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Bacterial Skin Diseases Flashcards

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1
Q

Resident bacteria vs transient bacteria?

A
  • Resident - live/multiply on normal skin and hair shafts
  • Transients - grow on/in damaged, unhealthy skin and can become pathologic
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2
Q

Where does Staphylococcus pseudointermedius live on the body normally?

A
  • Normal Flora of:
    • mouth
    • nares
    • inguinal areas
    • perianal areas
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3
Q

What is the most common bacterial pathogen of canine skin?

A

Staphylococcus pseudointermedius

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4
Q

How do staphylococcal bacteria become methicillin-resistant

A
  • Acquire mecA gene - encodes for a low affinity penicillin-binding protein (PBP2a) that results in impaired binding of beta-lactam antibiotics
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5
Q

What diagnostic tests can be ran to determine skin disease cause?

A
  • Cytology (impression smears - bacteria)
  • Bacterial culture and sensitivity (species ID)
  • Skin scraping (ectoparasites)
  • Fungal cultures (fungal infection)
  • tests for endocrinopathies (hypothyroidism/hyperadrenocorticism)
  • Allergy tests (secondary pyoderma)
    • Diet trial (food allergy)
  • Skin biopsy
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6
Q

When should bacterial skin disease have culture & sensitivity completed?

A
  • Deep infections
  • Infections that are poorly responsive to antibiotics
  • When rods are seen in impression smears
  • History of methicillin-resistant Staphylococcus
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7
Q

What antibiotic is commonly used for systemic therapy for skin diseases?

A
  • 1st gen cephalosporins (initially/empirically)
  • Amoxi-clav (some cases)
  • Fluoroquinolones
  • Lincosamides
  • Potentiated slfonamides
  • Chloramphenicol, Doxy, Minocycline, rifampin
    • for MRSA based on C&S
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8
Q

What topical therapies exist for bacterial skin infections? how do they work

A
  • Shampoos, conditioners, sprays, ointments,….
  • Active ingredients:
    • chlorhexidine
    • benzoyl peroxide
    • ethyl lactate
    • triclosan
    • bleach
  • Shampoos need 10-15mins contact time
    • Bathe at leat 2x weekly initially
    • massage helps remove scale, exudate, debris and trapped bacteria
    • after rinsing, dry thoroughly
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9
Q

What is “glycotechnology”

A
  • Microbial lectins are on the surfaces of yeast and bacteria
    • Lectins recognize sugars on the keratinocyte surface leading to adherence
  • Exogenous sugars/carbs (in the shampoo) saturate fungal/bacterial lectin binding sites
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10
Q

What are the effects of Benzoyl Peroxide?

A
  • Antibacterial
  • “follicular flushing”
  • Keratolytic
  • Degreasing
  • Drying
  • Irritating
  • Bleaching effect
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11
Q

What are the effects of Chlorhexidine?

A
  • antibacterial
  • Antifungal
  • Non-drying
  • Nonirritating (usually)
  • Best for methicillin-resistant Staphylococcus
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12
Q

What is Pyoderma

A
  • Bacterial skin infection
  • can be primary or secondary
  • classified by location on skin
    • surface
    • superficial
    • deep
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13
Q

What are the common underlying causes of secondary pyoderma

A
  • Allergic dermatitis
  • seborrhea
  • endocrinopathies
  • ectoparasitism
  • autoimmune conditions
  • other skin conditions
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14
Q

What are the common Surface bacterial skin infections?

A
  • Pyotraumatic dermatitis
  • Intertriginous pyoderma
    • between skin folds
  • Bacterial overgrowth syndrome (surface to superficial)
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15
Q

What is Bacterial overgrowth syndrome?

A
  • Surface to superficial bacterial skin infection
  • Typical features of pyoderma (papules, collarettes, pustules, crusts) are lacking
  • May only have erythema and pruritus
  • Topical therapy alone may be effective
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16
Q

What are common superficial pyodermas?

A
  • Superficial bacterial folliculitis
  • Mucocutaneous pyoderma
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17
Q

What are the signs/symptoms of Superficial Bacterial Folliculitis

A
  • Follicular papules
    • less commonly pusules
  • Crusts
  • epidermal collarettes
  • hyperpigmentation
  • erythema
  • patchy “moth eaten” alopecia in short-coated dogs
  • Generalized or localized (abdomen, inguinal areas, axillae, caudal thighs)
  • some are very pruritic
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18
Q

What is the treatment for Superficial Bacterial Folliculitis?

