Cellulitis/Erysipelas/Necrotising Fasciitis/TSS Flashcards Preview

Paeds - Systemic > Cellulitis/Erysipelas/Necrotising Fasciitis/TSS > Flashcards

Flashcards in Cellulitis/Erysipelas/Necrotising Fasciitis/TSS Deck (13):
1

Common aetiology of cellulitis/erysipelas

- Commonly: Staph aureus, Group A beta-haemolytic strep (GABHS) - esp. erysipelas

2

Difference between cellulitis and erysipelas

- Erysipelas: upper dermis and superficial lymphatics
- Cellulitis: deeper dermis & subcut fat

3

Common features of cellulitis/erysipelas

• May have site indicating portal of entry e.g. eczematous, burn, laceration (but often not seen)
• More commonly lower extremities

• Erythema, oedema, warmth
• Itch and tenderness
• +/- exudate/crusting
• Erysipelas has well-defined border

4

How can you tell between peri-orbital and orbital cellulitis?

Orbital cellulitis involves ophthalmoplegia

5

Abx for cellulitis/erysipelas

• Flucloxacillin, cephalexin

6

DDx for cellulitis/erysipelas

- Impetigo
- SSSS
- Necrotising fasciitis
- Allergic reaction/contact dermatitis

7

What is necrotising fasciitis?

Rapidly spreading infection of deep layer of superficial fascia, characterised by necrosis of subcutaneous tissue

8

Most common cause of necrotising fasciitis?

• Group A strep (+/- toxic shock) in healthy children (staph aureus is possible)

9

Main clinical pearl for necrotising fasciitis

• Constitutional unwellness out of proportion to cutaneous signs – soft tissue swelling + violaceous or bluish vesicles and bullae.

10

Mx for necrotising fasciitis

• Urgent surgical referral for radical debridement
• Supportive therapy (consider Hyperbaric O2)
• IV antibiotics (fluclox, clinda)

11

What is TSS caused by?

Due to toxin produced by S. aureus or Group A streptococcus 

12

How does TSS usually occur?

- Tampon use
- skin and soft tissue infections 

13

What are key features of TSS?

- Macular rash
- Hypotension
- Soft tissue necrosis/fever