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Year 3 Infection (JK) > Skin and soft tissue infection > Flashcards

Skin and soft tissue infection Flashcards

1
Q

What layer of the skin does impetigo affect?

A

epidermis

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2
Q

Causative organisms of impetigo

A

staph aureus

strep pyogenes

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3
Q

List some predisposing factors for impetigo

A

break in skin

  • burns
  • poor hygiene
  • minor trauma
  • eczema
  • chicken pox
  • insect bites
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4
Q

Treatment for small areas of impetigo

A

topical antibiotics

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5
Q

Treatment for large areas of impetigo

A

topical and oral antibiotics

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6
Q

Area which erysipelas affects and causative organism

A

upper dermis

strep pyogenes

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7
Q

Describe appearance of impetigo

A

golden crust with multiple vascular lesions on erythematous base on the face or arms of children

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8
Q

describe appearance of erysipelas

A

painful red area with distinct elevated borders

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9
Q

Systemic symptoms of erysipelas

A

fever, lymphadenopathy and lymphangitis

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10
Q

Where on the body does erysipelas occur

A

70-80% lower limb and rest is face

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11
Q

4 predisposing factors for erysipelas

A

DM
venous stasis
obesity
pre-existing lymphoedema

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12
Q

Area of skin cellulitis affects

A

deep dermis and subcutaneous fat

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13
Q

Causative organisms of cellulitis

A

staph aureus and strep pyogenes

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14
Q

Describe the appearance of cellulitis

A

spreading erythematous area with no borders

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15
Q

systemic symptoms of cellulitis

A

fever, lymphadenopathy and lymphangitis

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16
Q

What 2 groups of patients may a gram -ve bacteria be causing cellulitis?

A

diabetics and febrile neutropenics

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17
Q

3 disposing factors for cellulitis

A

lymphoedema
tinea pedis
DM

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18
Q

Treating erysipelas and cellulitis

A

anti staph and anti strep antibiotics
if severe IV antibiotics and rest
10-14 days

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19
Q

3 hair associated infection

A

folliculitis
furunculosis
carbuncles

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20
Q

Describe folliculitis briefly

A

1 hair follicle affected

less than 5mm pustule with small red papules

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21
Q

Where is folliculitis found?

A

head, back, buttocks, extremities

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22
Q

Causative organism of folliculitis

A

staph aureus

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23
Q

Briefly describe furunculosis

A

single hair follicle associated with inflammatory nodule extending to dermis and subcutaneous fat

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24
Q

Where is furinculosis found?

A

moist, hairy, friction prone areas eg buttocks, neck, face

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25
Q

Causative organisms of furinculosis and risk factors

A

DM, obesity, CKD, CCS

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26
Q

Describe a carbuncle

A

infection involves multiple furuncles

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27
Q

where are carbuncles found?

A

back of neck, posterior trunk or thigh

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28
Q

treatment for

a) folliculitis
b) furunculosis
c) carbuncle

A

a - none or topical antibiotics

b) no treatment or topical/oral antibiotics
c) hospital, surgery, IV antibiotics

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29
Q

type 1 necrotising fasciitis (causative organisms)

A

mixed aerobic and anaerobic infection - diabetic foot

strep/staph, enterococci, Gram -ve bacilli

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30
Q

Type 2 necrotising fasciitis (causative organisms)

A

monomicrobial

strep pyogenes

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31
Q

Describe appearance of necrotising fasciitis

A

rapid onset or erythema –> extensive oedema and pain
haemorrhagic bullae, skin necrosis
anaesthesia at site

32
Q

systemic symptoms of necrotising fasciitis

A

fever, hypotension, tachycardia, delirium, multi organ failure

33
Q

treatment of necrotising fasciitis

A

surgery and imaging

broad spectrum antibiotics eg flucloxacillin

34
Q

What is pyomyositis?

A

purulent infection deep within striated muscle secondary to seeding into damaged muscle

35
Q

Predisposing factors of pyomyositis

A

HIV, IVDU, malignancy, DM, liver cirrhosis, rheumatological

36
Q

pyomyositis causative organism

A

staph aureus

37
Q

Treatment of pyomyositis

A

do a CT/MRI

drain! antibiotics

38
Q

bursae

A

small sac like cavities that contain fluid and are lined by synovial membrane

39
Q

Where does infection in septic bursitis usually spread from?

