

Answer 3

if impetigo reaches the dermis

deep, ulcerated lesions with occasional crust on top, associated with poor nutrition and hygiene

Question 4

treatment of impetigo

Answer 4

involves topical Fucidic acid
Mupirocin
Povidone iodine (antiseptic) is used to soften crusts and exudates for 1 week

severe cases:
oral antibiotics for 7-10 days; Flucloxacillin in case of S.aureus penicillin V in case of S.pyogenes

Question 5

foliculitis

Answer 5

is an inflammation of the hair follicle caused by S.aureus

itchy or tender papules and pustules
more common in humid climates
treatment:
topical antibiotics ( Fucidin), topical antiseptics
oral antibiotics if extensive (Flucloxacillin or Erythromycin)

Question 6

Furuncles

Answer 6

these lesions are deeper skin infections (extensions of folliculits)
caused by S.aureus
large, painful, raised, red nodules (1-2 cm) that have an underlying collection of dead and necrotic tissue (abscess formation) with a central necrotic plug.
treatment:
involves surgical drainage of the abscess cavity with oral antibiotics (e.g. erythromycin) for 10-14 days
Antiseptics for prophylaxis

Question 7

Carbuncles

Answer 7

are fused furuncles (and thus are larger abscess formations) which extend deeper into the skin and subcutaneous tissues.
Carbuncles present with systemic signs such as fever and chills and bacteremia

Question 8

Staphylococcal scalded skin syndrome (SSSS) (+ bullous impetigo)

Answer 8

Is a toxin induced disease, caused by exfoliative toxins A and B (ET-A & ET-B) of S.aureus,
occuring mainly in newborns and infants (< 2yrs
erythema and widespread detachment of the epidermis from the dermis (positive Nikolsky’s sign) resembling scalding.
from a localized form (bullous impetigo) to extensive epidermolysis and desquamation.