8 - Derm - Bacterial infections - Staph + Strep toxic reactions

Question 1

2 staph toxic reactions

Answer 1

bullous imetigo/staph scalded skin syndrome
SSSS

toxic shock syndrome

Question 2

BI/SSSS - BI toxin? causes? more common in?

Answer 2

ET-A causes localised blistering - more in kids, very low mortality

Question 3

SSSS toxin? causes?

Answer 3

ET-B causes widespread erythema, blistering and shedding of skin

Question 4

SSSS - how different from TEN? common in? presents with?

Answer 4

no mucosal involvement
common in kids
present with fever and irritability

Question 5

BI/SSSS mgmt

Answer 5

fluclox or erythromycin (PO in BI, IV in SSSS)

Question 6

what is toxic shock syndrome caused by? generalised Sx?

Answer 6

TSST-1 90% and TSST-2

malaise, fever, D+V, circulatory collapse

Question 7

toxic shock s - skin Sx?

Answer 7

widespread macular erythema 1-3 days
skin peeling 10-21 days later

mucosal hand and feet oedema

Question 8

TSS mgmt

Answer 8

septic shock + rash = assume TSS

IV fluclox or erythromycin + supportive measures

Question 9

2 strep toxic reactions

Answer 9

scarlet fever, toxic shock-like syndrome

Question 10

scarlet fever - non skin Sx?

Answer 10

fever, severe tonsillitis, cervical lymphadenopathy

Question 11

scarlet fever - skin Sx

Answer 11

red rash arms > trunk (like sunburn)

scaling and desquamation follow ~7 days

Question 12

scarlet fever complications

Answer 12

myocarditis arthritis, glomerulonephritis, osteomyelitis, rheumatic fever

Question 13

scarlet fever Ix and mgmt

Answer 13

Ix - throat swab and ASO titre

mgmt- benzylpenicillin

Question 14

Toxic shock like syndrome - similar presentation to?? Ix??

Answer 14

to TSS

blood cultures and swabs

Question 15

TSLS mgmt

Answer 15

high dose penicillin and IV gamma globulin