A

adjacent skin infection

40
Q

predisposing factors of septic bursitis

A

RA, alcoholism, DM, IVDU, renal insufficiency

41
Q

Common signs of septic bursitis

A

peribursal cellulitis, warmth and swelling

fever and pain

42
Q

diagnosing septic bursitis

A

aspiration of fluid

43
Q

Causative organisms of septic bursitis

A

staph aureus

44
Q

What is infectious tenosynovitis?

A

infection of synovial sheaths surrounding tendons

45
Q

Common sites of infectious tenosynovitis

A

flexor muscle tendons and tendon sheaths of hand

46
Q

Causative organisms of infectious tenosynovitis

A

staph aureus and strep

47
Q

Chronic infectious tenosynovitis causative organisms

A

mycobacteria and fungi (? gonococcal)

48
Q

How infectious tenosynovitis presents

A

erythematous swelling of finger in semi flexed position

tenderness and pain with extension

49
Q

Treatment of infectious tenosynovitis

A

empiric antibiotics and hand surgeon

50
Q

What are toxin mediated syndromes often due to?

A

super antigens

51
Q

Staph aureus toxins

A

TSST1 and ETA+ETB

52
Q

strep pyogenes toxin

A

TSST1

53
Q

What causes toxic shock syndrome?

A

staph aureus and TSST1

54
Q

3 symptoms and signs of TSS

A

fever
hypotension
diffuse macular rash

55
Q

4 diagnostic criteria for TSS

A

3 of following organs: liver,blood, renal, GI, CNS, muscle
isolation of staph aureus from mucosal or normally sterile site
TSST1 produced by isolate
development of antibody to toxin

56
Q

Treatment of TSS

A 
remove offending agent 
IV fluids 
IV immunoglobulins 
antibiotics 
inotropes
57
Q

cause of SSSS

A

staph aureus toxin –> Exfoliative toxin A or B

58
Q

SSSS presentation

A

widespread bullae and skin exfoliation in adults

59
Q

treatment of SSSS

A

IV fluids and antimicrobials

60
Q

Is panton valentine leucocidin toxin an alpha haemolysin?

A

no - beta

61
Q

what can panton valentine leucocidin toxin cause?

A

skin and soft tissue infections and haemorrhagic pneumonia

62
Q

treatment of panton valentine leucocidin toxin

A

antibiotics reducing toxin production

63
Q

risk factors for IV associated catheter infections

A

continuous infusion >24 hours
cannula in situ >72 hours
cannula lower limb
neurological problems

64
Q

causative organism of IV catheter associated infections

A

staph aureus

65
Q

What can staph aureus in IV catheter associated infections lead to?

A

forms biofilm which spills into blood

seeds into other places

66
Q

treating IV catheter associated infections

A

remove cannula
express pus from thrombophlebitis
IV antibiotics for 14 days
echo

67
Q

5 ways to prevent IV catheter associated infections

A 
do not leave unused cannula 
only insert cannula if using 
change every 72 hours 
monitor for thrombophlebitis 
use aseptic technique when inserting
68
Q

class 1 surgical wound

A

clean - resp, GI, genital or infected urinary systems not entered

69
Q

class 2 surgical wound

A

clean contaminated wound

70
Q

class 3 surgical wound

A

open, fresh, accidental wounds

71
Q

class 4 surgical wound

A

infected wound

72
Q

list some causative organisms of IV catheter associated infections

A 
staph aureus 
coagulase -ve staph 
enterococcus 
E coli 
pseudomonas aeruginosa 
Enterobacter 
streptococci 
fungi 
anaerobes
73
Q

6 patient risk factors for IV catheter associated infections

A 
diabetes 
malnutrition 
obesity 
smoking 
staph aureus colonisation 
concurrent steroid use
74
Q

6 procedure risk factors for IV catheter associated infections

A 
perioperative hypoxia
improper antimicrobial prophylaxis 
shaving site the night prior to procedure 
break in sterile technique 
improper preoperative skin prep
inadequate theatre ventilation
75
Q

Diagnosing IV catheter associated infections and for especially what class of wound?

A

pus/infected tissue for cultures

clean wound infections

Year 3 Infection (JK) (12 decks)

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