A
  • Topical antibacterials
    • Shampoos
    • Rinses, sprays
    • Creams, gels
    • topical therapy alone may be effective
  • Systemic anibiotics may be needed
    • 3 week course (or longer)
  • Evaluate for underlying causes in recurrent cases
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19
Q

What are the signs/symptoms of Mucocutaneous Pyoderma

A
  • Lips become swollen, erythematous, and crusted
    • Commissures of the lips may especially be affected
  • May involve eyelids, nares, anus
  • May resemble autoimmune conditions (especially DLE)
  • Systemic antibiotic therapy may be needed
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20
Q

What are types of Deep Pyodermas?

A
  • Deep folliculitis, furunculosis and cellulitis
  • Canine acne
  • Bacterial pododermatitis
  • German shepherd folliculitis, furunculosis and cellulitis
  • Abscess
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21
Q

What is the treatment for Deep Pyodermas?

A
  • Long course of systemic antibacterial therapy
    • 4-6 weeks or longer
  • Topical antibacterial therapy should be used adjunctively
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22
Q

What are abscesses commonly caused by?

A
  • Commonly caused by cat bites
  • Pasteurella multocida commonly isolated
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23
Q

What are some Nontuberculous Mycobacteriosis?

A
  • Feline Leprosy signs
  • Canine Leproid Granuloma Syndrome
  • Opportunist Mycobacterial Infections
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24
Q

