Skin & Soft Tissue Infections Flashcards Preview

Term 4: Infectious Diseases > Skin & Soft Tissue Infections > Flashcards

Flashcards in Skin & Soft Tissue Infections Deck (26):
1

What organism is usually responsible for "hot tub" folliculitis?

-Pseudomonas aeruginosa

2

What kind of infection are patients who have undergone saphenous vein harvesting?


Cellulitis/Erysipelas with venous & lymphatic compromise



-Streptococcus


3

What organism is usually responsible for lymphangitis?

-S. Pyogenes

4

What two organisms are usually responsible for cat scratch infections?


-Strep pyogenes



-Pasturella multocida


5

What is included in the differential dx of a rapidly progressive necrotizing soft tissue infection?


-Group A streptococci (S. pyogenes);



-Vibrio species;



-Aeromonas species;



-Clostridium species;



-Rarely, Staphylococcus aureus (CA-MRSA)


6

Clostridial myonecrosis denotes invasion of ____________ (even spontaneously) by C. perfringens, C. novyi or C. septicum.


healthy muscle



**C. septicum is frequently associated with underlying systemic malignancy (e.g., colon cancer).


7

What is the Therapy of Clostridial Gangrene/Myonecrosis?


Therapy includes immediate aggressive surgical debridement/amputation & high dose penicillin



-add clindamycin to decrease toxin production


8

What is the Therapy of Life-Threatening Group A Streptococcal Infections, ie Toxic shock syndrome?


-Aggressive surgical debridement or amputation is frequently needed.



-?? Hyperbaric oxygen (if it is available).



-Intravenous immunoglobulin has been shown to be of some theoretical benefit in 2 trials:


9

Who is more susceptible to necrotizing soft tissue infections due to Vibrio species?

-Individuals compromised by cirrhosis, AIDS, or malignancy

10

Rapidly progressive cellulitis or necrotizing fasciitis due to ___________occurs in the setting of an injury related to fresh water exposure. The syndrome that results may be identical to that produced by Vibrio species.


Aeromonas hydrophila



*also think medicinal leeches


11

What is fournier's gangrene?


-Necrotizing perineal infections,that occur most frequently in diabetics and patients with granulocytopenia



-Microbiology reflects mixed bowel flora


12

What is Meleney's gangrene?


-Post-surgical mixed infection;



-Microbiology reflects site of surgery (e.g., intra-abdominal flora).


13

What is Ludwig's angina?


-Polymicrobial infection of submandibular & submental spaces;



-Bacteriology reflects complex oral flora.


14

Only_______of Foot Infections in Diabetics is Due to Vascular Disease/

15%

15

________ of Foot Infections in Diabetics is Due to Neuropathy

85%

16

The most common pathophysiologic process leading to diabetic foot infections is:



a. Peripheral vascular disease



b. Hyperglycemia



c. Neuropathy



d. Depressed neutrophil function


c. Neuropathy


17

Your roommate was celebrating his 21st birthday, injudiciously as it turns out, and lost all of his inhibitions due to alcohol. He happened to provoke a fight with a big guy in the bar and punched him in the mouth. 28 hours later, his right hand began to swell at the 2nd & 3rd metacarpal-phalangeal joints over some lacerations that he suffered. The bacteriology most likely includes:



a. Enterococcus faecalis



b. Streptococcus iniae



c. Pseudomonas aeruginosa



d. Anaerobic organisms (Veilonella, Peptostreptococcus, Fusobacterium)


d. Anaerobic organisms (Veilonella, Peptostreptococcus, Fusobacterium) =Clenched fist injury


18

36 hours ago, while trying to pet it, your neighbor’s cat bit you on the hand. Your index finger is now swollen & tender. The bacteriology likely includes:



a. Streptococcus zooepidemicus



b. Enterococcus faecium



c. Pseudomonas aeruginosa



d. Pasteurella multocida


d. Pasteurella multocida


19

The hand surgeons consulted you to help with management of an infection in a 34-year-old man who had amputated his right index finger in a snow blower 5 days ago. They reattached his finger, but it is now red, tender and swollen and a culture is growing an aerobic, gram-negative rod. You suspect the infection was caused by:



A. Pseudomonas aeruginosa that contaminated the snow blower blades.



B. Nosocomial Klebsiella pneumoniae infection.



C. Aeromonas hydrophila from medicinal leaches used to maintain blood vessel patency.



D. Fusobacterium from his mouth


C. Aeromonas hydrophila from medicinal leaches used to maintain blood vessel patency.


20

This 28-year-old man returned last night from a 4-day ski trip in Aspen. Yesterday, he began to develop this rash confined to his chest & below. He spent a lot of time drinking beer in the hot tub. It is likely caused by:



a. Streptococcus pyogenes



b. Staphylococcus epidermidis



c. Streptococcus iniae



d. Pseudomonas aeruginosa


d. Pseudomonas aeruginos


21

24 hours ago, while trying to unhook this fish from his line, a 42-year-old cirrhotic Gulf fisherman stepped on the dorsal fin which penetrated his foot. Now, he presents with a rapidly progressive necrotizing cellulitis of the foot and leg. The most likely organism causing this is:



A. Streptococcus pyogenes



B. Aeromonas hydrophila



C. Vibrio vulnificus



D. Pseudomonas aeruginosa


C. Vibrio vulnificus Salt Water*


22

The hand surgeons biopsied this abnormal bone 2 days ago; the culture is growing Eikenella corrodens. This likely resulted from:



A. Penetration from a fishing hook



B. A dog bite



C. Human bite/saliva contamination



D. Bacteremic spread from endocarditis


C. Human bite/saliva contamination


23

This 72-year-old man presented with pain in the left arm. On examination, it feels to you like Rice Krispies. Gram stain shows no neutrophils. What is the organism?



A. Streptococcus anginosus



B. Pseudomonas aeruginosa



C. Clostridium septicum



D. Aeromonas hydrophila


C. Clostridium septicum


24

While feeding this squirrel in Hermann Park, your girlfriend was bitten on the finger. Management should include:



A. Tetanus immunization



B. Rabies immunization



C. Prophylactic azithromycin



D. Both a & b


A. Tetanus immunization


25

A patient with a necrotizing ulcer on his scrotum likely has underlying:



A. Burn



B. Diabetes mellitus



C. Zipper trauma



D. Hidradenitis suppurativa


B. Diabetes mellitus


26

This 25-year-old man injured his leg while waterskiing in Lake Conroe. There are hemorrhagic bullae. The causative organism is likely to be:



A. Aeromonas hydrophila



B. Vibrio vulnificus



C. Streptococcus pyogenes



D. Staphylococcus aureus


A. Aeromonas hydrophila



 



**FRESH WATER