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Dermatology > Bacterial Skin Infections > Flashcards

Bacterial Skin Infections Flashcards

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1
Q

What is Impetigo

A

Contagious bacterial skin infection

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2
Q

Bacteria causing Impetigo

A

Staph aureus

Strep pyogenes

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3
Q

Who normally gets impetigo

A

Children

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4
Q

Impetigo can occur as a complication of what conditions

A

Eczema
Scabies
Insect bites

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5
Q

Presentation of impetigo

A

Well-defined honey-coloured lesions with erythematous bases around the nose and face

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6
Q

Ix for impetigo

A

Clinical diagnosis

+/- bacterial skin culture if treatment isn’t resolving

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7
Q

Tx of impetigo

A

Localised disease:
1. topical fusidic acid
2. topical retapamulin
If MRSA - topical mupirocin

Extensive disease:

  1. Oral flucloxacillin
  2. Oral erythromycin if pen allergic
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8
Q

What advice should be given to children with impetigo about attending nursery/school?

A

Excluded from school until lesions are crusted and healed, or 48h after commencing Abx treatment

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9
Q

What is cellulitis

A

Acute bacterial infection of the dermis and subcutaneous fat

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10
Q

Bacteria causing cellulitis

A

Staph. aureus

Strep. pyogenes (group A beta haemolytic strep)

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11
Q

Risk factors for cellulitis

A

any breaks in the skin, venous insufficiency/stasis

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12
Q

What is erysipelas

A

distinct form of superficial cellulitis with notable lymphatic involvement. Raised, sharply demarcated from uninvolved skin

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13
Q

Presentation of cellulitis

A

pain, swelling, erythema, warmth, systemic upset, +/- lymphadenopathy

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14
Q

Ix for cellulitis

A

FBC, swab of lesion if surface broken, blood cultures

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15
Q

Mx cellulitis

A

Flucloxacillin - MSSA

If pen allergic - Doxycycline

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16
Q

What is folliculitis

A

Inflammatory process involving any part of the hair follicle

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17
Q

Most common cause of folliculitis

A

Staph. aureus

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18
Q

Presentation of folliculitis

A

erythematous papules or pustules around hair follicles

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19
Q

What is furunculosis

A

an acute deep infection of the hair follicles

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20
Q

2 types of furunculosis

A

Boil > single hair follicle

Carbuncle > collection of hair follicles

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21
Q

Ix for folliculitis

A

Gram stain

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22
Q

Mx folliculitis if organism unknown

A

Benzoyl peroxide

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23
Q

Mx folliculitis is MSSA

A

Cefalexin

Flucloxacillin

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24
Q

Mx MRSA cellulitis

A

Vancomycin

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25
What is Bullous impetigo
Blistering impetigo - dermal inflammatory response
26
What can bullous impetigo progress to
Staphylococcal Scalded Skin Syndrome (SSSS)
27
What is Staphylococcal Scalded Skin Syndrome (SSSS)
Detachment within the epidermal layer by breaking down the desmosomes, caused by the exotoxins A and B which are released by Staph. aureus
28
Presentation of SSSS
widespread fluid filled blisters that are easily ruptured Nikolsky sign +
29
Are the mucous membranes affected in SSSS
No
30
Most common groups to get SSSS
children < 6 y immunosuppressed adults adults with renal failure
31
Ix for SSSS
Skin biopsy - shows intradermal separation
32
Histological appearance in TENS
separation along DEJ
33
Mx SSSS
Supportive care - rehydration, Mx of burns Tx of primary infection Parenteral Abx
34
What is necrotising fasciitis
Bacterial infection of subcutaneous tissue, spreading along fascial planes below the skin surface causing rapid tissue destruction
35
2 types/causes of necrotising fasciitis
1. Mixed anaerobes and coliforms | 2. Group A Strep infection
36
What does necrotising fasciitis NOT affect
the underlying muscle beneath fascia
37
presentation of necrotising fasciitis
pain +++, disproportionate to visible skin changes fever palpitations tachycardia hypotension
38
predisposing risk factors for causing necrotising fasciitis
``` Diabetes Mellitus Peripheral Vascular Disease Immunocompromised Chronic renal or hepatic insufficiency Herpes Zoster IVDU ```
39
How does bacteria get to the fascia in necrotising fasciitis
it is introduced to skin and soft tissue from minor trauma, puncture wounds or surgery
40
Ix for necrotising fasciitis
FBC, U+Es, CRP, CK, lactate | Blood + tissue cultures
41
Tx necrotising fasciitis
immediate surgical debridement + empirical broad spec Abx e.g. IV vancomycin + IV Tazocin
42
what is pitted keratolysis
a superficial bacterial skin infection affecting the soles of feet and sometimes palms of hands
43
cause of pitted keratolysis
corynebacteria
44
presentation of pitted keratolysis
smelly feet | white appearance with clusters of punched-out pits
45
treatment of pitted keratolysis
``` topical Abx - erythromycin clindamycin mupirocin fusidic acid ```
46
bacteria causing syphilis
treponema pallidum (spirochaete)
47
how many stages of syphilis is there
3
48
describe primary syphilis presentation
initially macule > papule > ulcerating to form hard chancre
49
how long after exposure to infection does primary syphilis occur
14-21 days
50
describe secondary syphilis presentation
symmetrical maculopapular rash over the body, non-itchy, prominent on soles of feet and palms generalised lymphadenopathy constitutional symptoms
51
describe tertiary syphilis presentation
gummas - granulomas in skin, mucosa, bone, joints, viscera
52
Ix for syphilis
swab of chancre for PCR
53
Tx of syphilis
IM injection of benzathine benzylpenicillin
54
What is Lyme disease
tick-borne infection by transmission of Borriela Burgdoferi
55
What shape is the Borriela Burgdoferi organism
spirochaete
56
explain the transmission process of Lyme disease
the tick gets the spirochaete from an infected host the infection is then transmitted to a new host via tick saliva
57
When is the chance of transmission of Lyme disease from an infected tick most likely to happen
after 48h
58
1st sign of Lyme disease
Erythema migrans - erythematous bullseye lesions - a circular rash beginning at the site of the tick bite that gradually expands
59
How soon does Erythema migrans resolve in Lyme disease
a few days after Tx | if untreated resolves within a month
60
How soon does Erythema migrans appear after tick bite in Lyme disease
around 14 days after the bite
61
2nd sign of Lyme disease
Borriela Lymphocytoma - firm blush/red swelling and tender, local lymphadenopathy
62
Most common locations for Borriela Lymphocytoma in Lyme disease
children - earlobe | adults - nipple
63
Non-cutaneous late features of Lyme disease
numbness/arthralgia/facial paralysis/meningitis/arrhythmia
64
3rd sign of Lyme disease
Acrodermatitis Chronica Atrophicans | - blue/red discolouration progressing to atrophy
65
How soon does Acrodermatitis Chronica Atrophicans appear after a tick bite in Lyme disease
6/12 months - 8 years after initial infection
66
Tx of Lyme disease
Solitary lesion - oral doxycycline or amoxicillin 2-3wk course Severe - IV penicillin/Ceftriaxone 14-21 days
67
Reaction that can be induced by Lyme disease treatment
Jarisch Herxheimer - fever, malaise, headache due to endotoxin release due to large numbers of organisms being killed

Dermatology (20 decks)

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