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Infectious Disease > EXAM #2: SKIN & SOFT TISSUE/ BONE & JOINT INFECTIONS > Flashcards

EXAM #2: SKIN & SOFT TISSUE/ BONE & JOINT INFECTIONS Flashcards

1
Q

What two common pathogens cause impetigo?

A

1) S. pyogenes

2) S. aureus

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2
Q

What is the most common pathogen to cause erysipelas?

A

S. pyogenes

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3
Q

What is the most common pathogen to cause folliculitis and furuncles?

A

S. aureus

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4
Q

What are the most common pathogens to cause cellulitis?

A

1) S. pyognes

2) S. aureus

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5
Q

What causes hot-tub folliculitis?

A

Pseudomonas aeruginosa

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6
Q

What is the gram-stain of pseudomonas?

A

Gram-negative

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7
Q

Is pseudomonas a cocci or baccilus?

A

Bacillus (rod)

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8
Q

You are seeing an elderly patient s/p CABG 1-year prior. Today he has cellulitis in the area of the great saphenous vein graft. What are you concerned about?

A

This is a ssociation with lymphedema, which is a nidus for infection

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9
Q

In a wrestler with a large abscess and surrounding cellulitis, what organism are you concerned about?

A

MRSA

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10
Q

What is the indication for anti-microbials after I/D of an abscess?

A

Surrounding cellulitis

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11
Q

What is the treatment for uncomplicated non-purulent cellulitis?

A

First ask yourself if there is a risk for MRSA?

  • No= Cefazolin* i.e. cephalosporin
  • Yes= Vancomycin
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12
Q

What is the treatment for uncomplicated purulent cellulitis?

A

1) I/D

2) Vancomycin

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13
Q

What is the treatment for hot tub folliculitis?

A

None

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14
Q

What are the organisms that cause Necrotizing Fasciitis? What notable organism rarely cause Nec. Fas?

A

1) Clostridium perfringens
2) Group A strep
3) Polymicrobial

*Note that MRSA is rare

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15
Q

What are the clinical features of Necrotizing Fasciitis?

A

1) Severe constant pain out of proportion to PE
2) Bullous lesion
3) Systemic toxicity
4) Gas in soft tissue
5) Rapid spread

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16
Q

What historical features are associated with Clostridium perfringes causing nec. fas?

A
  • Tissue tramua

- Surgery

17
Q

What gram stain is C. perfringes?

A

Gram negative

18
Q

What is sporotrichosis associated with?

A

Rose-gardening

*“Marching along the lymphatics”

19
Q

What is the most common etiology of septic arthritis?

A

Hematogenous spread* most common

20
Q

What are the risk factors for septic arthritis?

A

1) RA
2) Steroid use
3) DM

21
Q

What organism most commonly causes septic arthritis?

A

S. aureus

*Followed by Steptococci and gram negative bacteria

22
Q

What organisms most commonly cause septic arthritis if there is a prosthetic joint?

A

Coagulase negative Staph (S. epidermidis)

23
Q

What is the most common viral cause of septic arthritis?

A

Parvovirus B19

24
Q

What are the clinical manifestations of septic arthritis?

A
  • One joint (knee is most common)
  • Pain, swelling, redness, warmth
  • Fever
  • Limited use/ ROM
25
Q

How is aseptic vs. septic arthritis distinguished?

A

1) Septic is more commonly associated with WBC greater than 60,000
2) Septic will have positive cultures

26
Q

How is septic arthritis treated?

A

1) Systemic antibiotics

2) Drain infected joint

27
Q

In sexually active young adults/adults, what is the most likely cause of septic arthritis?

A

Neisseria gonorrhea

28
Q

How is N. gonorrhea septic arthritis treated?

A

Ceftriaxone (3rd generation cephalosporin)

29
Q

How is S. aureus septic arthritis treated?

A

Nafcillin or Vancomycin

30
Q

How is GAS septic arthritis treated?

A

PCN

31
Q

How is gram negative septic arthritis treated?

A

Cephalosporin

32
Q

How long are patients with septic arthritis placed on abx?

A

2-4 weeks

  • 2 weeks for N. gonorrhea
  • 4 weeks for S. aureus
33
Q

What are the possible etiologies of osteomyelitis?

A

1) Hematogenous= distant focus
2) Contiguous= adjacent spread from soft tissue
3) Direct= surgery/trauma

34
Q

What time frame distinguishes between acute and chronic osteomyelitis?

A

1 month

35
Q

What is the most common bacteria to cause osteomyelitis?

A

S. aureus

36
Q

How is osteomyelitis diagnosed?

A

1) Probe the bone
2) MRI*
3) Bone biopsy

Preferred

37
Q

What is the standard of care for imaging possible osteomyelitis?

A

MRI

38
Q

What is the most common etiology of puncture wound osteomyelitis?

A

Pseudomonas aeruginosa

39
Q

How do the main treatment modalities change in acute and chronic osteomyelitis?

A

Acute= Abx then surgery

Chronic= Surgery then abx

Infectious Disease (21 decks)

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