Lecture 12: Skin and Soft Tissue Infections

Question 1

What do skin and soft tissue infections involve?

Answer 1

Invastion of the skin and soft tissue

Question 2

Cardinal sign of a SSTI?

Answer 2

Host inflammatory response followed by the manifestations including fever and rapid progression of lesions

Question 3

How do we classify SSTI?

Answer 3

Depth of infection

Question 4

List some risk factors for SSTI’s

Answer 4

DM, cirrhosis, bite wounds, neutropenia, reptiles, hot tubs, fish tank, water, drug abuse

Question 5

A patient presents with a eruption of flaccid pustules which form a honey-coloured crust. These lesions are highly contagious and it is seen in children. What is this?

Answer 5

Epidemic impetigo

Question 6

What organisms cause epidemic impetigo?

Answer 6

Group A strep, staph aureus

Question 7

How is epidemic impetigo treated?

Answer 7

Antibiotic therapy

Question 8

What is a rapid spreading infection of deep skin layers that involves superficial dermal lymphatics that lead to swelling?

Answer 8

Erysipelas

Question 9

What can erysipelas be a a source of?

Answer 9

Bacteremia and has the potential for a systemic infection

Question 10

What causes erysipelas?

Answer 10

Streptococcus progenies (group A strep)

Question 11

What does cellulitis mean?

Answer 11

Refers to a deeper infection with acute spreading in the subcutaneous layer

Question 12

What does cellulitis tend to follow?

Answer 12

Local infection or trauma

Question 13

List the organisms which may cause cellulitis?

Answer 13

Staph aureus, streptococcus progenies, pseudomonas aeruginosa, gram negative bacilli- organisms depend on the sire of the wound

Question 14

Furuncles

Answer 14

Boil

Question 15

What causes boils?

Answer 15

ALWAYS staphylococcus aureus

Question 16

Carbuncle

Answer 16

Multiple furuncles

Question 17

How is a furuncle treated?

Answer 17

Cloxacillin

Question 18

Decubitus ulcers

Answer 18

Bed wound

Question 19

What type of organisms lead to bed wounds?

Answer 19

COlonozied with mixed potential pathogens or non-pathogens

Question 20

How are bed wounds treated?

Answer 20

Nursing care

Question 21

Clean

Answer 21

No significant contamination (i.e. heart surgery)

Question 22

Clean contaminated

Answer 22

Through mucous membrane, GU, Resp tract

Question 23

Contaminated

Answer 23

Colon, accident

Question 24

Dirty/infected

Answer 24

Greatest risk of infection

Question 25

What should you tell the lab if a client suffers from a bite wound?

Answer 25

The details of the situation

Question 26

What can bites lead to?

Answer 26

Cellulitis, abscess, deep tissue infections

Question 27

If a client has a clenched fist and is bitten here....

Answer 27

Do not ignore this as there is a high risk of deep infection as the skin over the knuckles is tight and there is a TON of bacteria in a human's mouth

Question 28

What is fasciitis?

Answer 28

A rapidly progressing cellulitis with extensive necrosis of the subcutaneous tissue as a result of toxin producing agents

Question 29

What is the most common agent of flesh eating disease?

Answer 29

Streptococcus progenies (group A strep)

Question 30

How do you diagnose flesh eating disease?

Answer 30

Rapid clinical followed by gram stain and culture confirmation

Question 31

Give an example of a dermatophyte

Answer 31

Tinea or ringworm, infections in the hair nails, and skin

Question 32

Where can infections pop up in the body in dermatophytes?

Answer 32

Anywhere in the body

Question 33

What causes tinea/rignworm?

Answer 33

Yeast infection of dermatophytic fungi

Question 34

How is this diagnosed in the lab?

Answer 34

Skin/nail scrapping sent to the lab, calcoflour stain and a +/- fungal culture is performed

Question 35

What do dermatophytes produce?

Answer 35

Keratinase which breaks down keratin

Question 36

Which sex of scabies burrow into the skin and lay eggs?

Answer 36

Females

Question 37

What are we able to see on the skin's surface with a scabies infestation?

Answer 37

The tracks from this microscopic mite

Question 38

What are the three "easy's" of lice?

Answer 38

Spreads, diagnosed, controlled

Question 39

How many types of herpes simplex virus are there?

Answer 39

Two

Question 40

Facial (cold sores) herpes

Answer 40

Type 1

Question 41

Genital herpes

Answer 41

Type 1 or 2

Question 42

How does transmission happen in herpes?

Answer 42

Direct contact

Question 43

How is herpes diagnosed

Answer 43

Clinical but with genital it may require the virus culture or molecular detection

Question 44

How is herpes treated?

Answer 44

With antiviral drugs which can shorten healing time if taken early

Question 45

Talk about recurrence and herpes viruses

Answer 45

Common, with genital this will usually diminish in a year and some people never have recurrences

Question 46

Varicella Zoster Virus

Answer 46

Chicken pox and shingles

Question 47

Vaccine for VSZ

Answer 47

Vaccine is safe and effective, live vaccine which has led to decreased hospitalizations and death by 95%

Question 48

What is shingles?

Answer 48

Varicella zoster reactivated which is diagnosed clinically

Question 49

How does the VSZ virus persist?

Answer 49

In a latent state in the nerve ganglia in the face and trunk

Question 50

List the microbes found: in mild infections (above the waist)

Answer 50

Staph Aureus, strep pyogenes

Question 51

List the microbes found: Infections of hand and head

Answer 51

S. Aureus S. Pyogenes Haemophilus influenzae

Question 52

List the microbes found: severe infections (above the waist) without special considerations

Answer 52

S aureus, S pyogenes

Question 53

List the microbes found: Mild infections below the waist

Answer 53

S aureus, S pyogenes, coliform species possible

Question 54

List the microbes found: Severe infections below the waist

Answer 54

Escherichia coli, Enterococcus species, other coliform species, S aureus, S pyogenes