Skin + soft tissue infections

Question 1

impetigo

Answer 1

superficial
vascular lesions on top of erythematous base

golden crust

staph aureus

face, scalp

flucloxacillin

Question 2

erysipelas

Answer 2

upper dermis
painful red, distinct borders

lymphadenopathy
lymphagenitis

strep pyogenes

lower limbs

Question 3

cellulitis

Answer 3

deeper dermis and sub cut

erythematous rash, no distinct borders

fever and lymphadenopathy

strep progenies or staph aureus

Question 4

folliculitis

Answer 4

individual hair follicles - pustular infection, red papules

staph aureus

buttocks back

Question 5

furunculosis

Answer 5

single hair follicle + inflammatory nodule

deeper extension

staph aureus

Question 6

carbuncle

Answer 6

multiple hair furuncles

multiseptated abscess
–> septic

Question 7

necrotising fasciitis

Answer 7

EMERGENCY unremitting pain, rapid onset, oedema, erythema - haemorrhage bull, skin necrosis

systemic: hypotensive, tachycardia, multi organ failure
tx: flucloxacillin, gentamicin, clindamycin, metronidazole

Question 8

pyomyositis

Answer 8

infection within deep striated muscle - abscess

staph aureus

Question 9

septic bursitis

Answer 9

patellar, olecranon

staph aureus + adjacent skin infection

peribursal cellulitis, fever, pain

Question 10

infectious tenosynovitis

Answer 10

infection of synovial sheets - hands

swelling of fingers, semi flexed position, pain with extension

penetrating trauma = staph aureus, strep pyogenes

Question 11

Toxic shock syndrome

Answer 11

staph aureus: TSST1,
- diffuse macular rash, hypotensive, fever, multi organ failure

strep pyogenes TSST1 - higher mortality rate.

urgent debridement - fluids + a/bs, IV Abs

Question 12

staphylococcal scalded skin syndrome (SSSS)

Answer 12

staph aureus - ETA, ETB
(exfoliative toxin)

wide spread bull, SKIN EXFOLIATION

commoner in children

Question 13

pantun-valentine leucocidin toxin

Answer 13

gamma haemolysin

recurrent boils, haemorrhage pneumonia

tx: clindomicin