Bacterial Skin Infections

Question 1

What is lymphangitis?

Answer 1

Red streaks extending proximally from areas of cellulitis

Question 2

Which organism is the most common cause of folliculitis

Answer 2

Staph aureus

Question 3

Which organism causes “hot tub folliculitis”

Answer 3

Psuedomonas

Question 4

Does folliculitis itch?

Answer 4

Yes

Question 5

Which is worse: a furuncle or a carbuncle

Answer 5

Carbuncle

Question 6

True or false:

Most cases of folliculitis are self limiting and do not require antibiotics

Answer 6

True

Question 7

What are the 3 variants of impetigo?

Answer 7

1. Nonbullous
2. Bullous
3. Ecthyma

Question 8

“Honey colored crusting”

Answer 8

Non bullous impetigo

Question 9

“Punched out” ulcers with overlying crust (look like cigarette burns)

Answer 9

Ecthyma

Question 10

Which organism usually causes Nonbullous and Bullous impetigo

Answer 10

staph aureus

Question 11

Which organism usually causes ecthyma

Answer 11

Strep

Question 12

What is the most common organism that causes cellulitis

Answer 12

B-hemolytic strep

Question 13

If cellulitis has purulent drainage, it is more likely to be caused by (strep/staph)

Answer 13

Staph

Question 14

What is this:

A superficial raised cellulitis with a sharply demarcated border. Tender, warm, and intensely erythematous

Answer 14

Erysipelas

Question 15

Which parts of the body are usually affected by erysipelas?

Answer 15

Cheeks

Legs

Question 16

Which bacteria is the main pathogen that causes erysipelas?

Answer 16

B-hemolytic strep (GAS)

Question 17

True or false:

Erysipelas is a form of cellulitis

Answer 17

True

Question 18

Best treatment for abscess

Answer 18

Incision and drainage

Question 19

Patients with erysipelas are (very sick/not sick)

Answer 19

Very sick

Question 20

Which bacteria most commonly causes abscesses?

Answer 20

Staph aureus

Question 21

Abscesses do not always require antibiotics after you drain them.

When DO they need antibiotics?

Answer 21

> 2cm or multiple abscesses

Toxic

Extensive cellulitis

Immunosuppression

Indwelling medical device

High risk for transmission (athlete, military)

Question 22

Risk factors for MRSA

Answer 22

Antibiotic use

Invasive device

Hospitalization

Group settings (miliatary, nursing home, etc)

Chronic wound

MRSA colonization in nose

Skin trauma (tattoo, IVDU)

Question 23

“I have a spider bite”

Answer 23

MRSA

Question 24

Oral antibiotics for MRSA

Answer 24

Bactrim

Doxycycline

Clindamycin

Question 25

risk factors for cellulitis

Answer 25

local trauma (bug bites, lacs, punctures) spread of preceding or concurrent skin lesion (furuncle, ulcer) preexisting skin infection (tinea pedis) inflammation (local dermatitis, radiation) edema and impaired lymphatics

Question 26

non-purulent cellulitis abx tx

Answer 26

tx for b-hemolytic strep (GAS) with: cephalexin amoxicillin augmentan clindamycin

Question 27

purulent cellulitis abx tx

Answer 27

call ID and tx for MRSA and strep with: clindamycin bactrim doxycycline + amoxicillin

Question 28

how many days do you need to give abx in cellulitis

Answer 28

5

Question 29

what could you use to decrease post inflammatory lymphatic damage by cellulitis

Answer 29

oral steroids

Question 30

for hospitalized pts w/ cellulitis, what tx should you consider

Answer 30

empiric tx for MRSA

Question 31

abx used to tx MRSA

Answer 31

IV vancomycin- DOC the rest have adverse effects/ are unreliable: linezolid doxycycline/ minocycline bactrim clindamycin

Question 32

pain, bright erythema, shiny, plaque like edema w/ sharply defined margins

Answer 32

erysipelas

Question 33

erysipelas has what associated sxs

Answer 33

chills, fever, HA, vomiting, joint pain, high white count

Question 34

erysipelas tx

Answer 34

empiric oral abx: Pen V amoxicillin clindamycin macrolide

Question 35

erythematous, warm, fluctuant nodule w/ several small pustules throughout surface, TTP

Answer 35

abscess

Question 36

what abx are recommended with abscess tx

Answer 36

clindamycin bactrim tetracycline hospitalized- vanco/ linezolid/ daptomycin

Question 37

acute, round, tender, circumscribed perifollicular abscess that ends in central pus

Answer 37

furuncle aka boil

Question 38

coalescence of several inflamed follicles into a single inflammatory mass w/ purulent drainage from multiple follicles

Answer 38

carbuncle

Question 39

furuncle/carbuncle tx

Answer 39

oral abx, warm compress, +/- I and D

Question 40

small, raised, erythematous, occasionally itchy pustules less than 5 mm

Answer 40

folliculitis

Question 41

can folliculitis be transmitted

Answer 41

genital folliculitis can

Question 42

folliculitis tx

Answer 42

clean w/ abx soap oral/ topical anti-staph (mupirocin) topical clindamycin +/- drainage

Question 43

is impetigo infectious

Answer 43

yes- easily

Question 44

common locations of bullous impetigo

Answer 44

face, extremities, diaper area

Question 45

in bullous impetigo, the bullae are ____ and when they rupture they leave a ___

Answer 45

in bullous impetigo, the bullae are FLACCID and when they rupture they leave a THICK BROWN CRUST

Question 46

tx of impetigo

Answer 46

oral abx

Question 47

rapidly progressing erythema, edema, fever, systemic sxs, crepitus, ecchymosis

Answer 47

necrotizing fasciitis

Question 48

what are poor prognostic factors associated w/ necrotizing fasciitis

Answer 48

delayed dx over 50 yo diabetes atherosclerosis infection involving trunk

Question 49

who do you immediately consult if you suspect necrotizing fasciitis

Answer 49

surgery- immediately

Question 50

is cellulitis dangerous

Answer 50

yes- untreated cellulitis can lead to sepsis and death

Question 51

abscess subtypes

Answer 51

furuncles and carbuncles