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19 Cards in this Set
- Front
- Back
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Skin infections - general
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Skin is natural barrier - get infection due to breaks in skin
-natural (hair follicles, sweat glands) -trauma/iatrogenic Resident and transient flora (Staph aureus) can cause infection MRSA increasingly common w/ skin/soft tissue infection |
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Impetigo - anatomic involvement, causative organisms, epidemiology, clinical features
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Intraepidermal
Group A strep and Staph aureus Most often in children; highly communicable Golden, stuck-on crusts, not painful |
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Folliculitis - anatomic involvement, causative organisms, epidemiology, clinical features
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Hair follicles and sweat glands - get pruritic papule often w/ pustule
Staph aureus Predisposing - diabetes, hot tubs Common on buttocks, axillae Can be acute and/or chronic |
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Furuncle - anatomic involvement, causative organisms, epidemiology, clinical features
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Deep inflammatory nodule (develops from folliculitis)
Staph aureus Common on skin w/ hair follicles subject to friction/perspiration Firm tender nodule, painful |
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Carbuncle - anatomic involvement, causative organisms, epidemiology, clinical features
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Furuncle coalescence and extension --> subcutaneous fat; multiple abscesses drain along hair follicles
Staph aureus Common on nape of neck, back of thighs Pt is acutely ill (fever/malaise) - can get bacteremia/cellulitis if not drained |
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Ecthyma - anatomic involvement, causative organisms, epidemiology, clinical features
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penetrates epidermis and dermis
Group A strep Elderly, children - lower extremities Punched out ulcers; greenish exudate |
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Erysipelas - anatomic involvement, causative organisms, epidemiology/predisposing factors, clinical features
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Superficial cellulitis w/ lymphatic involvement
Group A strep (pyogenes) Occur at sites of trauma, ulcers, abrasions Predisposing - venous stasis/lymphatic obstruction, lymphedema secondary to radical mastectomy Bright red, painful; advancing, raised, sharply demarcated border Fever |
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Cellulitis - anatomic involvement, causative organisms
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Spreading skin infection involving subcutaneous tissue
Most common causes - group A strep, staph aureus Rare - bacteremic seeding |
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Cellulitis - epidemiology
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Occurs at site of previous trauma (laceration, puncture) or skin lesion (furuncle, ulcer)
Post-op wound infections IV drug use (skin popping) Associated w/ sites of abnormal lymphatic drainage Often recurrent |
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Cellulitis - clinical features
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Acute; rapid local tenderness
Site is erythematous, swollen, warm Fevers, chills, malaise Borders not well demarcated Associated w/ lymphangitis Can develop local abscess |
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Necrotizing fasciitis - anatomic involvement, causative organisms
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Subcutaneous tissue including superficial and deep fascia
Type I - polymicrobial Type II - Group A strep (alone or w/ staph aureus) |
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Necrotizing fasciitis - epidemiology
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Usually at site of trauma (lac, burn, abrasion, bite); post-op sites
Diabetes, PVD, alcoholism, IV drug use (skin popping) Scrotum/perineum - Fournier's gangrene |
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Necrotizing fasciitis - clinical features
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Starts w/ diffuse redness, warm, very tender - rapidly progresses
Fluid filled bullae (purplish-blue skin sac) Cutaneous necrois, creptitus Pain out of proportion to physical findings Loss of pain w/ deeper injury |
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Necrotizing fasciitis - complications
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Compartment syndrome
Systemic toxicity Positive blood cultures Hypocalcemia Key = early recognition, treatment - SURGERY |
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Clostridial myonecrosis (gas gangrene) - anatomic involvement, causative orgnaism
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skeletal muscle necrosis due to histotoxic Clostridia spp
muscle disintegrates (coag necrosis) pale edematous, doesn't bleed when cut cause - C. perfringens |
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Clostridial myonecrosis - epidemiology
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Contamination w/ soil or material w/ Clostridial spores
Trauma (compound fracture) War wounds Post-surgical (bowel, biliary tract surgery) Spontaneous, non-traumatic (bacteremia) |
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Clostridial myonecrosis - clinical features
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LIFE threatening - 1/2 day incubation --> rapid progression (hours)
Severe pain XRAY - subcutaneous air Toxic appearance, shock, renal failure |
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Clostridium myonecrosis - exam findings, tx
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fever, delerium, stupor
local tenderness, tense edema, creptitus Dark green-black areas of necrosis and fluid-filled blebs on skin Serosanguinous discharge (coca-cola) - foul odor, gas bubbles Prompt surgical eval, antibiotics |
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Community-acquired MRSA causes
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Skin infections and pneumonia
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