What is canine leproid granuloma

A
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25
How do dermal infections occur? (MOA)
* Surface adhesion molecules bind host surface receptors on keratinocytes * ⇢ bacterial colonization of keratinocytes * ⇢ bacterial skin infection * form “biofilms” to help protect the bacteria
26
What bacteria are associated with TSS in dogs?
* Staphylococcal spp. * Streptococcoal spp. * *Streptococcus canis*
27
Why is MRSA / MRSP a huge concern?
* Interspecies transmission can occur * Animals/People can be carriers w/ no signs of illness
28
How is methicillin resistance tested for?
bacterial sensitivity to oxacillin
29
How does the skin protect itself?
* Stratum corneum is a physical and chemical barrier * sebum, sweat, fatty acids * Epidermal cells secrete antimicrobial peptides (AMPs) ⇢ help maintain healthy skin
30
What factors predispose animals to bacterial skin infections?
* Allergic dermatitis * Ectoparasites * endocrinopathies * environmental conditions (i.e humidity) * short hair coat * irritants * Seborrhea
31
Why is pyoderma common in dogs?
* thin stratum corneum * less intercellular lipids * alkaline pH
32
Which drugs used for pyoderma are bactericidal?
* Cephalexin and Cefadroxil (1st gen cehpalosporins) * Cefpodoxime (extended-spectrum cephalosporin) * Cefovecin (extended-spectrum cephalosporin) * Amoxicillin-clavulanic acid * Enrofloxacin * Orbifloxacin * Pradofloxacin * Marbofloxacin * Trimethoprim-sulfonamides (can be) * Chloramphenicol (high dose) * Rifampin
33
Which drugs commonly used for pyoderma are bacteriostatic?
* Clindamycin * Lincomycin * Chloramphenicol * Doxycycline * Minocycline
34
What is astringent therapy?
* Aluminum acetate (Domeboro's solution) * Dry agent for certain moist lesions * e.g. ‘Hot spots’
35
How is primary pyoderma differentiated from secondary pyoderma?
* No apparent underlying cause of pyoderma * Usually occurs in otherwise healthy skin * Can be cured with appropriate therapy * Less common
36
How is secondary pyoderma differentiated from primary pyoderma?
* Underlying causes include allergic dermatitis, seborrhea, ectoparasitism * Affects already diseased/damaged skin * More than one species of bacteria may be isolated * Therapy may be less effective and treatment of the underlying cause is necessary * More common
37
What is surface pyoderma? examples?
* On skin surface only * Ex: * Intertrigo (skin fold dermatitis) * pyotraumatic dermatitis ‘Hot spot’
38
What is superficial pyoderma?
* Involves the epidermis and follicular epithelium * Usually heals without scarring * Usually doesn't involve regional lymph nodes and rarely produces systemic signs * Very common in dogs
39
What is Deep pyoderma
* Involves the dermis and/or subcutaneous tissue * May heal with scarring * Often long, chronic course and may see systemic signs
40
What are common surface bacterial infections?
* Pyotraumatic Dermatitis * Intertriginous Pyoderma * Bacterial Overgrowth Syndrome
41
What is Pyotraumatic dermatitis? Why does it happen?
* Acute moist dermatitis ‘Hot Spot’ * Intense inflammatory reaction * Surface bacterial colonization occurs * Predisposing factors: * scratching/chewing * ectoparasites, matted coat, allergies, trauma, foreign bodies, otitis, etc) * Increased moisture of skin * Thick-coated dogs in warm, humid weather
42
What are the clinical signs of pyotraumatic dermatitis
* Well-demarcated, erythematous, moist lesion * Very pruritic and often painful * Acute onset *
43
How is Pyotraumatic Dermatitis diagnosed?
* History * Clinical signs * Impression smear cytology to assess for concurrent pyoderma
44
How is Pyotraumatic Dermatitis diagnosed?
* Clip and Clean (chlorhexidine, weak providone-iodine) * Drying agents/astringents * Topical medication containing an antibiotic and steroid * Short course (days) of systemic corticosteroids to relieve intense pruritus and irritation
45
What is intertriginous Pyoderma?
* Skin fold dermatitis or Intertrigo * Predisposing factors: * breed * Conformation * poor husbandry
46
What are the clinical signs of intertriginous pyoderma?
* Skin folds are erythematous, eroded or ulcerated * Lip folds (spaniels) * facial folds (brachycephalic breeds) * vulvar folds * corkscrew tails * body folds (Shar Pei, obese dogs) * Odiferous * Often pruritic * +/- pain
47
How is Intertriginous pyoderma diagnosed?
* Clinical presentation * Impression smear of fold
48
What is the treatment for Intertriginous pyoderma
* Medical management (keep folds clean/dry) * Topical antibacterials * antifungals if yeast is present * Systemic antibiotics may be needed initially, in severe cases * Surgical correction to remove folds may be considered
49
What is Bacterial Overgrowth Syndrome (BOG Syndrome)? why does it occur?
* Can be surface to superficial pyoderma * Hyperproliferation of bacteria (usually *S. pseudointermedius*) * cocci adhere to and colonize corneocytes * Fairly common * Usually secondary to underlying skin disease * especially allergic dermatitis
50
