Chapter 151 - Cellulitis and Erysipelas

Question 1

Unilateral LE involvement is typical and systemic symptoms are usual.
True or False

Answer 1

False, usually absent

Question 2

Sharply demarcated, bright red, edematous plaques resulting from superficial lymphatic infiltration

Answer 2

Erysipelas

Question 3

Localized pustules or abscesses associated with cellulitis

Answer 3

Purulent cellulitis

Question 4

Classic signs of inflammation (4)

Answer 4

Rubor
Tumor
Calor
Dolor

Question 5

More than ___% of hospitalizations in US are due to cellulitis

Answer 5

10%

Question 6

Spreading, ill defined erythema, edema, often warm and painful

Answer 6

Classic cellulitis

Question 7

Presence of the ff (3) warrants concern for necrotizing soft tissue infection

Answer 7

1. Crepitus
2. Anesthesia
3. Pain disproportionate to clinical finding

Question 8

Frequent complication of cellulitis that increases risk of recurrence

Answer 8

Lymphedema

Question 9

Fever is more common in erysipelas than classic cellulitis.

True or False

Answer 9

True

Question 10

Important clues to diagnosis of orbital cellulitis (4)

Answer 10

Proptosis
Bulbar conjunctival edema
Ophthalmoplegia
Decreased visual acuity

Question 11

Risk factors for bilateral cellulits (2)

Answer 11

Deficient cellular immunity

1. Solid organ transplant recipients
2. HIV

Question 12

Portal of entry is identified in ___%

Answer 12

62

Question 13

MC etiology

Answer 13

Toe web infections

Question 14

Etiology of cellulitis from aquatic trauma (4)

Answer 14

Aeromonas spp
Erysipelothrix rhusiopathiae
Mycobacterium marinum
Vibrio vulnificus

Question 15

At greater risk for polymicrobial or atypical infections (3)

Answer 15

Surgical site infections
Pressure or diabetic ulcers
Cellular immunodeficiency

Question 16

Systemic risk factors for primary and recurrent cellulitis (4)

Answer 16

Age
Obesity
Systemic disease
Summer

Question 17

Local risk factors for primary cellulitis (2)

Answer 17

Lymphedema 70%

Disrupted skin barrier 24%

Question 18

The 2014 update to Infectious Diseases Society of America guidelines recommends routinely culturing blood or cutaneous aspirates or swabs.
True or False

Answer 18

False, does not

Question 19

ALT risk prediction for cellulitis (4)

Answer 19

Asymmetry 3
WBC >10,000 cells/ul 1
Tachycardia > 90bpm 1
70 y/o and older 2

Question 20

ALT -70 risk score of ___ has 83.3% likelihood of pseudocellulitis

Answer 20

0-2

Question 21

ALT -70 risk score of ___ has 83.3% likelihood of true cellulitis

Answer 21

> /= 5

Question 22

Skin surface temp gradient greater than __ on therma imaging has sensitivity if 96.6% for diagnosis of cellulitis

Answer 22

0.47 C

Question 23

The MC of pseudo cellulitis

Answer 23

Stasis dermatitis

Question 24

Genetic testing of ___ expression was 34 fold higher among cases with cellulitis

Answer 24

HLADQA1

Question 25

Recurrence occurs in more than ___% of patients

Answer 25

10

Question 26

1st line Tx for mild nonpurulent cellulitis

Answer 26

Cephalexin Dicloxacillin Pen V

Question 27

1st line Tx for moderate nonpurulent cellulitis

Answer 27

Cefazolin Ceftriaxone Pen G

Question 28

1st line Tx for severe nonpurulent cellulitis

Answer 28

Vancomycin | Piperacillin-Tazobactam

Question 29

1st line Tx for mild purulent cellulitis

Answer 29

``` MSSA 1. Cephalexin 2. Dicloxacillin MRSA 1. Clindamycin 2. Tetracycline 3. TMP SMX ```

Question 30

1st line for moderate purulent cellulitis

Answer 30

``` MSSA Oxacillin Nafcillin Cefazolin MRSA Clindamycin Vancomycin ```

Question 31

Criteria for SIRS (4)

Answer 31

36 < T> 38 C HR > 90bpm RR > 20 4,000 < WBC > 12,000

Question 32

In general, recommended duration of Tx for uncomplicated; immunosuppressed

Answer 32

5- 10 days | 7-14 days

Question 33

In IDSA guidelines, uncomplicated cases should be treated for; if signs of infection persist then should

Answer 33

5 days | Extend

Question 34

Significant involvement of lymphatics or superficial edema

Answer 34

Peau d’orange appearance

Question 35

MC site of cellulitis

Answer 35

Lower extremity

Question 36

MC site of erysipelas

Answer 36

Leg (76-90%)

Question 37

Small areas of spared intervening skin in cellulitis are termed as

Answer 37

Skip areas

Question 38

Inconsistent complication of cellulitis

Answer 38

Fever

Question 39

Most common etiology of cellulitis (2)

Answer 39

GABHS | S. Aureus

Question 40

Increase in both cellulitis and pseudocellulitis

Answer 40

ESR | CRP

Question 41

Reassessment at ___ is impt to assess response to therapy

Answer 41

24-72hrs