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Dermatology - Clinical Medicine IV > Bacterial Skin > Flashcards

Flashcards in Bacterial Skin Deck (65)
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1

What are the localized infections?

Folliculitis
Cellulitis
Erysipelas
Abscess
Impetigo

2

What are potentially lethal infections?

Necrotizing fasciitis
Clostridial myonecrosis (gas gangrene)

3

What is the treatment for impetigo?

may resolve on it own or progress to cellultitis or glomerulonephritis

4

What is the systemic abx for impetigo?

Dicloxacillin 250-500 mg po q4-6h x 5-10d

5

What is the topical meds for impetigo?

Mupirocin (Bactroban) – apply tid x 5-10d

6

What pt education do you need for give for impetigo?

hand washing, don't share towels, bed linens, wash lesions 2-3x a day or warm soaks

7

What are the general features of cellutitis and erysipelas?

varying degrees of skin or soft-tissue erythema, warmth, edema, and pain
associated fever and leukocytosis
history of trauma, abrasion, or skin ulceration (not reported by every patient)

8

How is celluitis on PE?

ill-defined border that merge smoothly with adjacent skin; usually pinkish to redish

9

What is erysipelas on PE?

elevated and sharply demarcated border with a fiery-red appearance

10

How do you dx celluitis and erysipelas?

clinically

11

What is the management of cellutitis and erysipelas?

local care - immoblize, elevate to reduce swelling
2 weeks of abx
-penicillin and dicloxacillin for most pt

12

What is the admission criteria for cellulitis?

Animal bite on patient’s face or hand
Area of skin involvement >50% of limb or torso, or >10% of body surface
Coexisting morbidity
(diabetes, heart failure, renal failure, generalized edema)
Edge of cellulitis advancing at rate >5cm/2 in, per hour
History of saphenous venectomy, pelvic surgery, pelvic irradiation, or neoplastic pelvic lymph nodes
(with lower extremity cellulitis)
Immunosuppression
Intolerance of oral or IM antibiotic therapy
Lack of response after 72 hours of oral therapy
Noncompliance with medication and follow-up visits
Purpuric or petechial rash, numbness at skin surface, or impaired tendon or nerve function
shock or disseminated intravascular coagulation
Signs and symptoms suggestive of bacteremia
Total WBC

13

What do you give for erysipleas most common?

pencillin V 500 mg po q6h

14

What do you give most common for cellulitis?

dicloxacillin 500 mg po q6h

15

What is inflammation of hair follicle that occurs as a result of various infections, or it can seconday to follicular trauma or occlusion?

Infectious folliculitis

16

What does infectious folliculitis looks like?

follicular based pustules, multiple small papules and pustules on an erythematous base that are pierced by a ccentral hair

17

What do deeper infectious folliculitis look like?

erythematous, often fluctuant, nodules

18

What orangism cause infectious folliculitis?

staphylococcus aureus

19

What is the topical treatment of infectious follicultis?

topical bactroban, dicloxacillin or cephalosporin first choice

20

What is chronic pustular staph infection of the beard?

pseudofolliculitis barbae

21

Who is pseudofollicuilits barbae more common in?

african americans

22

What is the treatment for pseudofollicultitis barbae?

skin cleanse, bacitracin, bactroban, erythro, diclox

23

What do you do for formed abscess?

I and D, give abx to immunocompromised (in real world give to all)

24

Streptococcal/Staph skin infection confined to epidermis

impetigo

25

infection of the skin and subcutaneous tissue. Flat lesions and edges are indistinct. Cause GAS

cellulitis

26

a type of cellulitis that is bright red, raised, with sharp borders.

erysipelas

27

What causes skin abscess?

s. aureus

28

What causes impetigo?

s. aureus, GAS

29

What are features of impetigo?

honey crusted lesions, kids get it, exposed areas, contagious

30

What are predisposing factors to impetigo?

poor hygiene, anemia, malnutrition, warm climates