Skin and Soft Tissue Infections Flashcards Preview

Week 65: Sepsis > Skin and Soft Tissue Infections > Flashcards

Flashcards in Skin and Soft Tissue Infections Deck (17)
Loading flashcards...
1

What is the main bug that causes purulent infections?

Staph aureus

2

What is the cornerstone of management for purulent infections?

Incision and drainage
Send a sample of pus to lab for gram stain and culture

3

2 abx for MSSA

Cloxacillin
Cefazolin

4

Purulent infection empiric abx for
1. No systemic toxicity/immunocompromise
2. Yes ystemic toxicity/immunocompromise

1. TMP-SMX or Doxycycline
2. Vancomycin

5

4 signs of systemic toxicity

Temp > 38
HR > 90
RR > 24
WBC < 12 000

6

Non-bullous impetigo

Highly infectious
Mostly in school age children
Staph aureus > GrpA strep but cover both
Clinical dx
Topical abx if localized (Mupirocin) or cephalexin
Post-strep GN RARE complication

7

Bullous impetigo

Neonates most commonly
From toxin producing staph aureus (exfoliative toxin A and B)
Dx is clinical and blood cultures
Oral or IV anx (cephalexin, cefazolin or vanco)
Risk of dehydration and sepsis

8

Erysipelas

Non purulent infection
Limited to upper dermis and superficial lymphatics
Sharp, raised, well-demarcated erythema
Rapid onset, fever and signs of systemic toxicity
Facial involvement common
Almost always group A strep!
Oral: penicillin, amoxicillin, cephalexin. IV: penicillin, cefazolin

9

Cellulitis

Lower extremities most common
Normal skin flora invades a break in the skin to cause infection in the dermis and subcutaneous tissue
Can be simple and localized or severe

10

What is the microbiology of non-purulent cellulitis?

> 75% is streptococcus
Staph aureus is less common, more so with injection drug users, penetrating trauma, and open wounds
MRSA is NOT a common cause of non-purulent cellulitis

11

Which empiric abx to choose for non purulent cellulitis
1. No systemic toxicity, immunocompromised, or failed abx
2. Yes systemic toxicity, immunocompromised, or failed abx
3. 2, plus signs of sepsis or necrotizing faciitis

1. Cephalexin or amoxicillin or penicillin V
2. Cefazolin
3. Pip-tazo and Vancomycin

12

Clinical triad of septic arthritis

Fever
Pain
Decreased ROM

13

Most common micro cause of septic arthritis

Staph aureus

14

Tx for septic arthritis
1. Gram + cocci
2. Gram - bacilli
3. Gram stain negative or mixed

1. Vanco
2. Ceftriaxone
3. Vanco and Ceftriaxone

15

What abx is used to treat biofilms?

Rifampin

16

Most common cause of
1. Cat bites
2. Dog bites

And how to treat them

1. Pastuerella multocida
2. Pastuerella canis

Amoxicillin-clavulanate

17

What is the best test for osteomyelitis?

MRI!
But x-ray is pretty good with chronic wounds