Chapter 26: Surgical Infections- MIsc.

Question 1

What is a “stitch” abscess?

Answer 1

• Subcutaneous abscess centered around a subcutaneous stitch, which is a “foreign body”
• treat with drainage and stitch removal

Question 2

Which bacteria can be found in the stool (colon)?

Answer 2

Anaerobic—Bacteroides fragilis

Aerobic—E. coli

Question 3

Which bacteria are found in infections from human bites?

Answer 3

• Streptococcus viridans
• S. aureus
• Peptococcus
• Eikenella (treat withAugmentin®)

Question 4

What are the most common ICU pneumonia bacteria?

Answer 4

Gram-negative organisms

Question 5

What is Fournier’s gangrene?

Answer 5

• Perineal infection starting classically in the scrotum in patients with diabetes
• treat with triple antibiotics and wide débridement—a surgical emergency!

Question 6

Does adding antibiotics to peritoneal lavage solution lower the risk of abscess formation?

Answer 6

No

Question 7

Which antibiotic is used to treat amoeba infection?

Answer 7

Metronidazole (Flagyl®)

Question 8

Which bacteria commonly infects prosthetic material and central lines?

Answer 8

S. epidermis

Question 9

What is the antibiotic of choice for Actinomyces?

Answer 9

Penicillin G (exquisitely sensitive)

Question 10

What is a furuncle?

Answer 10

Staphylococcal abscess that forms in a hair follicle (Think: Follicle = Furuncle)

Question 11

What is a carbuncle?

Answer 11

• Subcutaneous staphylococcal abscess (usually an extension of a furuncle)
• most commonly seen in patients with diabetes (i.e., rule out diabetes)

Question 12

What is a felon?

Answer 12

Infection of the finger pad (Think: Felon = Finger printing)

Question 13

What microscopic finding is associated with Actinomyces?

Answer 13

Sulfur granules

Question 14

What organism causes tetanus?

Answer 14

Clostridium tetani

Question 15

What are the signs of tetanus?

Answer 15

• Lockjaw
• muscle spasm
• laryngospasm
• convulsions
• respiratory failure

Question 16

What are the appropriate prophylactic steps in tetanus-prone (dirty) injury in the following patients:

Three previous immunizations?

Answer 16

None (tetanus toxoid only if >5 years since last toxoid)

Question 17

What are the appropriate prophylactic steps in tetanus-prone (dirty) injury in the following patients:

Two previous immunizations?

Answer 17

Tetanus toxoid

Question 18

What are the appropriate prophylactic steps in tetanus-prone (dirty) injury in the following patients:

One previous immunization or none?

Answer 18

Tetanus immunoglobulin IM and tetanus toxoid IM (at different sites!)

Question 19

What is Fitz-Hugh–Curtis syndrome?

Answer 19

RUQ pain from gonococcal perihepatitis in women

Question 20

Midline laparotomy wound that drains continuous straw-colored fluid

Answer 20

Fascial dehiscence

Question 21

POD #1 with bright red wound infection

Answer 21

Streptococcus infection

Question 22

POD #1 with painful wound and weeping bronze-colored fluid

Answer 22

Clostridial wound infection

Question 23

67-year-old male POD #5 s/p AAA repair with bloody diarrhea

Answer 23

Ischemic colitis

Question 24

80-year-old man s/p appendectomy with fever, right-sided facepain, and elevated WBCs

Answer 24

Parotitis