Flashcards in 11 - Bacterial Infections Of Skin Deck (79):
List of bacterial infections of skin
Slistering distal dactylitis
Pseudomonas folliculitis and cellulitis
What accounts for the maj of skin and soft tissue infections?
Staphylococcus aureus and group A beta-hemolytic streptococci
S. Aureus causes?
Invades the skin and causes
Elaborations of S. Aureus causes?
Leasions of bullous impetigo and SSSS
What does group A beta hemolytic strep cause?
Beta hemolytic strep causes?
Non bullous impetigo
Aka impetigo contagiosum
Progression of beta hemolytic strep - non bullous impetigo?
Starts as stratum corneum pustule or vesicle -> ruptures to expose a red moist base
Progresses to adherent “honey crusted” weeping lesions
Pt population for beta hemolytic strep - non bullous impetigo?
Warm moist climate
Beta hemolytic strep - non bullous impetigo often comes with?
Non derm symptom of beta hemolytic strep - non bullous impetigo?
Tx for beta hemolytic strep - non bullous impetigo?
Cool or warm soaks (remove crust)
Control infection (bactroban)
Systemic abx prn
Dressing to prevent spread
Beta hemolytic strep - eryspelas is aka?
St. Anthony’s fire
What is erysipelas?
Superficial cellulitis of lymphatics
Seen on: (2/2 vascular insufficiency)
Presentation of Erysipelas?
Slightly raised plaque w sharp demarcation
Red, warm, tender
ILL w malase, fever, nodes
Tx for erysipelas?
Cephelexin, diclox etc
infection that extends into sub Q
Etiology of cellulitis?
H. Flu (kids <2)
Where does cellulitis present?
Usually areas compromised by stasis/lymphedema
- erythema, edema, TTP (diffuse)
- no sharply defined border
- red streaks w swollen nodes
- vesicles or bullae
- dusky red skin
- constitutional ssx
- H WBC
- dicloxacillin, cephalexin
- IV Nafcillin
- IV vancomycin
blistering distal dactylitis is?
Superficial infx of anterior fat pad of fingertips
blistering distal dactylitis is MC seen in?
Progression of blistering distal dactylitis ?
Faint erythema, Vesicles to oval 1-3cm bullae and exfoliation
Tx for blistering distal dactylitis?
Oral (anti-strep) abx x 10 days
Carriers of strep like to keep it?
MC secondary invader?
Constitutional symptoms w Staph?
Epidermolytic toxin as in SSS or bullous impetigo
Staph aureus - bullous impetigo
Caused by toxin release in epidermis -> cleaving
- staph only (usually)
Bullous lesions are?
Less exudative crusting
- 1 or more vesicles enlarged rapidly to form bullae
- turn from clear to cloudy
Describe bullous impetigo?
Bullous lesion where the center collapses and leaves a TUBE-LIKE RIM
HONEY CRUST at center
- removal leaves bright red, moist base, that oozes
She said “youre taking the inter-tube down the staph river”
Tx for bullous impetigo?
Strict hand washing
Warm/coal soaks (remove crusts)
Systemic abx PRN
What is SSSS?
Staph scalded skin syndrome
- more diffuse form of bullous impetigo
What is folliculitis?
Inflammation of hair follicle
Typically caused by infection, chemical irritation, or physical injury
Think makeup, motor oil, steroid therapy
MC form of infectious folliculitis?
- comes from the nose
- scrape and put on cotton swab
Tx for folliculitis?
Removal of occlusion/irritants etc
Good skin hygiene
Long term scalp folliculitis?
Treat for folliculitis decalvans
What is sycosis barbae?
Inflammation of entire follicle
- staph impetigo of beard
- spread by razor
Tx for syscosis barbae?
Same as staph impetigo
- oral abx prn
Severe sycosis barbae?
Eval for dermatophyte infx
- remove hair for culture
Furncle vs carbuncle?
Furuncle - boil/abscess - walled off collection of pus
- fluctuant mass
Carbuncle - multi furncles
Furry uncles get together and get in a car...
Where do furuncles and carbuncles present?
Friction prone or traumatized areas
Tx for furuncle/carbuncle?
- moist heat to localize/spontaneously rupture (can also ease I/D)
Systemic abx prn
- not usually necessary
Consider w recurrent furnculosis
- chlorhexidine/bleach baths
Abx for MRSA?
- like impetigo but worse
Ulcers w crust
Heals w scar
Common on legs
Warm/coal soaks (remove crust)
This gram neg organism is not part of the normal flora?
Seen in sugar aids pts
Pseudomonas aeruginosa causes?
- pyoverdin - seen on wood light
- light green
Fruity, grape like odor
Pseudomonas folliculitis is aka?
Hot tub folliculitis
Presentation of pseudomonas folliculitis?
Hx of hot tub 8hrs-5 days ago
Often seen on bathing suit lines
Multiple pruritic, round, urticarial plaques w/ central papule or pustule
Malaise w low grade fever
So i got drunk and got in a hot tub, what now?
Showering will not help so, just pray i suppose
Fortunately its usually a self-limiting disease (7-10 days)
Tx for pseudomonas folliculitis?
- hydrozyzine (atarax) PRN
Vinegar soaks (acetic acid)
Ciprofloxacin if severe
Pt population for pseudomonas cellulitis?
Debilitated sugar aids pt
pseudomonas cellulitis is?
2/2 infasion of tinea of toe webs or groin
Or following injury
pseudomonas cellulitis is encouraged by?
Occlusion and or suppression of normal flora w broad spectrum abx
Seen in swampy environment
pseudomonas cellulitis can also be found?
- due to external otitis
pseudomonas cellulitis tx?
DM - blood sugar
- watch for sepsis
Domeboro (aluminum acetate)
- oral cipro
- IV aminoglycosides
- clindafloxacin IV
Pseudomonas toe web infection?
Between 4th and 5th toe
Caused by moisture
Thick white macerated skin
Green fluoresence (woods light)
Pseudomonas toe web infection commonly mixed w?
Or other bacteria
Pseudomonas toe web infection txt?
Keep clean and dry
Acetic acid soaks
Drysol (aluminum chloride)
What is trichomycosis axillaris?
Corynebacterium infection of the hair of the axilla
Describe trichomycosis axillaris?
Whitish or colored hair
Associated w heavy sweating
Tichomycosis axillaris txt?
Topical naftifine (naftin)
What is naftifine (naftin) normally used for?
It is for superficial fungal (tinea)
Also has antibacterial properties
MC site for erythrasma - C. Minutissimum?
4th interdigital space
Other sites for erythrasma - C. Minutissimum?
Describe erythrasma - C. Minutissimum?
Looks like T. cruris
Hwo to differentiate T. Cruris from C. Minutissimum?
What does C. Minutissimum look like under a woods lamp?
Coral red fluorescence
- due to porphyrins produced by organism
Tx for erythrasma?
Keep clean and dry
Systemic (pick one)
Topical (pick one)
Your pt presents with multiple 1-3mm pits to wt bearing areas of the feet
What causes pitted keratolysis
caused by micrococcus sedentarius which produces an enzyme that digests keratin
Symptoms of pitted keratolysis
1-3 mm pits to wt bearing areas
Sliminess of skin
Pitted keratolysis is associated with?
Pitted keratolysis tx?
Drysol (20% aluminum chloride)
Topical ( pick one)
Oral (alternate treatment)