Cellulitis and skin tx Flashcards Preview

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Flashcards in Cellulitis and skin tx Deck (43):
1

What is cellulitis?

Acute, spreading pyogenic inflammation of the dermis and subq tissue

2

What is cellulitis a complication of?

Wound or ulcer

3

Describe cellulitis feeling.

Warm, tender, swollen, and erythematous

4

Is cellulitis sharply demarcated from unaffected skin?

No

5

Who is affected by impetigo? And when?

Children
Hot, humid weather

6

What are some common signs of impetigo? What are they secondary to?

Puritis, scratching
Staph infection

7

How do you treat impetigo?

Benzathine PCN

8

How do you administer benzathine?

Single IM injection

9

What is staphylococcal scalded skin syndrome (SSSS)?

Severe manifestation of S. aureus infection

10

What is SSSS caused by?

Exfoliative exotoxin

11

Can SSSS produce epidemics? If so, where?

Yes, in neonatal nurseries

12

What is the rate of mortality for SSSS?

3%

13

How do you treat SSSS? What is the name of this drug?

Penicillinase resistant PCN
Nafcillin

14

What is folliculitis?

Pyoderma in the hair shafts

15

What is the etiology of folliculitis?

S. aureus
Pseudomonas
Candida

16

What is the tx for folliculitis?

Local/topical abx or antifungals

17

What is a furuncle?

Deep inflammatory nodule

18

What is a carbuncle?

Larger nodule that extends into subQ fat (abscess)

19

What causes furuncles and carbuncles?

S. aureus

20

What are predisposing factors for furuncles and carbuncles?

Obesity, blood dyscrasias, steroid tx, DM

21

Tx for furuncles and carbuncles

Antistaphlococcal abx
Clindamycin 150-300 mg po q6 hours (if PCN allergic)
Vancomycin, linezolid, or daptomycin (MRSA)

22

What were chancriform lesions previously associated with?

Wool and animal hides

23

What are chancriform lesions caused by?

Spores of Bacillus anthracis

24

Are chancriform lesions painless or painful?

Painless

25

What happens to the chancriform lesions as they grow??

They become hemorrhagic and necrotic

26

What is the tx for chancriform lesions?

Ciprofloxacin 500 mg po q12 h 7-10 days
(60 for bioterror)

27

What is erysipelas?

Its a distinctive type of superficial cellulits

28

What is erysipelas characterized by?

Prominent lymphatic involvement

29

Describe the characters of erysipelas.

Raised border, sharply demarcated

30

How do you treat early cases of erysipelas?

Penicillin
Pen V 250-500 mg po q 6
Erythromycin 250-500 mg po q 6

31

How do you treat extensive or hospitalized cases of erysipelas?

Pen G 2 mill units IV q 6
Nafcillin 2g IV q 4
Cefazolin 1-2 g IV q8

32

What are some initiating sources of cellulitis?

Skin trauma
Bites
Wounds
Hot tubs/pools
Edema

33

What % of cellulitis aspirates are gram + organisms, and what are some examples?

80%
S. aureus
Group A or B streptococci
Viridians streptococci
E. faecalis (rare)

34

Are cultures/bx useful for cellulitis?

Not really -> only really reveal typical skin flora
They are reserved for special cases

35

For diabetic pts what do you add to tx?

Anaerobic coverage

36

What areas does necrotizing fasciitis affect?

Extremities, abdominal wall, perianal, and groing

37

What is Fournier's gangrene?
What is the mortality rate?

NF of the genitalia
10-20%

38

What to gangrenous areas look like and feel like?

Swollen, hot, and VERY painful
*disproportionate pain is important clue*

39

Does NF progress slowly or rapidly? And over what period of time?

Rapidly over several days

40

What leads to the necrosis?

Thrombosed subQ vessels

41

What is something that can proceed NF?

Anesthesia

42

What is the mortality rate of NF?

20-50%

43

What abx do you give for NF?

Ampicillin, gentamicin, clindamycin, and metronidazole