Exam 3 - Skin & Soft Tissue Infection Flashcards

(35 cards)

1
Q

what are the 3 types of SSTIs

A

Non-purulent
Purulent
Necrotizing Fasciitis

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2
Q

describe non purulent

A

epidermis + no pus
tender, erythema, swelling, warm to touch
orange peel skin

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3
Q

cultures in non purulent?

A

non routine, saved for severe or immunocompromised

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4
Q

what are the classifications of non purulent

A

mild, moderate, and severe

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5
Q

how to classify mild non-purulent

A

no systemic signs of infection

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6
Q

how to classify moderate non purulent

A

systemic signs

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7
Q

how to classify sever non purulent

A

2 or more SIRs criteria

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8
Q

what is SIRs criteria

A

Temp >38 or <36
HR > 90 BPM
RR > 24 BPM
WBC > 12k or < 4k

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9
Q

what are the causative pathogens of non purulent

A

streptococcus spp.
MRSA if needed

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10
Q

how long do you treat non purulent

A

5 days at least

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11
Q

how to treat mild non purulent

A

oral ABXs
pen VK
cephalosporins
clindamycin

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12
Q

how to treat moderate non purulent

A

IV ABXs
penicillin
ceftriaxone
cefazolin
clindamycin

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13
Q

how to treat severe non purulent

A

surgery/debride then empiric vanc + pip/tazo

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14
Q

describe purulent

A

abscesses/furuncles/carbuncles
tender, red nodules, erythema

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15
Q

cultures for purulent?

A

wound is recommended if systemic and get an image to confirm abscess

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16
Q

what is the classification of purulent

A

same as non purulent

17
Q

what are the causative pathogens for purulent

A

MRSA
MSSA
Streptococcus

18
Q

how long to treat purulent

A

at least 5 days

19
Q

how to treat mild purulent

20
Q

how to treat moderate purulent

A

empiric: TMP/SMX or doxy
MRSA: TMP/SMX or doxy
MSSA: Cephalexin

21
Q

how to treat severe purulent

A

empiric: vanc or dapto or linezolid
MRSA: same as empiric
MSSA: nafcillin or cefazolin or clindamycin

22
Q

describe necrotizing fasciitis

A

profound systemic toxicity
changing color of skin, cracking, edema, pain

23
Q

cultures for nec?

A

do blood and wound cultures w/ imaging

24
Q

what are the causative pathogens for nec

A

either monomicrobial or polymicrobial
-strep spp.
-CA MRSA
-Vibrio vulnificus
-Aeromonas hydrophila
-Peptostreptococcus
-Clostridium perfringens

25
treatment duration of nec
treat until no more debridement, improved clinically, fever absent 48-72 hours
26
how to treat nec
empiric: vanc + pip/tazo s. pyogenes: penicillin + clindamycin polymicrobial: vanc + pip/tazo
27
why is clindamycin used in nec
inoculum effect clears path to cell wall for penicillins
28
are cultures needed for impetigo
no
29
what are you trying to cover in impetigo
strep and staph aureus
30
how to treat impetigo w/ few lesions
topical x5 days mupirocin
31
how to treat impetigo w/ many lesions
oral x7 days - first line: cephalexin - strep only: penicillin - allergies or MRSA: doxy, clinda, bactrim
32
do you get cultures for animal bites
yes especially with cats
33
what are you trying to cover with animal bites
mostly anaerobes
34
how to treat animal bites
first line: augmentin alternate: 2/3 gen ceph bL allergy: cipro/levo + anaerobe or moxi get shots
35
how long to treat animal bites
established infection: 7-14 days preemptive infection: 3-5 days