Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
29 Cards in this Set
- Front
- Back
- 3rd side (hint)
|
DDx of skin infections |
- impetigo - scalded skin syndrome - cellulitis - erysipelas |
4 |
|
|
DDx of a swollen leg |
- DVT - cellulitis - myositis - fasciitis - haematoma - muscle injury - compartment syndrome |
|
|
|
DDx in cellulitis |
- vasculitis: erythema nodosum - post-phlebitic limb: chronic venous insufficiency - eczema: atopic, contact - venous insufficiency: venous eczema, often bilateral, yellow crusting, scaling - thrombophlebitis: swelling along path of vein, chronic skin discolouration, typically no erythema or discomfort - DVT: unilateral swelling of >3cm |
6 |
|
|
Cellulitis |
|
|
|
Definition of cellulitis |
Bacterial infection of the skin and subcutaneous tissue - most commonly affects the legs |
|
|
|
Definition of erysipelas |
An acute, superficial form of cellulitis that involves the dermis and upper subcutaneous tissue - has a well defined, red, raised border |
|
|
|
Classical features of cellulitis |
- erythema - heat - swelling - pain - features of severe infection: fever, malaise, chills, lymphangitic spread, disproportionate pain |
4 |
|
|
Lesions in cellulitis |
- erythematous - oedematous - tender - regional lymphadenopathy - vesicles/bullae - entry wound/pre-existing skin pathology |
6 |
|
|
Investigations in cellulitis |
- leukocytosis - raised inflammatory markers - swab skin for organism |
3 |
|
|
Predisposing causes of cellulitis |
- PVD: leg ulcer, eczema, oedema - immunosuppression: HIV, steroid therapy, DM - systemic illness - chronic kidney disease - chronic liver disease - skin break: entry point for infection, e.g. insect bite - recent surgery - tinea pedis - obesity |
4 |
|
|
Causative agents in cellulitis |
- beta haemolytic streptococci (group A, strep pyogenes) - staph aureus |
2 |
|
|
Assessing cellulitis severity |
- class I: no systemic toxicity/co-morbidity - class II: systemically ill/co-morbidity - class III: marked systemic illness/severe co-morbidity - class IV: sepsis syndrome/life threatening infection (necrotising fasciitis) |
4 |
|
|
Management of cellulitis |
- elevate affected limb - analgesia & antipyretics - hydration - mark extent of erythema - non-adherent saline dressings if weeping - antibiotics: benzylpenicillin, flucloxacillin (clindamycin if penicillin allergy) |
3 |
|
|
Antibiotics in cellulitis |
Flucloxacillin or benzylpenicillin (clindamycin if allergic to penicillin) - class I: flucloxacillin 500mg QDS (covers both organisms) - class II/III: flucloxacillin 2g QDS - class IV: IV benzylpenicillin & co-amoxiclav |
|
|
|
Complications of cellulitis |
- local necrosis - abscess - septicaemia |
3 |
|
|
Necrotising fasciitis |
|
|
|
Definition of necrotising fasciitis |
A rapidly spreading infection of deep fascia with secondary tissue necrosis (may involve underlying muscle) - leads to massive tissue loss, multiorgan failure & death rapidly |
|
|
|
Bacteria in necrotising fasciitis |
Can be single microbe or polymicrobial - group A haemolytic streptococci - staph aureus Anaerobes (form gas gangrene) - clostridium perfringens - bacteroides |
4 |
|
|
Risk factors for necrotising fasciitis |
50% of cases occur in young healthy individuals - abdominal surgery - immunosuppression: DM - haematological malignancies - IV drug use |
3 |
|
|
Presentation of necrotising fasciitis |
- severe pain: may be no visible skin changes - erythematous, blistering skin - systemically unwell - surgical emphysema |
5 |
|
|
Investigations in necrotising fasciitis |
- FBC: decreased WCC - U&Es: increased urea, hyponatraemia - inflammatory markers: increased CRP - creatine kinase: >600 - x-ray: soft tissue gas may be present |
5 |
|
|
Management of necrotising fasciitis |
- urgent referral for extensive surgical debridement - empiric broad spectrum IV ABx - ICU management |
3 |
|
|
Prognosis in necrotising fasciitis |
Mortality is up to 76% |
|
|
|
Bullous impetigo |
|
|
|
Non-bullous impetigo |
|
|
|
Definition of impetigo |
A common, highly contagious, superficial bacterial skin infection caused by staph epidermis (bullous impetigo), staph aureus (incl. MRSA), or streptococci (non-bullous impetigo) |
|
|
|
Definition of scalded skin syndrome |
An exfoliating condition that affects children, particularly neonates, caused by staph aureus |
|
|
|
Folliculitis |
|
|
|
Definition of folliculitis |
Infection of hair follicles caused by staph aureus - a subtype of impetigo |
|
