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BLOCK 2 > Superficial/Deep skin tissue infection > Flashcards

Superficial/Deep skin tissue infection Flashcards

1
Q

What is the order of skin anatomy from surface to the inside?

A

Epidermis»Dermis»Subcutaneous layer»Fascia layer»muscle

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2
Q

When are skin infections considered superficial?
What are the possible example of such infections?

A
  • Superficial skin and soft tissue infections (SSTIs) are superficial if they present only on epidermis and dermis:
    -Impetigo
    -Focullitis
    -Erysipelas
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3
Q

When are skin infections considered deep?
What are the possible examples of such infections?

A

-SSTI are considered deep if they expand through the subcutaneous layer:
-cellulitis
-Necrotizing fasciitis
-clostridial/non-clostridial myonecrosis

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4
Q

What is the clinical manifestations of impetigo? How does it present or look like?

A
  • Presents as vesicular pustules which rapture»producing purulent discharge (pus)»which dries to form characteristic ‘golden-yellow crusts’

*Pruritis-itchy sensation is common. Scratching spreads the disease

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5
Q

Provide the epidemiology if impetigo. Population most prone to the infection? When is the disease mostly seen? (seasons)

A
  • Common in children
  • Peaks in hot and humid summer months.
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6
Q

What is the clinical manifestation of folliculitis? How does it present or look like?

A
  • Pyoderma (pus) located within and around hair follicle.
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6
Q

What bacteria species causes impetigo?

A

Group A Streptococcus (GAS)

  • staphylococcus aureus causes bullous impetigo
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7
Q

What other 2 conditions extend from folliculitis?

A
  • Furuncle: usually smaller than carbuncles and involve a single hair follicle. (Are superficial)
  • Carbuncle: larger and more severe form of skin abscess that involves multiple interconnected furuncles. (Are deeper)
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8
Q

What bacteria causes folliculitis?

A

Staphyloccoccus eureus

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9
Q

What are the clinical presentations of facial erysipelas?

A
  • Tender erythematosus
  • demarcated boarder
  • Indurated plaque
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10
Q

What are the 2 types/forms of erysipelas and their causative organisms?

A
  • Erysipelas in the face: Streptococccus pyogenes
  • Lower extremities: Staphylococcus aerues
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11
Q

What happens in the site of infection when you are having erysipelas, and what symptoms do you present with?

A

“St. Anthony’s fire”- originated from the intense burning sensation and fiery red appearance of the affected skin

  • Regional lymph node swelling

*Symps: malaise, aches, fever, nausea

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12
Q

What’ the treatment for erysipelas?

A
  • spontaneous resolution
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13
Q

What bacterial organisms cause celllulitis?

A
  • Staphylococcus aureus.
  • GAS
  • Vibro vulnificus(gram- bacteria) -through contact with brackish waters
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14
Q

What’s the prominent characteristic of cellulitis?

A
  • Non-necrotizing inflammation of the skin and subcutaneous tissue
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15
Q

What are the symptoms of cellulitis?

A
  • Erythema(redness)
  • Pain
  • Warmth
  • Swelling

*inflammatory symptoms coz naye uyi inflammation vele

16
Q

When do we suspect a sever infection with cellulitis?

A
  • When patient is presenting with:
    -circumferential cellulitis
    -Lymphangitic spread
    -Pain disproportionate to examination finding
    -malaise, chills, fever, and toxicity
17
Q

What antibiotics are used to treat cellulitis?

A
  • co-amoxyclav
  • Clindamycin
  • Cefazolin
  • ciprofloaxicin

*IV for severe infection

18
Q

What is fournier gangrene?

A

A form of necrotising fasciitis localised to scrotum and perineal area

19
Q

What is a signs of necrotising fasciitis heard beneath the skin on the early ages of the skin infection where the infection has not yet presented to the surface?

A
  • Crepitus

*grating/crackling sound under the skin

Other signs seen within 3-5 days following crepitus:
-Skin breakdown with Blisters
-foul smelling discharge
-Frank cutaneous necrosis and gangrene.
-discolouration

20
Q

What are the 3 types of necrotising fasciitis?

A
  • Type 1- Caused by a mixture of pathogens: 1 anaerobe, facultative anaerobe, and an enterobacteriaceae. Common in diabetic patients
  • Type 2- Caused by GAS/S pyogenes alone, or with S aerus
  • Type 3- Cuased by rare pathogens
21
Q

What bacterial species cause ‘clostridial gangrenous myonecrosis’?

A
  • Clostridium perfringens
  • novyii
22
Q

At what setting should 1 expect to see ‘clostridial gangrenous myonecrosis’?

A
  • Traumatic injuries
  • Penetrating wounds
  • surgical wounds
  • vascular insufficiency in extremity (inadequate blood flow to extremities)
23
Q

What bacterial species cause non-clostridial gangrenous myositis?

A
  • streptococcus pyogenes
24
Q

What’s the treatment for ‘clostridial gangrenous myonecrosis’?

A
  • Aggressive surgical debridement (even amputation) +effective antibiotics
  • Penicillin and clindamycin are recommended (incase of penicillin allergy, use metronidazole)- This is to inhibit the synthesis of clostridial exotoxins and lessen their toxic effect.
25
Q

What are the differences between ‘clostridial and non-clostridial gangrenous myonecrosis’?

A
  • Species causing them
  • Clostridial produce gas gangrene and non-clostridial does not
26
Q

What organisms are considered the normal flora of the skin?

A
  • Propionibacterium acnes
  • Staphylococcus epidermidis
  • Candida species

*Staphylococccus areus is a transient coloniser.

27
Q

What are the risk factors to acquiring SSTIs?

A
  • Immunicompromised state
  • Immune suppressive thearpy
  • Trauma: invsv medcl tchnq, surgery
  • Chronic venous insufficiency (veins failing to send blood back to heart)
28
Q

What is a severe staphylococcal infection caused by S. aures toxin on younger children?

*it heals within 2 weeks

A

Staphylococcal Scaled Skin Syndrome (SSSS)

*can be caused by methicillin resistant and methicillin sensitive staphylococcus aerus

*A syndrome-causing toxin is called exfoliative exotoxin

29
Q

Elaborate on the progression of SSSS on younger children

A

It starts off as fever»»tenderness»»scarlatiniform rash

30
Q

What are the treatment measures for SSSS?

A
  • Fluid therapy
  • IV anti-staphylococcal antimicrobials
  • Ribosomally active antibiotics: clindamycin
31
Q

What is a ‘toxic shock Syndrome’?

A

Acute febrile illness with a generalized scarlatiniform rash associated with S.aureus infection

*A disease is not caused by an organism but by a toxin from the organism. Toxic Shock Syndrome Toxin 1 (TSST1)

32
Q

What are the 2 toxin mediated cutaneous manifestations?

A
  • SSSS
  • Toxic Shock Syndrome
33
Q

What are the clinical manifestations of toxic shock syndrome??

A
  • hypotension
  • three or more organ system dysfunction
  • desquamation of skin lesions

BLOCK 2 (56 decks)

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