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82 Cards in this Set
- Front
- Back
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What are the 2 most common bugs that cause impetigo?
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s. aureus
s. pyogenes can also be caused by MRSA. |
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Impetigo, folliculitis, cellulitis, erysipelis, furunculosis/carbunculosis and hydradenitis suppurativea are all examples of...?
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superficial bacterial infections
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Definition: a primary superficial bacterial infection of superficial layers of epidermis....?
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impetigo
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What are the 2 forms of impetigo?
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Bullae and Nonbullae (crusted)
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A thin roofed bullae that turns from clear to cloudy, when ruptures, creates honey crusts, lesions enlarge then coalesce...is what?
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Bullous Impetigo
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Vesicles or pustules form then rupture, brown-yellow crusted lesions that extend radially then satellite lesions appear beyond periphery..is what?
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nonbullous-crusted impetigo
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T/F
Impetigo is highly contagious infection in young children especially in kids <6 y.o. |
true
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Impetigo may spread by...
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physical contact
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T/F
Impetigo occurs only in persons under age 12. |
false-occurs in any age.
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impetiginization is AKA...
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secondary impetigo
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bacterial infection of a preexisting diseased, traumatized, or injured skin that is most often caused by staph aureus is called...secondary....or ....
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secondary impetigo or impetiginzation
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conditions predisposing to secondary impetiginazation include....
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eczema
atopic dermatitis stasis dermatitis herpes infections bites and wounds lacerations and burns |
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What are the most common bugs assoc. with impetigo?
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s. aureus
s. pyogenes mrsa |
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what is the typical lesion distribution of impetigo..in kids..and adults..
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kids usually perinasal and perioral areas
adults-lesions may appear anywhere |
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impetigo lesions spread by __-innoculation.
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auto innoculation
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T/F
impetigo lesions are usually self-limiting, clearing within a few weeks even without topical or systemic treatment. |
true
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diagnosis of impetigo is usually made...
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clinically
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Definition: acute inflammatory form of cellulitis, often with lymphangetic "streaking"
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erysipelis
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Definition: deep dermal infection, which may result in permanent scarring
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echthyma
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SSS staphylococcal scalded skin syndrome (SSS)
What is the tx? |
may occur in younger children
BID abx soaps, betadine, hibiclens used for gentle debridement. mupriocin 2% ointment or cream applied TID topical abx of choice p.o. abx ie dicloxacillin/ keflex |
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IF SSS is MRSA +, then what do you want to tx with?
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septra/bactrim or
TCN |
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Definition: A deep infection of the dermis and sub Q tissues characterized by fever, erythema, edema, and localized pain.
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Cellulitis
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T/F localized pain and tenderness occur for a few days before presentation.
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true
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Cellulitis typically presents at sites of :
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trauma, bites, surgical wounds
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Common pt. types that develop cellulitis include:
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DM
cirrohosis chf renal failure malnutrition hiv/aids ivda/etoh |
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Cellulitis is most often caused by what 2 bugs?
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GABHS
S. aureus that may or maynot be mrsa |
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cellulitis resulting from an animal bite or scratch will be caused by...
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pasteurella multicida
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cellulitis resulting from a human bite will most likely be from...
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eikenella corrodans
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the most common anaerobic bug that causes cellulitis is..
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clostridium perfringens
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What is the most common port of entry in the lower extremities for cellulitis?
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athlete's foot
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cellulitis with crepitus can indicate a....
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penetrating injury
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T/F
lymphangitis lymphadenopathy are uncommon physical findings in pts. with cellulitis |
false, you'll see em...
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elephantiasis nostras results from what repeated condition?
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cellulitis infections
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What 2 blood tests should be checked in a pt with cellulitis?
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CBC-shows left shift
ESR-mild to moderate elevation |
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T/F
cultures are not always reliable indicators of the bug |
true, aspiration cultures are sometimes helpful
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T/F
treatment of cellulitis can be handled with topical antibiotics only. |
false, empiric abx therapy should be aimed at staph and strep organisms such as pcnase resistant PCn or 1st generation cephalosporin, or augmentin
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T/F
I&D is often necessary tx in cellulitis |
true-severe infxn may require hospitalization and IV abx and/or surgical debridement.
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Definition: inflammatory form of cellulitis, characterized by the presense of lymphangitic streaking.
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erysipelis
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erysipelis is involvement of eipidermis and sub q tissue that is more deep/superficial than classical cellulitis.
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superficial
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erysipelis margins are more __ demarcated than classical cellulitis.
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sharply
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___ is the most common pathogen of erysipelas.
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GABHS
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T/F
Site of entry, while usually due to previious trauma or injury, is not always identified. |
true
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T/F
erysipelas onset is usually insiduous. |
false, usually sudden onset
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what are the prodromal sx's of erysipelas?
