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Host and Defense > Skin and Soft Tissue Infections (Durrant) > Flashcards

Skin and Soft Tissue Infections (Durrant) Flashcards

(61 cards)

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1
Q

what is the first line of defense for SSTIs

A

intact skin (physical barrier)

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2
Q

what are some ways bacteria can get in to skin?

A

loss of barrier via trauma of some sort

-ducts of skin

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3
Q

what are classical presentations of SSTIs

A

erythema, warmth, edema, tenderness

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4
Q

what is crepitus

A

caused by gas production of microbes
feels crunchy under the skin
-usually caused by C. perforingins

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5
Q

necrosis

A

death of tissue

Group A strep

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6
Q

fluctuance

A

fluid filled

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7
Q

purpura

A

leaking blood vessels

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8
Q

bullae

A

blisters

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9
Q

what are some other diseases that can mimic SSTIs

A 
gout
thrombophlebitis
DVT
contact dermatitis
drug eruption (allergy to drug)
foreign body reaction
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10
Q

folliculitis

A

minor infxn associated with friction and sweat gland activity
**number one cause is S. aureus
2nd is Group A strep

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11
Q

what causes hot tub folliculitis

A

Psuedomonas aeruginosa

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12
Q

what is the treatment of folliculitis

A

soap and water and topical ABX

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13
Q

Acne

A

inflammation of hair follicles and associated sebaceous glands
-casued by Propionibacterium acnes also can be S. aureus

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14
Q

what can cause acne

A

hormonal influences, organic acids produced by P. acnes

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15
Q

Soft tissue Abscesses

A

any breach in skin

-local superficial cellulitis->bacteria necrose/liquefy tissue->cellular debris+WBCs accumulate to make pus

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16
Q

description of abscesses

A

fluctuant, tender, erythematous nodule with surrounding erythema

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17
Q

most common cause of soft tissue abscesses

A

Staph aureus including MRSA

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18
Q

Tx for abscess

A

I and D with a possibility of systemic ABX

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19
Q

what is a furuncle

A

abscess in the area of a hair follicle
also called a boil
usually recurrent

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20
Q

what is a carbuncle

A

-multiloculated abscess
-spread of infection to subcutaneous tissue
-S. aureus
Tx=I and D

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21
Q

necrotizing fascitis

A

enzyme producing bacteria digest fascial barriers and cause tissue necrosis
-Rapid extension of infection

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22
Q

what are the common pathogens of necrotizing fascitis

A

Group A strep aka flesh-eating bacteria
Staph aureus
C. perforingins
polymicrobial of G+ and anaerobes

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23
Q

what is Fournier’s gangrene

A

polymicrobial infection of the genitals and perineum

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24
Q

patient characteristics of necrotizing fasciitis

A

usually a sick patient
edema(rare), erythema, pain, crepitus
**pain out of proportion to exam findings

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25
surgical wound infections causes and sources
S. aureus most common sources: pts own skin, trans by fomites, hands, air, and environment * *hand hygiene very important as well as perioperative ABx
26
fungal infections of the superficial hair and nail infections
dermatophyte fungi-tinea cruris, corporis
27
what do dermatophyte fungi causes
ringworm nail infections keratinized layers of skin/nails **superficial hair nail and skin
28
what is the most common yeast infections
Candida albicans usually warm moist areas of the body eg: mouth, vagina, butt
29
Tx for fungal infections
topical antifungals, systemic antifungals if severe
30
Candida albicans infections
diaper rash intertrigo(under breasts) thrush
31
Impetigo characteristics, causative agents
epidermis honey crust Group A strep, S. aureus **highly contagious
32
treatment of impetigo
penicillin only for Group A, topical ABx
33
Erysipelas characteristics, causative agent
``` deep layers of dermis rapidly spreading rubor, calor, tumor, dolor maybe some systemic signs **Group A strep ```
34
Treatment of erysipelas
penicillin
35
cellulitis characteristics, causative agents
subcutaneous tissue Group A strep, S. aureus Gram negatives in immunocompromised pts, nosocomial, wounds, DM
36
Treatment of cellulitis
systemic ABx | not usually biopsied
37
what factors increase risk of wound infections
``` high number of organisms higher virulence of organisms Poor circulation near wound Poor general health Poor nutrition status Immunocompromised ```
38
staphylococcal toxins
alpha-toxin exfoliatin TSST-1 Enterotoxin
39
staphylococcal toxins | alpha toxin
scalded skin syndrome
40
staphylococcal toxins | exfolliatin
bullous impetigo
41
staphylococcal toxins | TSST-1
toxic shock syndrome | usually from old blood, sinus surgeries, tampons
42
staphylococcal toxins | enterotoxin
food poisoning
43
MRSA vs MSSA
MRSA strains acquire mecA gene which makes a new PBP with reduced affinity for beta lactams. resistant to all beta lactams -MSSA use nafcillin, oxacillin, or cephalosporins
44
MRSA risk factors
close skin-skin contact crowded living conditions poor hygiene IV drug users
45
MRSA treatment
trimethoprim-sulfa, doxycycline, vancomycin, linezolid, daptomycin
46
Group A strep ( strep pyogenes) | post strep sequelae
rheumatic fever or glomerulonephritis | over 100 serotypes based on antigenic differences in M protein
47
streptolysins O and S
cytotoxic | lyse leukocytes, tissue cells, platelets
48
pyrogenic exotoxins A and B
- superantigens (APC and T cells lock) - causes major immune response and causes damage to human cells - systemic illness, shock - in about 10% Group A strep
49
streptokinase
protease
50
hyaluronidase
degrades carbohydrates and connective tissue
51
DNase
degrades DNA
52
Clostridium perfringens
anaerboic spore forming Gram + rod with square ends found in soil and human colon produces hydrogen and CO2 gas in tissue lots of exotoxins
53
soft tissue infections with C. perfringens
wound infections Gas gangrene rapidly fatal
54
Pasteurella multocida
gram negative rod | animal bites
55
Pseudomonas aeruginosa
gram negative rod non fermentor environmental pathogen-water, hospital rooms
56
skin diseases of P. aeruginosa
hot tube folliculitis | secondary infection after burns
57
Vibrio vulnifcus
gram neg rod in brackish salt water environments-colonize shellfish Fever->sepsis->hemorrhagic bullae associated with iron overload, cirrhosis
58
Mycetoma "madura foot"
bacterial- actinomyces, nocardia | Fungal-lots of molds
59
what bacteria causes cellulitis and erysipelas predominantly?
think Group A strep
60
abscess of skin are caused by what?
think Staph aureus
61
abscess of mouth/rectum/vagina caused by?
polymicrobial | G+, anaerobes, fungi

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