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Infectious Disease > Infectious Disease Exam 2 - Skin & Soft Tissue Infections > Flashcards

Infectious Disease Exam 2 - Skin & Soft Tissue Infections Flashcards

(57 cards)

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1
Q

Impetigo

A

Common skin infection in children
Very contagious
Normal flora invade skin via breakdown in defenses

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2
Q

Impetigo - Common pathogens

A

Staph. Aureus

  • Bullous (Blister)
  • All produce penicillinase

Strep.
-Non-bullous

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3
Q

Impetigo - Treatment (Non-pharmacological)

A

Cleanse w/ mild soap & water

Skin emollients to dry skin

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4
Q

Impetigo - Treatment (Topical)

A

Mupirocin
Retapumulin
Triple Antibiotic

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5
Q

Impetigo - Systemic Antibiotics (B-Lactams)

A

***DOC

Dicloxacillin (Covers staph & strep - NOT MRSA)
Cephalexin (Covers staph & strep & some Gm-)
Amoxicillin/Clavulanate (Covers staph & step)

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6
Q

Impetigo - Systemic Antibiotics (B-Lactam Allergy)

A

Erythromycin (Diarrhea & resistance - Not used much)

Clindamycin

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7
Q

Folliculitis

A

Inflammation of the hair follicle
Superficial or deep
Infectious or non-infectious

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8
Q

Folliculitis - Common pathogens

A

Stap.
Strep.
Hot tub folliculitis - pseudomonas

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9
Q

Folliculitis - Treatment (Staph)

A

Typically self limiting

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10
Q

Folliculitis - Treatment (Strep)

A

Typically self limiting
5% acetic acid wet compress
Silver sulfadiazine
Oral cipro (pseudomonas)

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11
Q

Furuncle

A 
Abscess or boil in one follicle
Painful
Risk factors:
  -Post-puberty, diabetes, obesity, male
Lesions favor area prone to friction/trauma
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12
Q

Carbuncle

A

Same as Furuncle but with more than one follicle

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13
Q

Furuncle/Carbuncle - Treatment (Non-pharmacological)

A

Moist heat

Incision and drainage

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14
Q

Furuncle/Carbuncle - Treatment (MSSA - B-Lactam)

A

**DOC
Dicloxacillin
Cephalexin

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15
Q

Furuncle/Carbuncle - Treatment (MSSA - B-Lactam Allergy)

A

Doxycycline or Minocycline (don’t used on kids)
TMP/SMX
Clindamycin

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16
Q

Furuncle/Carbuncle - Treatment (MRSA)

A

Linezolid
Clindamycin (D-test)
Doxycycline or Minocycline (don’t use on kids)
TMP/SMX

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17
Q

Erysipelas

A

St. Anthony’s FIre
Superficial infection of the upper dermis & lymphatics
Can occur anywhere but mostly on the legs

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18
Q

Erysipelas - Common pathogen

A

Group A strep

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19
Q

Erysipelas - Signs/symptoms

A 
Infection site is very painful (burning)
Low grade fever
Fiery red
Raised above non-infected skin
Well-defined borders
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20
Q

Erysipelas - Treatment (B-Lactam)

A 
***DOC
Penicillin (DOC)
Naficillin or Oxacillin
Dacloxacillin
Cefazolin (Severe infection -IV)
Cephalexin (Severe infection -IV)
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21
Q

Erysipelas - Treatment (B-Lactam allergy)

A

Clindamycin

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22
Q

Cellulitis

A

Infection of dermis & subcutaneous tissue (deeper infection)

