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43 Cards in this Set

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Cellulitis predisposing factors
i. skin trauma or ulceration
Cellulitis major pathogens
i.group A beta hemolytic strep
ii.staph aureus
Cellulitis treatment (minor)
dicloxacillin PO 500mg QID or cephalexin PO 500mg QID
Cellulitis treatment (advanced)
nafcillin IV 1-2g Q4H
How long should antibiotic therapy last for cellulitis
7-10days
Cellulitis treatment for suspected polymicrobial infection
a. Augmentin 500mg TID
b. FQ (levofloxacin 500mg QD or ciprofloxacin 500mg BID) PLUS clindamycin 450mg Q6H
Cellulitis treatment for advanced polymicrobial infection
IV clindamycin 900mg Q8H PLUS aminoglycoside
Potential complications of cellulitis
i.lymphangitis, lymphadenitis
ii.necrotising fasciitis, gangrene
iii.osteomyelitis
iv.bacteremia
Septic arthritis laboratory abnormalities
i.leukocytosis
ii.ESR
Septic arthritis predisposing factors
i.joint trauma or disease
ii.compromised immune system
iii.systemic infection
Septic arthritis major pathogens
i.staph aureus
ii.beta hemolytic strep
iii.neisseria gonorrheae
Septic arthritis empiric treatment
Nafcillin IV 1-2g Q4-6H PLUS 3rd gen cephalosporin
Gonococcal septic arthritis treatment
i.3rd gen cephalosporin (ceftriaxone 1g QD; cefotaxime 1g Q8H)
Potential complications of septic arthritis
i.synovitis
ii.irreversible cartilage and bone damage
Necrotising fasciitis presentation
superficial cellulitis -> spreads to SQ tissue and fascia -> local pain and systemic fever -> dull gray fascia, may produce brown exudates
Necrotising fasciitis predisposing factors
i.PVD
ii.IV drug use
iii.diabetes
Necrotising fasciitis major pathogens
i. 90% polymicrobial
ii. Group A B-hemolytic strep
iii.Staphylococci
iv. variety of other aerobic and anaerobic bacteria (peptostreptococcus and bacteroides)
Necrotising fasciitis treatment
Parenteral
Penicillin/B-lactamase inhibitor PLUS Clindamycin + Ciprofloxacin
Necrotising fasciitis potential complications
i.severe systemic toxicity (hypotension, resp failure)
ii. life threatening
Toxic Shock syndrome presentation
i. sunburn like rash
ii. HA, vomiting, myalgias
iii.elevated CPK, LFTs, thrombocytopenia, hypocalcemia, hypoalbuminemia
iv.advanced stages can cause systemic shock with hypotension, multiple organ failure, and high fever
Toxic shock syndrome predisposing factors
i.tampon use
ii.previous skin or soft tissue infection
Toxic shock syndrome major pathogens
i. strep pyogenes
ii. staph aureus
Toxic shock syndrome treatment
Clindamycin 900mg IV Q8H PLUS beta-lactam (pen or nafcillin)
Toxici shock syndrome potential complications
i.shock
ii.multiple organ failure
Gangrene presentation
i.sudden pain at wound site 24-48hrs after injury
ii. hemorrhagic and necrotic areas
iii.clostridial gangrene affects muscle or deep skin levels
iv.toxins can induce local thrombosis of cutaneous blood vessels
Gangrene predisposing factors
i.trauma
ii.surgery
Gangrene major pathogens
i. group A B-hemolytic strep
ii.clostridia (GAS gangrene)
(perfringes, septicium, histolytica)
Gangrene treatment
Parenteral Penicillin G (high doses) PLUS parenteral clindamycin
Gangrene potential complications
i.systemic shock
ii.amputation
Osteomyelitis presentation
i.erythematous w/ drainage
ii.instability, impaired range of motion, bone pain
Osteomyelitis diagnositic criteria
2 of 4 must be present

i.pus on aspiration
ii.positive bacterial culture from blood/bone
iii.classic signs
iv.radiographic changes
Osteomyelitis predisposing factors
i.open wounds
ii.compromised immune system
iii.prior soft tissue infection
iv.PVD
Osteomyelitis major pathogens in infants (<1yr)
-Group B strep
-Staph aureus
-E. coli
Osteomyelitis major pathogens in children (1-16yrs)
-staph aureus
-strep pyogenes
-h.influenzae
Osteomyelitis major pathogens in adults (>16yrs)
-staph epidermidis
-staph aureus
-pseudomonas
-e.coli
Osteomyelitis treatment in infants
Cefazolin 40mg/kg/day in 2 divided doses
Osteomyelitis treatment in children (<5yrs)
Cefuroxime 100mg/kg/day
Osteomyelitis treatment in older children
Nafcillin 100mg/kg/day OR
Cefazolin 100mg/kg/day
Osteomyelitis treatment in adults
Nafcillin 2g Q4H OR
Cefazolin 2g Q8H
Osteomyelitis duration of treatment
4-6weeks
Osteomyelitis potential complications
i.bacteremia
ii.amputation
iii.recurrent osteomyelitis
Diabetic foot infections predisposing factors
i.peripheral neuropathy
ii.hyperglycemia
iii.vascular insufficiency
iv.noncompliance w/ foot care precautions
Diabetic foot infections major pathogens
i.staph aureus
ii.beta-hemolytic strep
iii.chronic wounds more likely to contain gram negative species