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chills, high fever, malaise, and myalgias lasts for 4-48 hours.
Lymphangitis, adenitis and adenopathy not usual |
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What is the most common site seen with erysipelas?
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lower leg....face, arm, thigh
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Which dx begins with one or more red, tender, indurated areas that coalesce and rapidly increase ins ize, to form a tense, deeply red, hot, elevated, shiny, sharply demarcated lesion?
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erysipelas
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T/F
with erysipelas vesicles may appear, as the border advances |
true
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ternder, painful red lymphangitic streaks appear extending toward and involving regioan lymph nodes are identified in what skin infection?
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erysipelas
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What is a rare but severe and potenially lethal complication of facial erysipelis?
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cavernous sinus thrombosis
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What are some s/s of cavernous sinus thrombosis?
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tachycardia, fever, sepsis, nuchal rigidity.
CN palsies esp. 5th and 2nd CN impaired corneal reflex periorbital hypoestesia retinal hemorrhages, papiledema dialted pupil proptosis diplopia |
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What are the top 4 lab/xrays that should be done in a pt with suspicision of cavernous sinus thrombosis?
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CBC-ele. WBC/left shift
ESR-elevated blood/sinus cultures contrast enhanced CT or MRI |
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Which organism is found in >80% of erysipelas cases?
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strep cocci most commonly GABHS fikkiwed bt streo G and non-A strep
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What is the DOC for erysipelis?
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Pen VK 250-500mg QID
zmax/biaxin are alternatives |
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Definition: a superficial or deep infection or inflammation of the hair follicle (pilosebaceous unit)...
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folliculitis
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Folliculitis ___ occurs most commonly in black individuals and is characterized by extensive inflammation, pustule formation, scarring and alopecia of the scalp.
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decalvans
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Folliculitis is more common in patients with what other dx processes.
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DM
obesity immunocomprimised |
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What is the most common pathogen seen with bacterial folliculitis?
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Coagulase-positive s. aureus.
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The primary lesion of folliculitis is a __ or __ with a central hair.
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pustule or papule
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Which infection is in a characteristic grid-like pattern, with polymorphic lesions that consist of papules or pustules?
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folliculitis
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A tender, painful folliculities involoving an eyelash is called a ?
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hordelum or "sty" which is an infection of the meibomian glands of the eye lids.
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What is the tx of mild folliculitis?
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antibacterial soaps or topical abx
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What is the tx of chronic, recurrent cases of folliculitis?
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bactroban (mupricin) ung for s. aureus or mrsa or systemic tx with dicloxacillin, cephalosporin's, or minocycline.
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What bug causes hot tub cellulitis?
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pseudomonas, is very pruritic, tend, and occurs due to improperly sanitized hot tubs, jacuzzies, etc
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folliculitis in sites of shaving is called/....
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pseudofolliculitis barbae
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Pityrosporum folliculitis is AKA
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fungal folliculitis
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how do you diagnose fungal folliculitis?
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skin scraping and KOH testing is positive for short hyphae and round spores
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the tx of fungal folliculitis is ....
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topical or oral antifungals such as oral ketoconazole x1 then repeated in 1 week
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A circular lesion inside a fungal infxn is called
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Majocchi's granuloma
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Viral folliculitis is often caused by an infection by ?
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HSV 1
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A __ is a waled-off, deep, painful, firm or fluctuant mass enclosing a collection of pus.
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furuncle
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A__ is an extremely painful, deep, interconne ted aggregate of infected, abscessed follicles (network of furuncles)
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carbuncles
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The most common bug associated with furuncles and carbuncles is...?
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s. aureus then...
e. coli p. aeruginosa s. faecalis |
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predisposing disorders in furuncles and carbuncles are...?
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DM
Immunosuppressive dos malnutrition |
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Any __ bearing site can be affected by a furuncle.
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hair bairing
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Favored sites for carbuncles include?
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posterior neck
upper back lateral thighs |
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Which lesion may cause systemic signs and symptoms of infection?
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carbuncle
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which lesion furuncle/carbuncle eventually points twoard the surface and drains thru multiple openings?
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furuncle
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With a __, systemic signs and symptoms of infection, such as malaise, fatigue, chills, and fever may precede or accompany infection.
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carbuncle
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I & D is the primary mgt for pointing, __ lesions.
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flucuant
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Eosinophilic pustular folliculitis is pruritic, extensive follicular papules that suddenly appear on face, neck and chest....what MUST you test for?
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HIV
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Definition: Chronic suppurative, scarring dx of the apocrine glands of the axillae, and the anogenital and inframammary regions...is ?
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hydradenitis suppurativa (acne inversa)
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The hallmark of hydradenitis suppurative (acne inversa) is ?
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double comedome; blackhead with >2 ostia, sinus tracts common, deep painful abcesses with cordlike bands of scar tissue, typically progressive
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