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

Skin and Soft Tissue Infections (Durrant) Flashcards

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
Q

surgical wound infections causes and sources

A

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
Q

fungal infections of the superficial hair and nail infections

A

dermatophyte fungi-tinea cruris, corporis

27
Q

what do dermatophyte fungi causes

A

ringworm
nail infections
keratinized layers of skin/nails
**superficial hair nail and skin

28
Q

what is the most common yeast infections

A

Candida albicans
usually warm moist areas of the body
eg: mouth, vagina, butt

29
Q

Tx for fungal infections

A

topical antifungals, systemic antifungals if severe

30
Q

Candida albicans infections

A

diaper rash
intertrigo(under breasts)
thrush

31
Q

Impetigo characteristics, causative agents

A

epidermis
honey crust
Group A strep, S. aureus
**highly contagious

32
Q

treatment of impetigo

A

penicillin only for Group A, topical ABx

33
Q

Erysipelas characteristics, causative agent

A 
deep layers of dermis
rapidly spreading
rubor, calor, tumor, dolor
maybe some systemic signs
**Group A strep
34
Q

Treatment of erysipelas

A

penicillin

35
Q

cellulitis characteristics, causative agents

A

subcutaneous tissue
Group A strep, S. aureus
Gram negatives in immunocompromised pts, nosocomial, wounds, DM

36
Q

Treatment of cellulitis

A

systemic ABx

not usually biopsied

37
Q

what factors increase risk of wound infections

A 
high number of organisms
higher virulence of organisms
Poor circulation near wound
Poor general health
Poor nutrition status
Immunocompromised
38
Q

staphylococcal toxins

A

alpha-toxin
exfoliatin
TSST-1
Enterotoxin

39
Q

staphylococcal toxins

alpha toxin

A

scalded skin syndrome

40
Q

staphylococcal toxins

exfolliatin

A

bullous impetigo

41
Q

staphylococcal toxins

TSST-1

A

toxic shock syndrome

usually from old blood, sinus surgeries, tampons

42
Q

staphylococcal toxins

enterotoxin

A

food poisoning

43
Q

MRSA vs MSSA

A

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
Q

MRSA risk factors

A

close skin-skin contact
crowded living conditions
poor hygiene
IV drug users

45
Q

MRSA treatment

A

trimethoprim-sulfa, doxycycline, vancomycin, linezolid, daptomycin

46
Q

Group A strep ( strep pyogenes)

post strep sequelae

A

rheumatic fever or glomerulonephritis

over 100 serotypes based on antigenic differences in M protein

47
Q

streptolysins O and S

A

cytotoxic

lyse leukocytes, tissue cells, platelets

48
Q

pyrogenic exotoxins A and B

A
  • 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
Q

streptokinase

A

protease

50
Q

hyaluronidase

A

degrades carbohydrates and connective tissue

51
Q

DNase

A

degrades DNA

52
Q

Clostridium perfringens

A

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
Q

soft tissue infections with C. perfringens

A

wound infections
Gas gangrene
rapidly fatal

54
Q

Pasteurella multocida

A

gram negative rod

animal bites

55
Q

Pseudomonas aeruginosa

A

gram negative rod
non fermentor
environmental pathogen-water, hospital rooms

56
Q

skin diseases of P. aeruginosa

A

hot tube folliculitis

secondary infection after burns

57
Q

Vibrio vulnifcus

A

gram neg rod
in brackish salt water environments-colonize shellfish
Fever->sepsis->hemorrhagic bullae
associated with iron overload, cirrhosis

58
Q

Mycetoma “madura foot”

A

bacterial- actinomyces, nocardia

Fungal-lots of molds

59
Q

what bacteria causes cellulitis and erysipelas predominantly?

A

think Group A strep

60
Q

abscess of skin are caused by what?

A

think Staph aureus

61
Q

abscess of mouth/rectum/vagina caused by?

A

polymicrobial

G+, anaerobes, fungi

Host and Defense (26 decks)

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