What are the clinical signs of BOG Syndrome?
* Erythema * hyperpigmentation * lichenification * Usually do Not have papules or crusts * Pruritus * Distribution is mainly ventral
51
How is BOG syndrome diagnosed?
* Clinical presentation * Impression smear cytology
52
What is the treatment for BOG syndrome?
* Topical antiseptic shampoos and rinses * systemic antibiotic therapy may be necessary
53
What is Superficial Bacterial Folliculitis? How does it develop?
* Bacterial infection of the superficial portion of the hair follicle and adjacent epidermis * Lead to destruction of the hair with resulting alopecia * Can progress to hair follicle rupture (furunculosis ) leading to deep pyoderma * Usually *Staph. Pseudointermedius* * Usually secondary to other skin diseases
54
How is Superficial Bacterial Folliculitis diagnosed?
* Cytology * Culture (not usually necessary initially when cytology shows cocci) * Biopsy (especially to evaluate for underlying causes in certain cases) * Rule out other causes of folliculitis * especially demodicosis and dermatophytosis
55
What is the etiology of mucocutaneous pyoderma
unknown
56
What are the clinical signs of Mucocutaneous Pyoderma
* Lips become swollen, erythematous, and crusted * Erosions and ulcers may occur in severe cases * May also see lesions on the eyelids, nares, anus
57
How is mucocutaneous pyoderma diagnosed
* Clinical presentation * Cytology * Biopsy is sometimes done
58
What is the treatment for Mucocutaneous pyoderma?
* Topical antibacterial ointments * Systemic antibiotic therapy is usually required
59
What are the common deep pyodermas
* Deep Folliculitis, Furunculosis, and Cellulitis * Canine Acne (muzzle folliculitis and furunculosis) * Bacterial Pododermatitis * German Shepherd Dog Folliculitis, Furunculosis and Cellulitis * Feline Abscessation (cellulitis)
60
What is Deep Folliculitis, Furunculosis, and Cellulitis?
* Hair follicle rupture and spread of infection into dermis * Usually *Staph pseudointermedius* * Usually associated with underlying cause(s)
61
What are the clinical signs of Deep Folliculitis, Furunculosis, and Cellulitis?
* Papules and pustules * +/- Hemorrhagic bullae * +/- Fistulae/oozing tracts * Circular areas of erythema, scaling, crusting, and alopecia * Variable pruritus * More common in dogs * deep pyoderma of pressure points in large/giant breeds) * Feline deep pyoderma is Rare * chin acne may progress to furunculosis
62
How is Folliculitis, Furunculosis, and Cellulitis diagnosed?
* Cytology (neutrophils usually predominate) * C&S (deep pyos should be cultured!) * Biopsy (histopath and deep tissue culture) * Evaluate for underlying cause * immunodeficiency, endocrinopathy, etc * Rule out other causes of similar signs: * demodicosis * dermtophytosis * etc
63
What is the treatment for Folliculitis, Furunculosis, and Cellulitis?
* Systemic antibiotics for 4-6 weeks * + 2-3 weeks beyond clinical resolution * Warm soaks/Whirlpools may help * Adjunctive topical antimicrobial shampoos and rinses * Correct underlying cause(s)
64
What is Canine Acne? why does it develop?
* Muzzle folliculitis and furunculosis * Common inflammatory disorder, usually associated bacterial infection * affect young dogs (\<6mo) * Affects areas rich in sebaceous glands (chin, lips) * Hair impaction/trauma may be initiating cause * Folliculitis may progress to furunculosis or cellulitis
65
What are the clinical signs of Canine Acne?
* Papulopustular eruptions * may ooze bloody, purulent discharge
66
How is Canine Acne Diagnosed?
* Clinical signs are suggestive * Cytology (neutrophils, macrophages, eosinophils, may not see many bacteria) * Culture * Possible biopsy (usually not needed) * Rule Out: demodicosis, dermatophytosis, contact dermatitis (uncommon)
67
What is the Treatment for Canine Acne?
* Topical antibacterials * Systemic antibiotic therapy is necessary for advanced cases * Mild cases may regress with sexual maturity * Topical corticosteroids my help prevent recurrence * decrease the inflammatory reaction
68
What is Pododermatitis? Why does it occur?
* Dermatitis of the feet * Numerous etiologies, may occur as a result of underlying causes such as: * bacterial infection * parasitism (demodicosis) * fungal infections * allergies * immune mediated conditions * Irritation * Trauma * Foreign bodies * Furunculosis may develop * Rare in cats
69
What are the clinical signs of Pododermatitis?
* One or all feet * Interdigital pustules, papules, nodules, hemorrhagic bullae * may have fistulae and interdigital cystic-like lesions * Serosanguineous and/or purulent exudate * Feet may be swollen and painful
70
How is Pododermatitis diagnosed?
* Physical Exam * Cytology * Culture * Possible biopsy * Work-up for possible underlying etiologies
71
What is the treatment for Pododermatitis?
* Long term systemic antibiotics based on C&S * Antibacterial soaks/whirlpools * especially w/ oozing, exudative tracts * Surgical debridement, drainage, and curettage may be necessary * Sterile dermal granulomas may develop after the infection has resolved * may then respond to therapy such as prednisone or cyclosporine * Correct underlying cause
