Canine Bacterial Pyoderma Flashcards by jared Jensen

What are the bacterial pyoderma syndromes (superficial)

1) Bacterial overgrowth

2) Superficial bacterial pyoderma

3) Acute moist dermatitis / pyotraumatic dermatitis (hotspots)

4) Canine recurrent bacterial pyoderma

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What are the different types of bacterial pyoderma syndromes (deep)

1) Mucocutaneous bacterial pyoderma

2) Deep bacterial pyoderma

3) Bacterial furunculosis

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What is #1 cause of bacterial pyoderma in dogs

Staph pseudintermedius

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What is underlying cause of majority of bacterial pyoderma

allergies
-inflammation of skin causes skin barrier to be compromised

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Types of commensal opportunitists

> 90% Staph

-Staph pseudintermedius is most common
-S. aureus (cats)
-S. schleifri
-S. epidermidis
-Coag negative?

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What is another name for skin fold pyoderma

Intertrigo

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What is another name for interdigital pyoderma

Pododermatitis

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Canine bacterial pyoderma is secondary to another issue. how do you determine this

Cytology (impression, acetate tape)

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What might cause bacterial overgrowth

the environment
-skin fold
-interditial

not many inflammatory cells (not breaking skin barrier) but will have high count

typically secondary to allergy or conformation

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How do you treat bacterial overgrowth

No need for systemics
use topical therapies preferred - use chlorhexidine 2-4%

typically secondary to allergy conformation

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What is a typical sign of bacterial overgrowth

Malodor

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What breed is predisposed to lip ofld pyoderma

german shepherd
st bernards

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What topical would you use for multifocal

shampoos or spreads

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acute manifestation of pruritic trauma

excoriation often secondarily infected

Acute moist dermatitis “hot spots”

also called pyotraumatic dermatitis

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Acute moist dermatitis is often secondary to

allergy

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acute moist dermatitis often occur where

facial lesions common
flanks

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How do you treat acute moist dermatitis

clip and clean

diagnose with cytology (impression smear)

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Superficial bacterial pyoderma is often

follicular (papules, pustules, epidermal collarettes)

if non-follicular (impetigo, pemphigus)

not due to trauma

often secondary to allergy

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Pustules that arent follicular

1) Pemphigus
2) Impetigo (puppies born in dirty environments)

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How do you treat superficial bacterial pyoderma

three weeks antimicrobial therapy (one week past resolution)

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For superficial bacterial pyoderma, how often should you bathe with antimicrobial shampoo

three times a week

(just as effective as 3 weeks of antimicrobials)

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What is most common cause of epidermal collarette

1) Bacterial pyoderma
2) Dermatophytosis
3) Demodecosis

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What are causes of recurrent bacterial pyogerma

1) Inadequate duration/dose re:therapy

2) Anatomic predisposition

3) Allergy

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What are causes of bacterial pyoderma

1) Allergy
2) Endocrinopathies
3) Immunocompromise
4) Congenital immuno-insufficiency (GSD)

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How do you treat recurrent bacterial pyoderma

1) Systemic antibiotics? 2) Topical therpay preferred 3x week 3) Twice weekly- maintenance therapy 4) Treat the primary cause (ie allergy, immunocompromise)

T/F: Staphylococcal bacterin vaccine works well

False

What might cause chronic bacterial pyogderma

1) Mucocutaneous bacterial pyoderma 2) Deep bacterial pyoderma 3) Bacterial furunculosis 4) Methicillin-resistant Staph -Culture interpretation and treatment options

Where does mucocutaneous pyoderma occur

Lip margins (cheilitis) Nasal planum (nares) Vulva Canthi/eyelids can mimic immune mediated disease (ie DLE)

What does mucocutaneous pyoderma look like

-Erythema -Crusting -Depigmentation -Fissuring (nasal planum): vasculitis (GSD) (looks like immune mediated ie DLE)

What are differentials for mucocutaneous pyoderma

Allergy Neoplasia (SCC) Immune mediated disease (DLE, MCLE)

T/F: histologic changes of mucocutaneous bacterial pyoderma are very simular to those of the lupus group of diseases like discoid lupus erythematosus

TRUE - biopsy is often ambiguous

How do you treat mucocutaneous pyoderma

Cytology to confirm (intracellular) bacteria 4-8 weeks of systemic antibiotics Culture highly recommended Mupirocin (gram +) topically BID Mandatory to do these things before biopsy

