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Dermatology > Sec 29 Bacterial Disease > Flashcards

Sec 29 Bacterial Disease Flashcards

1
Q

Sites of colonisation in carriers of Staphylococcus aureus

A 
Anterior nares 
Throat
Axillae, perineum 
Hands
Involved skin in individuals with atopic dermatitis
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2
Q

Sites of colonisation in neonates of Staphylococcus aureus

A

Skin
Umbilicus
Circumcision site
Conjunctivae

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3
Q

Primary pyoderma of skin

A

Impetigo
Bullous impetigo
Erythema
Botryomycosis

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4
Q

Primary pyoderma of hair follicles

A

Superficial folliculitis (follicular or Bockhart impetigo)
Folliculitis (sycosis barbae)
Furuncle (boil)
Carbuncle

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5
Q

Secondary pyoderma

A

Impetiginization of dermatoses such as atopic dermatitis, herpes simplex (superinfection)
Pyodermas associated with systemic disease Job syndrome
Chédiak–Higashi syndrome
Chronic granulomatous disease

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6
Q

First line topical therapy for Impetigo

A

Mupirocin BID
Retapamulin BID
Fusidic acid BID (not available in United States)

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7
Q

First line systemic therapy for Impetigo

A

Dicloxacillin 250–500 mg PO qid for 5–7 days
Amoxicillin plus clavulanic acid 25 mg/kg tid
Cephalexin 250–500 mg qid

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8
Q

Second line systemic therapy for Impetigo (if with penicillin allergy)

A

Azithromycin 500 mg × 1, then 250 mg daily for 4 days
Clindamycin 15 mg/kg/day TID
Erythromycin 250–500 mg PO qid for 5–7 days

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9
Q

Bacterial folliculitis

A

Staphylococcus aureus folliculitis
Periporitis staphylogenes
Superficial (follicular or Bockhart impetigo)
Deep (sycosis) [may progress to furuncle (boil) or carbuncle]
Pseudomonas aeruginosa folliculitis (“hot tub” folliculitis)
Gram-negative folliculitis (occurs at the site of acne vulgaris, usually the face, with long-term antibiotic therapy)
Syphilitic folliculitis (secondary; acneiform)

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10
Q

First line topical treatment for Streptococcal Pyoderma

A

Mupirocin BID

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11
Q

First line systemic treatment for Streptococcal Pyoderma

A

Penicillin V 250–500 mg PO qid for 5–7 days

Dicloxacillin 250–500 mg qid for 5–7 days

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12
Q

Second line topical treatment for Streptococcal Pyoderma

A

Retapamulin BID

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13
Q

Second line systemic treatment for Streptococcal Pyoderma

A

Azithromycin 500 mg × 1 then 250 mg daily for 4 days
Clindamycin 15 mg/kg/day tid
Erythromycin 250–500 mg PO qid for 5–7 days

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14
Q

Toxins: Staphylococcus aureus

A

Exfoliatin type A - Epidermolytic - Bullous impetigo, SSSS
Exfoliatin type B - Epidermolytic - SSSS, Bullous impetigo
TSS toxin 1 - Superantigen - TSS (menstrual > nonmenstrual), food poisoning
Staphylococcal enterotoxins A–C - Superantigen - TSS (nonmenstrual > menstrual), food poisoning

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15
Q

Toxin: Streptococcus pyogenes

A

Streptococcal pyrogenic exotoxins A, C - Superantigen - TSS (nonmenstrual), scarlet fever

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16
Q

Major Criteria: Staphylococcal Toxic Shock Syndrome

A

Fever - Temperature >38.9°C (102°F)
Rash - Diffuse macular erythroderma
Desquamation - 1–2 week after onset of illness, particularly on palms/soles
Hypotension - Systolic blood pressure <95 mm
Hg for adults, or less than 5th percentile by age for children <16 years of age, or orthostatic syncope

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17
Q

MCC: Erysipelas

A

Group A Streptococcus

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18
Q

MCC: Cellulitis

A

S. aureus

Group A Streptococcus

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19
Q

MCC: Facial/periorbital cellulitis in children

A

S. aureus

Group A Streptococcus

20
Q

MCC: Perianal cellulitis in children

A

Group A Streptococcus

21
Q

MCC: Cellulitis secondary to bacteremia

A

Pseudomonas aeruginosa

22
Q

MCC: Cellulitis associated with water exposure

A

E. rhusiopathiae (erysipeloid)

23
Q

DOC: Erysipelas, simple outpatient

A

Penicillin V
Intramuscular procaine penicillin
Amoxicillin
Vancomycin

24
Q

DOC: Erysipelas, severe hospitalized

A

Ampicillin/sulbactam
Ticarcillin/clavulanate
Piperacillin/tazobactam
Imipenem/cilastatin, meropenem