72
What is German Shepherd Dog Folliculitis, Furunculosis and Cellulitis?
* Heritable defect * possibly autosomal recessive * Uncommon condition * once it occurs, relapses are common * Immunodeficiencies have been demonstrated (lymphocyte subset and immunoglobulin abnormalities, defects in cell-mediated immunity) * hypothesis: exaggerated tissue response to shaphylococci triggering release of inflammatory mediators * Lesions triggered by an insult to the skin or occur spontaneously
73
What are the clinical signs of German Shepherd FFC?
* Middle age dogs, males at increased risk * Lesions are papules, pustules, crusts * ALopecia, hyperpigmentation, ulceration and fisulae as disease progresses * Distribution: * back, rump, ventral abdomen and thighs * may become generalized * May have some degree of pruritus * Lesions may be painful
74
How is German Shepherd FFC diagnosed?
* Physical exam (distinctive distribution pattern) * Cytology * Culture * +/- Biopsy * Evaluate for underlying disease * Rule out other dermatoses that cause papules and crusting
75
How is German Shepherd FFC treated?
* Clip and bathe with antibacterial shampoo, whirlpools * _Long_ term systemic antibiotics * Immunomodulatory therapy (certain cases) * May relapse when antibiotics discontinued * may require maintenance therapy * Resolve possible trigger factors/other skin disease
76
What is Cat Abscessation?
* Abscess - Focal accumulation of pus * Cellulitis - diffuse dermal and subcutaneous infection * Common in cats * Secondary to cat bite wounds * *Pasteurella multocida* common isolate
77
What are the clinical signs of Feline Abscessation
* Signs vary from classic, focal abscess to asymptomatic swelling * Commonly: face, limbs, tail base, back * Very painful * +/- Fever * Other signs: * pyothorax * osteomyelitis * septic arthritis * sinusitis * bacteremia
78
How is Cat abscessation diagnosed
* Physical exam * Cytology * Culture
79
What is the Treatment for Cat Abscessation?
* Drainage and flushing * warm packs * Topical antiseptics/antibiotics * Systemic antibiotic
80
What are examples of Nontuberculous Mycobacteriosis? (mycobacterium infections that is _not_ tuberculosis)
* Feline leprosy * Canine leproid granuloma * Opportunistic Mycobacterial Infections (Atypical Mycobacterial Infections)
81
WWhat is Feline Leprosy caused by?
* *Mycobacterium lepraemurium*, and others species (Aerobic, acid-fast bacilli) * Rare * Transmitted by rodent bites and insect vectors
82
What are the clinical signs of Feline Leprosy
* Cutaneous or subcutaneous nodules or plaques * Lesions may be solitary or multiple * Lesions may be ulcerated * Head and limbs are often affected * Rarely disseminates to organs
83
How is Feline Leprosy diagnosed?
* Cytology (acid-fast stains) * PCR * Biopsy - intact nodules if possible * Culture is _very difficult_
84
What is the treatment for Feline Leprosy
* Wide surgical excision with antimicrobial therapy * Combination therapy with antibiotics such as rifampin, clarithromycin, pradofloxacin
85
What causes Canine Leproid Granulomas?
* Uncommon * Inoculation route unknown - biting insects?
86
What are the clinical signs of Canine Leproid Granuloma
* Short-coated breeds * Cutaneous or subcutaneous granulomatous or pyogranulomatous nodules are often located on the head and dorsal fold of the pinnae * Otherwise healthy
87
How is Canine Leproid Granulomas diagnosed
* Cytology (acid-fast) * PCR * Biopsy
88
What is the treatment for Canine Leproid Granuloma?
* Most spontaneously resolve w/in 3 months * cell-mediated immune response by host
89
What are Opportunistic Mycobacterial Infections?
* Uncommon/Rare infections of dogs/cats * Nontuberculous mycobacteria - aerobic, acid-fast bacilli * *Mycolicibacterium fortuituitum* * *Mycolicibacterium phlei* * *Mycolicibacterium smegmatis* * *Mycobacteroides chelonae/abscessus* * *M. thermoresistable* * Bacteria inhabit soil/water ⇢ contaminate broken skin and wounds
89
What are the clinical signs of Opportunistic Mycobacterial Infections?
* Dermal and subcutaneous nodules, ulcers, fistulae * Lesions frequently located on the ventrum, lumbar region and extremities
90
How are Opportunistic Mycobacterial Infections diagnosed?
* Cytology * Culture (exudate from aspirates of affected tissue) * Biopsy (special stains, PCR testing)
91
How are Opportunistic Mycobacterial Infections treated?
* Surgical excision of affected tissue * Antimicrobial therapy (empirical until C&S results) * Doxycycline * Fluoroquinolones * Clarithromycin * Treated fir 3 - 12 _months_
92
Do cats/dogs get Tuberculosis?
* Rare * *Mycobacterium tuberculosis* & *M. tuberculosis bovis* * Airborne transmission and ingestion of unprocessed meat/milk * Clinical signs: * respiratory signs * Digestive signs * Cutaneous nodules and ulcers * Public Health Hazard - euthanasia recommended

Medicine I (43 decks)

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