Bacterial Disorders of skin

Question 1

Cellulitis Definition

Answer 1

acute inflammation of dermis and subcutaneous tissue

Question 2

Cellulitis Etiology

Answer 2

β-hemolytic streptococci (GABHS - pyogenes) (2/3)
Staphylococcus aureus (1/3)
Pseudomonas sp.
Haemophilus influenza

Question 3

Cellulitis Predisposing Conditions

Answer 3

DM (diabetes mellitus)
IV drug use
cirrhosis
renal failure
tinea pedis
immunosuppression
surgical wounds
chronic edema
bite

Question 4

Cellulitis Clinical features

Answer 4

unilateral
erythematous, warm, tender patch/plaque with irregular, ill-defined margins
fever, malaise, anorexia, chills, lymphadenopathy, systemic toxicity, lower extremity common

Question 5

Cellulitis Diagnosis

Answer 5

clinical presentation
cultures
occasional biopsy

Question 6

Cellulitis Differential diagnosis

Answer 6

stasis/contact dermatitis
superficial thrombophlebitis
deep venous clot

Question 7

Cellulitis Treatment

Answer 7

PO antibiotics
elevation
supportive measures
occasionally IV antibiotics (+/- I&D)

Question 8

Cellulitis Complications

Answer 8

sepsis
gangrene
lymphangitis
recurrence
chronic edema
endocarditis

Question 9

Cellulitis Prevention

Answer 9

support stocking
proper skin hygiene
early tinea pedis treatment

Question 10

Erysipelas Clinical features

Answer 10

"acute illness" phase
Unilateral
erythematous
raised
indurated
tender
warm
peau d' orange appearance 
sharp, elevated margins with predisposition for face, scalp, legs, abdomen
lymphangitis common

Question 11

Erysipelas Complications

Answer 11

sepsis; desquamation
chronic edema
lymphatic damage

Question 12

Erysipelas Definition

Answer 12

acute superficial infection of the dermis (superficial subset of cellulitis)

Question 13

Erysipelas Diagnosis

Answer 13

clinical appearance
cultures
neutrophilic leukocytosis

Question 14

Erysipelas Differential diagnosis

Answer 14

contact dermatitis
thrombophlebitis
drug reaction
erythema migrans

Question 15

Erysipelas Etiology

Answer 15

group A B-hemolytic streptococcus (pyogenes)

Question 16

Erysipelas Predisposing conditions

Answer 16

malnutrition
EtOH
IV drug use
stasis dermatitis
lymphedema
DM

Question 17

Erysipelas Treatment

Answer 17

aggressive antibiotics
supportive/symptomatic
treat other skin conditions (+/- I&D)

Question 18

Impetigo Clinical features

Answer 18

initial vesicle/pustule - ruptures and dries forming –honey-colored” crust with characteristic stuck on appearance
clustered or polycystic
occur anywhere
various stages seen

Question 19

Impetigo Complications

Answer 19

post-strep glomerulonephritis
secondary infection
guttate psoriasis (rheumatic fever?)

Question 20

Impetigo Definition

Answer 20

an acute, very contagious, superficial bacterial skin infection

Question 21

Impetigo Diagnosis

Answer 21

appearance

cultures

Question 22

Impetigo Differential diagnosis

Answer 22

varicella
herpes simplex
tinea corporis

Question 23

Impetigo Etiology

Answer 23

Staphylococcus aureus&raquo_space; B-hemolytic streptococcus

Question 24

Impetigo Predisposing conditions

Answer 24

preexisting skin disease/minor breaks
insect bites
head lice
trauma/burns
poor hygiene
staphylococcal colonization
incisional sites
warm/moist climates

Question 25

Impetigo Prevention

Answer 25

adequate hygiene

Question 26

Impetigo Treatment

Answer 26

local - topical cream/ointment; vinegar wet dressings widespread - PO antibiotics recurrent - swab/treat for colonization

Question 27

Toxic Shock Syndrome CDC definition

Answer 27

``` fever diffuse rash mucus membrane hyperemia hypotension at least 3 organ systems involved (see Habif; Box 10.2; p. 310) ```

Question 28

Toxic Shock Syndrome Clinical features

Answer 28

``` RAPID ONSET acute fever > 102 F hypotension myalgias rash + mucous membranes organ failure desquamation ```

Question 29

Toxic Shock Syndrome Complications

Answer 29

death

Question 30

Toxic Shock Syndrome Definition

Answer 30

acute toxin-mediated illness (menstrual & non-menstrual) | MEDICAL EMERGENCY

Question 31

Toxic Shock Syndrome Diagnosis

Answer 31

``` clinical findings blood culture gram stain biopsy CDC criteria ```

Question 32

Toxic Shock Syndrome Differential diagnosis

Answer 32

``` Scarlet fever pelvic infection septic abortion rubeola rheumatic fever ```

Question 33

Toxic Shock Syndrome Etiology

Answer 33

S. aureus (tampon use) | Strep pyogenes strains can also be toxin-producing

Question 34

Toxic Shock Syndrome Predisposing conditions

Answer 34

``` tampon use wounds cellulitis other infection foreign body (FB) ```

Question 35

Toxic Shock Syndrome Treatment

Answer 35

remove FB early empiric IV antibiotics supportive care ICU

Question 36

Cellulitis Distribution

Answer 36

Lower extremity most common location