Flashcards in Skin, Bone, Healthcare Infections Deck (35):
most skin and soft tissue infections are caused by?
acute inflammatory process involving skin and soft tissues causing erythema, tenderness, warmth, swelling, lymphangitis
mostly lower limb
lymphangitis vs lymphadenitis
lymphangitis is inflammation of lymph tracks, red lines running up the legs
lymphadenitis is painful swollen nodes
risk factors for cellulitis
dermatophytic infections (tinea)
mycobacterium marinum causes
fish tank granuloma
management of cellulitis
or cephalexin or cephazolin if allergic to penicillins
what is chronic venous insufficiency
disruption of the valves in veins which overwhelms the lymphatics.
get blood in the interstitial space that isnt cleared, breaks down leaving hemosiderin stains.
get swelling of legs
not as painful as cellulitis
how to differentiate acute contact dermatitis with cellulitis
usually have an exposure to irritant
and isnt as tender as cellulitis
differentials for cellulitis
markers for deeper infection (necrotising fasciitis/gas gangrene)
systemic toxicity (high HR, low BP)
clinical deterioiration despite antibiotics
elevated CK (due to muscle destruction)
typical pathogen post-burn
treatment for cellulitis (suspected staph or strep)
flucloxacillin or cephalexin if allergic
if strep pyogenes likely can use penicillin
treatment of severe cellulitis
IV fluclox 2g/6 hourly
or IV cephazolin if allergic
what is gout? what joint is most common? treat with?
urate crystal deposition in joints, usually metatarsophalyngeal
diagnosed by urate aspirate
treat with NSAIDS
what is thrombophlebitis
inflammation and thrombus within a vein
septic arthritis mostly occurs via
blood borne infection
but oculd be direct innoculation
what is a fomite
what is MRSA, what is it resistant to?
methicillin resistant staph aureus
resistant to all penicillins, most cephalosporins
treat with vancomycin
does culture of klebsiella in sputum mean a patient has pneumonia?
what about staph aureus in blood?
for pneumonia look at the patient and assess them for actual symptoms of pneumonia.
staph aureus in blood is ALWAYS significant
what is VRE
vancomycin resistant enterococcus
what is CPE
carbapenemase producing enterobacteriaceae
difference between gram positive and gram negative
gram positive = 1 membrane and surrounding peptidoglycan wall
gram negative = inner and outer membrane (LPS) with a thin peptidoglycan wall in between
examples of beta lactam drugs and how they work
they inhibit cell wall synthesis by blocking transpeptidase so only work on dividing bacteria
antibiotics that inhibit protein synthesis by blocking ribosomal subunits
antibiotics that inhibit nucleic acid synthesis
normal white cell count range
normal CRP levels
gram positive diplococci present on sputum culture would indicate?
treatment for pneumoccal pneumonia
penicillin G (IV)
and penicillin V (oral)
a broad specturm penicillin with activity against pseudamonus aeriginosa
commonly prescrribed with beta-lactamase inhibitor tazobactam
if patient with pneumococcal pneumonia developed rash from penicillin what would you give?
cephtriaxone (a cephalosporin)
cephtriaxone doesnt work well for staph aureus
the kind of organisms that cause atypical pneumonia?
treatment: doxycycline (a tetracycline)
or azithromycin (a macrolide)
with intracellular activity
what causes rigors?
other than influenza it is mostly bacterial infections
when should you treat asymptomatic bacteriuria
only in pregnancy or before urology procedures