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Infectious Disease > Skin/Soft tissue/Bone Infections > Flashcards

Skin/Soft tissue/Bone Infections Flashcards

(49 cards)

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1
Q

Skin and soft tissue infections are most commonly seen where?

A

Outpatient and inpatient

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2
Q

Skin and soft tissue infections can affect a single or all layers of what?

A

Fascia, skin, or muscle

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3
Q

(T/F) - Skin surface is conducive to bacterial growth - not resistant to infection

A

FALSE - it is NOT conducive to bacterial growth - resistant to infection

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4
Q

What are reasons that skin is resistant to infection?

A
  1. Extremely dry surface
  2. Continual renewal of skin cells
  3. Sebaceous secretions inhibit the growth of many bacteria and fungi
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5
Q

What are risk factors for skin infection?

A
  • High concentrations of bacteria (> 10^5)
  • Inadequate blood supply
  • Damage to the stratum corneum allowing for bacterial entry
  • Availability of nutrients
  • Excessive moisture of the skin
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6
Q

What is normal flora that is common in exposed skins (face, neck)?

A

Staph. epidermidis

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7
Q

What is the normal flora that is common in moisture areas (axilla, groins)?

A

Acinetobacter spp.

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8
Q

What are other predominant bacterial organisms of normal skin other than staph. epidermidis and acinetobacter spp.?

A
  • Corynebacterium spp.
  • Propionibacterium spp.
  • Micrococcus spp.
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9
Q

What are predominant fungal organisms involved in normal skin?

A
  • Malassezia spp.

- Candida spp.

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10
Q

What are the classic signs and symptoms of a patient experiencing skin or soft tissue infection?

A
  • Heat/localized fever
  • Erythema/redness
  • Inflammation/swelling
  • Pain
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11
Q

Define primary infections of skin/soft tissue infections

A

Usually involve areas of previously healthy skin and typically caused by one pathogen

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12
Q

Define secondary infections of skin/soft tissue infections

A

Usually occur in areas of previously damaged skin and often polymicrobic

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13
Q

What are some primary skin/soft tissue infections (SSTIs)?

A
  • Impetigo
  • Erysipelas
  • Purulent SSTIs
  • Cellulitis
  • Necrotizing fasciitis
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14
Q

Define impetigo

A

Superficial infection of stratum corneum

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15
Q

Impetigo is usually involved in which population(s)?

A
  • Children

- Poor hygiene

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16
Q

What organisms cause impetigo?

A
  • Staph. aureus (including MRSA)

- Group A streptococci

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17
Q

How is impetigo usually clinically presented?

A
  • Purulent, localized vesicles/lesions
  • Mild pain, pruritus
  • Common in exposed areas
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18
Q

What nonpharmacological therapy can be done with impetigo?

A

Wash affected area with soap and water

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19
Q

What topical treatment can be used for impetigo, localized lesions? For how long?

A
  • Mupirocin
  • Retapamulin
    Both for 5 days
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20
Q

What oral treatment can be used for impetigo, extensive/nonresponsive? For how long?

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A
  • Dicloxacillin
  • Cephalexin
  • Amoxicillin/clavulanate
    Both for 7 days
21
Q

Define erysipelas

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A

Cellulitis involving the more superficial layers of the skin and cutaneous lymphatics

22
Q

Erysipelas is usually involved in which population(s)?

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A
  • Very young

- Very old

23
Q

What organisms cause erysipelas?

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A

Group A streptococci

24
Q

How is erysipelas usually clinically presented?

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A
  • Raised, erythematous with clear line demarcation
  • Orange peel appearance
  • Often with systemic symptoms (fever, malaise)
  • Intense burning
  • Common in lower extremeties
25
What are the treatment options for erysipelas? For how long?
- PCN G (IV, PO, IM) - Amoxicillin Both for 7-10 days
26
There are 3 types of purulent SSTIs, what are they?
- Furuncles - Carbuncles - Cutaneous abscess
27
Define furuncle's
Infection of hair follicles that usually extend through the dermis into the SQ tissue resulting in small abscess
28
Define carbuncles
Inflammatory nodules that extends through multiple adjacent follicles
29
Which population has a chance of gaining purulent SSTIs?
Those who have irritated/injured hair follicles/skin
30
What organisms cause purulent SSTIs?
Staph. aureus (including MRSA)
31
(T/F) - Carbuncles usually start as a firm, tender, red nodule, that become painful and fluctuant
FALSE - This is describing farbuncles
32
(T/F) - Carbuncles are inflamed, drain nodule involving a hair follicle
FALSE - This is describing farbuncles
33
(T/F) - Furuncle's lesion often drain spontaneously
TRUE
34
(T/F) - Carbuncles lesions caused by CA-MRSA often have a characteristic of a 'spider bite'
FALSE - This is describing furuncle's
35
(T/F) - Carbuncle's form a broad, swollen, erythematous, deep, and painful follicular masses
TRUE
36
(T/F) - Furuncle's commonly develop at the back of the neck and are likely to occur in diabetic patients
FALSE - This is describing carbuncles
37
What is highly recommended for all carbuncles, large furuncles, and abscesses?
- Incision and drainage | - Culture and sensitive testing
38
How is a mild (localized but no signs of systemic infections) purulent SSTIs treated?
No need for antibiotics
39
How is a moderate (signs of systemic infection) purulent SSTI treated empirically? For how long?
- Doxycycline - TMP/SMX For both 5-10 days PO
40
How is a moderate (signs of systemic infection) MRSA purulent SSTI treated? For how long?
- TMP/SMX | For 5-10 days PO
41
How is a moderate (signs of systemic infection) MSSA purulent SSTI treated? For how long?
- Doxycycline - Cephalexin For 5-10 days PO
42
When should PO meds be switched to IV meds for purulent SSTIs?
- Failed incision and drainage plus PO antibiotics OR | - Systemic inflammatory response syndrome (SIRS) is present
43
What are the SIRS symptoms?
- Fever - Hypotension - Tachypnea - Tachycardia - High WBC count
44
How is a severe purulent SSTI treated empirically? For how long?
``` Treat as if it were MRSA infection - Vancomycin - Daptomycin - Linezolid - Ceftaroline - Dalbavancin - Ortiavancin - Telavancin For all of them 5-10 days IV ```
45
How is severe MRSA purulent SSTI treated? For how long?
Same as severe purulent SSTI treated empirically
46
How is severe MSSA purulent SSTI treated? For how long?
- Nafcillin - Oxacillin - Clindamycin
47
Define cellulitis
Involves the deeper dermis and SQ fat
48
Who is at risk of gaining CA-MRSA of cellulitis?
- Smoker - Diabetics - Recurrent infections - IVDU - Skin contact - Sharing personal contaminated items - Lack of cleanliness - Crowding - IVDU
49
What are the most common organisms that cause cellulitis?
- Group A streptococci | - Staph. aureus

Infectious Disease (41 decks)

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