25
Q

DOC: Cellulitis, simple outpatient

A

Cephalexin

Dicloxacillin

26
Q

DOC: Cellulitis, severe hospitalized

A 
Ampicillin/sulbactam 
Cefazolin 
Piperacillin/tazobactam 
Ticarcillin/clavulanate 
Imipenem/cilastatin, meropenem
27
Q

Invasive infections caused by Group A Streptococcus

A 
Acute lymphangitis
Erysipelas
Cellulitis
Streptococcal gangrene
Bacteremia, septicemia
28
Q

Toxin-associated Syndromes caused by Group A Streptococcus

A

Scarlet fever
Streptococcal toxic-shock-like syndrome
Streptococcal gangrene

29
Q 
Streptococci, Staphylococcus aureus
Predisposing: Surgery or drainage sinus
Fever: minimal
Pain: prominent
Anesthesia: absent
Crepitus: absent
Course: slow
A

Progressive Bacterial Synergistic Gangrene

30
Q 
Mixture of organisms: Bacteroides, peptostreptococci, or Escherichia coli
Predisposing: Diabetes
Fever: moderate
Pain: prominent
Anesthesia: absent
Crepitus: may occur
Course: rapid
A

Synergistic Necrotizing Cellulitis

31
Q 
Group A streptococci
Predisposing: Diabetes or abdominal surgery
Fever: high
Pain: prominent
Anesthesia: may occur
Crepitus: absent
Course: very rapid
A

Streptococcal Gangrene

32
Q 
Clostridium perfringens
Predisposing: Trauma
Fever: moderate to high
Pain: prominent
Anesthesia: absent
Crepitus: present
Course: extremely rapid
A

Clostridial Myonecrosis (gas gangrene)

33
Q

Rhizopus, Mucor, Absidia, Pseudomonas aeruginosa
Predisposing: Diabetes, corticosteroid use, immunosuppression, burn
Fever: Low in fungal, high in pseudomonal
Pain: prominent
Anesthesia: may occur
Crepitus: absent
Course: rapid

A

Necrotizing Infections in Immunosuppression

34
Q

Exogenous cutaneous TB

A

Primary inoculation tuberculosis

Tuberculosis verrucosa cutis

35
Q

Endogenous cutaneous TB, high immune status

A

Lupus vulgaris

Scrofuloderma

36
Q

Endogenous cutaneous TB, low immune status

A

Acute miliary tuberculosis
Orificial tuberculosis
Metastatic tuberculous abscess (tuberculous gumma

37
Q

Cutaneous TB due to BCG

A

Normal primary complex-like reaction
Perforating regional adenitis
Postvaccination lupus vulgaris

38
Q

Tuberculids: conditions in which Mycobacterium tuberculosis/bovis appears to play a significant role

A

Lichen scrofulosorum

Papulonecrotic tuberculid

39
Q

Facultative tuberculids: conditions in which M. tuberculosis/bovis may be one of several pathogenic factors

A

Nodular vasculitis/erythema induratum of Bazin

Erythema nodosum

40
Q

Nontuberculids: conditions formerly designated as tuberculids; there is no relationship to tuberculosis

A

Lupus miliaris disseminatus faciei
Rosacea-like tuberculid
Lichenoid tuberculid

41
Q

Lump with draining sinuses
Site: Cervicofacial, thorax, abdomen, pelvic
Source: Endogenous flora
Common with grains (Filamentous bacteria)
Stain: Gram-positive

A

Actinomycosis

Actinomyces israelii

42
Q 
Sporotrichoid, cellulitis
Site: Extremities (upper > lower)
Source: Environment
Rare with grains (Filamentous bacteria)
Stain: Gram-positive; Weak acid-fast bacillus
A

Nocardiosis

Nocardia brasiliensis, Nocardia asteroides

43
Q

Lump with draining sinuses
Site: Feet, back, extremities
Source: Environment
Always with grains (Filamentous bacteria)
Stain: Gram-positive; Weak acid-fast bacillus

A

Actinomycetoma
(Nocardia brasiliensis, Actinomadura
madurae, Actinomadura pelletieri, Streptomyces
somaliensis)

44
Q 
Lump with draining sinuses
Site: Feet mainly
Source: Environment
Always with grains (Hyphae)
Stain: Periodic acid-Schiff, Grocott
A

Eumycetoma

Madurella mycetomatis, Magnaporthe grisea, Pseudallescheria boydii

45
Q 
Lump with draining sinuses
Site: Hand, head, feet
Source: Environment
Always with grains (Cocci)
Stain: Gram-positive
A

Botryomycosis
(Staphylococcus aureus, Escherichia coli, Pseudomonas
aeruginosa)

Dermatology (26 decks)

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