What should you do for mucocutaneous pyoderma before biopsy

1) Cytology to confirm (intracellular) bacteria 2) 4-8 weeks of systemic antibiotics 3) Culture highly recommended 4) Mupirocin (gram +) topically BID

T/F: yeast can be ingested by neutrophils

False - yeast cant be ingested by neutrophils

How do you confirm mucocutaneous pyoderma

intracellular bacteria

What are signs of deep bacterial pyoderma

Ulcers Hemorrhage Plaques/nodules

How do you treat deep bacterial pyoderma

4-6 weeks antibiotic therapy two weeks past resolution systemic preferred culture is highly recommended

How do you culture deep bacterial pyoderma

1) biopsy is preferred - 4mm biopsy punch trim off epidermis (on the top) 2) Squeeze from underneath - bacterial is pushed outwards and you can culture

exploded hair follicles often mistaken for foreign body can lead to deep secondary pyoderma

bacterial furunculosis

bacterial furunculosis typically occurs where

interdigital/ intertriginous spaces short-coated dogs

What typically causes bacterial furunculosis

typically allergy conformational possible

What is typically bacterial furunculosis typically mistaken as

foreign body

What does bacterial furunculosis typically look like

draining tracts pyogranulomatous inflammation fibrosis

How do you treat bacterial furunculosis

4-6 weeks systemic antibiotics two weeks past resolution topical antimicrobial prevention control underlying cause (allergy/orthopedic) cyclosporin- for chronic anti-inflammatories

Reasons why bacterial pyoderma will not resolve

1) Error in antibiotic selection 2) Dosage error 3) Inadequate duration of therapy 4) Lack of compliance 5) Resistance infection (above conditions are ruled out)

T/F: you cant tell difference between Methicillin susceptible staph vs resistant staph

True

What are risk factors for MRSP

-Previous history of antibiotic exposure -Fluoroquinolones -Previous clinic/hospital visits (community vs hospital acquired) -Primary disease (risk factor for pyoderm) -Immunocompromise

T/F: Methicillin-Resistant Staph has an identical appearance to susceptible pyoderma

True

T/F: Methicillin-Resistant Staph is more severe than susceptible

False - (aureus excluded?)

T/F: you can differentiate Methicillin-Resistant Staph on cytology

false you need to do a cuture

Methicillin-Resistant Staph is resistant to

all beta-lactam antibiotics (penicillins/cephalosporins)

What is needed for diagnosis of Methicillin-Resistant Staph

culture required

How is Methicillin-Resistant Staph transmitted

surfaces - not airborne

What lesions are most at risk for transmission of Methicillin-Resistant Staph

exudative lesions

Methicillin-Resistant Staph can be killed with

conventional bactericidal cleaners

How do you get culture sample for superficial vs deep bacterial pyoderma

Superficial: under crusts, pustules Deep: Draining tracts, ulcers, biopsy, squeezes

You need to always pair culture with

cytology

What are the indications for culture

1) Deep infection (tough to treat topically, prolonged course) 2) Mixed infection 3) Does not respond to anticipated treatment 4) Unable to treat topically (disseminated)

What should you use to treat bacterial pyoderma if not methicillin-resistant staph

Clindamycin or Cephalexin

What should you use to treat bacterial pyoderma if you are suspicious of methicillin-resistant staph

Clindamycin

On your lab results, what indicates Methicillin-Resistant Staph

Oxacillin - R

How do you treat Methicillin-Resistant Staph

slower to respond to therapy use culture reuslts one week past resolution (superficial) two weeks past resolution (deep)

How should you pick you antibiotic selection based on culture

1) Susceptible 2) Narrow-spectrum antbitoics preferred 3) Adverse effects 4) Ease of administration

What topical treatment should you use for methicillin-resistant staph

2-4% chlorhexidine shampoo/sprays/wipes/mousse three times weekly (more is better) contact time 5-10 minutes dilute bleach aceelerated hydrogen peroxide topical antibiotics -Mupirocin -Silver sulfadiazine -Aminoglycoside

What should you do for vigilance of methicillin-resistant staph

Isolation Environmental cleanup Difficult to transmit to healthy individuals carriage sites: anus, nose, mouth

Canine Bacterial Pyoderma Flashcards

(65 cards)