Can occur anywhere but mostly on legs

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23
Q

Cellulitis - Common pathogen

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A

Group A Strep

24
Q

Cellulitis - Signs/symptoms

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A 
Not as painful
Redness 
Edema
Non-raised lesion
Poorly defined borders
25
Cellulitis - Treatment of previously healthy patient -Mild infection (B-Lactam)
***DOC Dicloxacillin* Cephalexin
26
Cellulitis - Treatment of previously healthy patient -Mild infection (B-Lactam allergy or MRSA)
Clindamycin (D-test) - not used often Doxycycline or minocycline TMP/SMX
27
Cellulitis - Treatment of previously healthy patient -Moderate-Severe infection
Cefazolin IV | Naficiliin or Oxacillin
28
Cellulitis - Treatment of previously healthy patient -Moderate-Severe infection (B-Lactam allergy or MRSA)
Clindamycin (D-test) - not used often Linezolid Vancomycin Daptomycin
29
Cellulitis - Treatment of previously unhealthy patient -Mild infection or step down therapy
Amoxicillin/Clavulanate (Gm-, Gm+, anaerobes) Levofloxacin plus clindamycin (anaerobes) Moxifloxacin
30
Cellulitis - Treatment of previously unhealthy patient -Moderate-Severe infection (poly agent therapy-MRSA coverage)
Vancomycin Daptomycin Linezolid
31
Cellulitis - Treatment of previously unhealthy patient -Moderate-Severe infection (poly agent therapy-Gm(-) & anaerobic coverage)
``` Ertapenem (No pseudo) Ampicillin/sulbactam (No pseudo) Piperacillin/tazobactam (Pseudo) Imipenem/cilastatin (Pseudo) Cefepime plus metronidazole (Pseudo) Levofloxacin plus clindamycin (Pseudo) ```
32
Cellulitis - Treatment of previously unhealthy patient -Moderate-Severe infection (monotherapy)
Tigecycline (Not used)
33
Diabetic Foot Infection
Common and costly complication of diabetes Poor circulation Poor sensation Altered immune system
34
Diabetic Foot Infection - Common pathogens
``` Staph Group A strep Enterobacteriacea Pseudomonas Enterococci Anaerobes ```
35
Diabetic Foot Infection - PEDIS Grade 1
Uninfected | Wound lacking purulence or inflammation
36
Diabetic Foot Infection - PEDIS Grade 2
Mild Presence of two manifestations of inflammation Does not extend further than 2cm around ulcer and infection is limited to the skin and superficial subcutaneous fat
37
Diabetic Foot Infection - PEDIS Grade 3
``` Moderate Presence of two manifestations of inflammation And one of the following: Extends greater that 2cm Lymphangitic streaking Spread beneath the superficial fascia Deep tissue abscesses Gangrene Involvement of muscle, tendon, joint or bone ```
38
Diabetic Foot Infection - PEDIS Grade 4
Severe | Infection in a patient with systemic toxicity or metabolic instability
39
Diabetic Foot Infection - PEDIS Grade 1 (Treatment)
Avoid antibiotics
40
Diabetic Foot Infection - PEDIS Grade 2 (Treatment)
Oral therapy that covers staph and strep | May consider MRSA coverage
41
Diabetic Foot Infection - PEDIS Grade 3 (Treatment)
Broad coverage IV or oral therapy that also covers anaerobes | May consider MRSA coverage
42
Diabetic Foot Infection - PEDIS Grade 4 (Treatment)
Broad IV coverage for everything
43
Necrotizing Fasciitis
AKA: | Gas gangrene, flesh eating bacteria, Fournier's Gangrene
44
Necrotizing Fasciitis - Signs/symptoms
Severe pain disproportionate to clinical signs Pain extends beyond borders Blisters Shock
45
Necrotizing Fasciitis - Treatment
Surgery | Broad antibiotics
46
Necrotizing Fasciitis - Treatment (Bacterial toxin production)
Agents that decrease protein synthesis: Clindamycin (DOC) Linezolid
47
Necrotizing Fasciitis - Treatment (Group A strep or C. perfringens)
High dose of penicillin | Clindamycin
48
Animal Bite Wound - Pathogens
``` Polymicrobial Pasteurella Capnocytophaga (mainly dogs) Staph (skin flora) Strep (skin flora) ```
49
Animal Bite Wound - Presentation
Painful | 12-24h after bite
50
Animal Bite Wound - Prophylaxis
Not normally done
51
Animal Bite Wound - Treatment (Oral)
10-14 days Amoxicillin/clavulanate (1st line) Moxifloxacin (B-lactam allergy) TMP/SMX + clindamycin (B-lactam allergy)
52
Animal Bite Wound - Treatment (IV)
10-14 days Ampicillin/sulbactam (1st line) Moxifloxacin (B-lactam allergy) TMP/SMX + clindamycin (B-lactam allergy)
53
Human Bite Wound - Common pathogens
Strep (skin flora) Staph (skin flora) Eikenella corrodans Oral anaerobes
54
Human Bite Wound - Presentation
Purulent discharge | Painful, throbbing, swollen extremity
55
Human Bite Wound - Prophylaxis
``` Always given 3-5 days Dicloxacillin + penicillin (1st line) Amoxicillin/clavulanate (1st line) Cefuroxime (1st line) Fluoroquinolone + Clindamycin (2nd/B-lactam allergy) TMP/SMX + Clindamycin (2nd/B-lactam allergy) Moxifloxacin (2nd/B-lactam allergy) ```
56
Human Bite Wound - Treatment (Oral)
10-14 days Dicloxacillin + Penicillin (1st line) Amoxicillin/clavulanate (1st line) Doxycycline (2nd/B-lactam allergy) Fluoroquinolone + clindamycin (2nd/B-lactam allergy) TMP/SMX + clindamycin (2nd/B-lactam allergy) Moxifloxacin (2nd/B-lactam allergy)
57
Human Bite Wound - Treatment (IV)
Nafcillin or Oxacillin + Penicillin (1st line) Ampicillin/sulbactam (1st line) Doxycycline (2nd/B-lactam allergy) Fluoroquinolone + clindamycin (2nd/B-lactam allergy) TMP/SMX + clindamycin (2nd/B-lactam allergy) Moxifloxacin (2nd/B-lactam allergy)

Infectious Disease (3 decks)

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