Bacterial Infections: Impetigo, Erysipelas, Folliculitis, Cellulitis, Intertrigo

Question 1

Impetigo

Answer 1

Common acute superficial bacterial infection, characterised by pustules and honey-coloured crusted erosions, peak onset is summer, common in children

Question 2

Causes of Impetigo

Answer 2

Staphylococcus aureus

Question 3

Ecthyma

Answer 3

A type of Impetigo that form deeper erosions of the skin into the dermis beneath were ulcers form

Question 4

Causes of Ecthyma

Answer 4

Streptococcus Pyogenes

Question 5

Risk factors for Impetigo

Answer 5

Atopic Eczema, Scabies, Skin trauma e.g. chicken pox, Insect bite, wound, burn, dermatitis

Question 6

Features of Impetigo

Answer 6

Exposed areas mainly affected i.e. face and hands, trunk, erineum, single or multiple, irritable superficial plaques, lymphadenopthy, mild fever and malaise

Question 7

Types of Impetigo

Answer 7

Non-bullous, Ecthyma, Bullous

Question 8

Non-bullous Impetigo

Answer 8

Staph/Strep invades minor trauma site
Starts as a pink macule to crusted eroisions
Resolves in 2-4 weeks without treatment

Question 9

Ecthyma Impetigo

Answer 9

Caused by Streptococcus Pyogenes
Starts as non-bullous to punched-out necrotic ulcer
Slow healing, leaves scar

Question 10

Bullous Impetigo

Answer 10

Staphy protiens infect skin by cleaving off epidermis
Starts as small vesicles to flaccid transparent bullae
Heals without scarring

Question 11

Complications of Impetigo

Answer 11

• Soft tissue infection e.g. cellulitis
• Staphylococcal scalded skin syndrome (EMERGENCY)
• Post-streptococcal glomerulonephritis

Question 12

Diagnosis Impetigo

Answer 12

Bacterial Swabs for cnonfirmation

Question 13

Treating Impetigo

Answer 13

• Clean wound with aseptic, cover affected area
• Oral antibiotics: flucloxacillin
• Children to avoid school until crust dies
• Anti-bacterial soap

Question 14

Cellulitis and Erysipelas

Answer 14

Spreading of bacterial infection involving deep subcutaneous tissue.

Erysipelas is an acute, superficial form only involving dermis and upper subcutaneous tissue

Question 15

Necrotising Fasciitis

Answer 15

• Affects skin, subcutaneous tissue, fascia and muscle
• Oedema beyond erythema
• More painful than cellulitis
• Crepitus on palpation
• Rapid progression

Question 16

Causes of Cellulitis and Erysipelas

Answer 16

Staphylococcus aureus, Streptococcus Pyogenes

Question 17

Risk factors for Cellulitis and Erysipelas

Answer 17

Fissure in toes and heels, venous disease, surgery, immunodeficiency, obesity, diabetes, pregnancy

Question 18

Features of Cellulitis and Erysipellas

Answer 18

Common in lower limbs, mostly unilateral, inflammatory signs, systemically unwell i.e. fever, malaise

Question 19

How is Erysipelas distinguished from Cellulitis

Answer 19

Well-define, red, raised border

Question 20

Complications of Cellulitis and Erysipelas

Answer 20

Local necrosis, abscess, septicaemia

Question 21

Diagnosing cellulitis and Erysipelas

Answer 21

Blood culture or wound swabs

Question 22

Antibiotics for Cellulitis and Ersipelas

Answer 22

Flucloxacillin, Benxylpenicillin

Question 23

Folliculitis

Answer 23

Group of skin conditions where hair follicles are inflamed. Acne is a type of Follicultis

Question 24

Causes of Folliculitis

Answer 24

• Staphylococcus Aureus
• Pseudomonal Aeruginosa ‘Spa Pool Folliculitis’
• Viral: HSV, Herpes Zoster
• Fungi: Candida, Tinea Capitis
• Occlusion
• Irritation

Question 25

Features of Folliculitis

Answer 25

Tender red spot, often with surface pustule. Superfical or deep. Anywhere with hair

Question 26

Types of Folliculitis

Answer 26

Acne Variants and Buttock Folliculitis

Question 27

Acne Variants

Answer 27

Acne vulgaris, Rosacae, Nodulocystic acne, scalp folliculitis

Question 28

Buttock Folliculitis

Answer 28

Usually bacterial, Common and non-specific, affects males and females equally

Question 29

Treating Follicuits

Answer 29

Bacterial: Tetracycline Viral: Aciclovir Fungal: Antifungal

Question 30

Intertrigo

Answer 30

Rash in flexures/body folds, may affect one or multiple sites, affects males and females of any age

Question 31

Risk factors for Intertrigo

Answer 31

Obesity, genetic tendency, hyperhidrosis

Question 32

Causes of Intertrigo

Answer 32

- Flexural skin has high surface temp - Moisture is stopped from evaporating due to folds - Friction from movement of fold skin can cause chafing - Bacteria and/or yeast multiply in warm, moist settings - -

Question 33

Types of Intertrigo

Answer 33

- Infectious: unilateral & asymmetrical - Inflammatory: bilateral, armpits, groin, under breasts and abdominal fold Acute, relapsing or chronic (>6 weeks)

Question 34

Complication of Intertrigo

Answer 34

- Soft tissue infection - Staphylococcal scalded skin syndrome - Post-streptococcal glomerulonephritis

Question 35

Treatment for Intertrigo

Answer 35

- Antiperspirant - Topical steroids: hydrocortisone - Calcineurin inhibitors e.g. tacrolimus