Skin and soft tissue Flashcards
What are predisposing factors to folliculitis?
Steroids, drug use, immunocompromised
What gives you perioral folliculitis?
Steroids
What gives you eosinophilic folliculitis?
Immunocompromised state
What kind of hemolysis does staph have? WHat are its virulence factors?
Coagulase and catalase positive
Beta-hemolysis
Protein A virulence
Pseudomonas: What does it look like on gram stain? What does it NOT ferment? oxidase/catalase?
Gram - rod -does NOT ferment lactose -oxidase positive -catalase positive "flea-bitten appearance"
What allowed s aureus to become resistant to penicillin? To nafcillin?
beta lactamase production
–Penicillin binding proteins
What virulence factors does staph have?
- lipase degrades lipids on the skin
- Protein A binds Fc portion, reducing phagocytosis
- Catalase breaks down hydrogen peroxide
What test helps you distinguish staph from strep
Catalase
What kind of hemolysis do you see in other types of staph?
alpha hemolysis
What do you use for hot tub folliculitis?
Cipro to treat pseudomonas
What do you use to treat staph aureus folliculitis?
- mupirocin cream
- polymyxin B, neomycin, bacitracin
- benzyll peroxide wash
How do you treat a furuncle?
Incision and drainage. Only need Abx if infection is on face, systemic symptoms, or comorbidities, multiple lesions, cellulitis
What are the PO options for MRSA
TMP/SMX
Clindamycin/doxycycline
What are the IV options for MRSA
Vanc
TMP/SMX
What is the “ladder” of treatment options for a MRSA infection (least to most serious)
- TMP/SMX PO
- doxycycline/clindamycin PO
- Vancomycin IV (first line if pt is hospitalized
