Skin And Soft Tissue Infections

Front 1

Impetigo

Back 1

vesicular, crusted superficial infection of the skin

Front 2

cellulitis

Back 2

spreading infection in the dermis

Front 3

boil

Back 3

small abscess in dermis and sub q

Front 4

abscesses

Back 4

walled-off collection of purulent material composed of bacteria and inflammatory cells (neutrophils)

Front 5

necrotizing fasciitis

Back 5

spreading infection of fascial tissues

Front 6

myonecrosis

Back 6

spreading infection of muscle and fascia

Front 7

toxic shock syndrome

Back 7

toxin-mediated diseases associated with local infection with staph or strep

Front 8

Which organisms are more likely to cause a spreading infection?

Back 8

streptococci

Front 9

Which organisms are more likely to cause a localized infection with purulence?

Back 9

staphylococcus

Front 10

Who is susceptible to skin and soft tissue infections?

Back 10

- healthy kids and adults
- pts with underlying diseases
-DM, neuropathy, IDU, burns....

Front 11

Which organism is typically colonized at higher rates in diabetics, IV drug users, dialysis pts?

Back 11

s. aureus

Front 12

What is an indicator for increased colonization with group B strep?

Back 12

- people who use needles...

Front 13

What is the pathogenesis of skin infection?

Back 13

- need to be colonized with the organism
- needs to be a breakdown of skin integrity

Front 14

Which genetic factor lead to the emergence of MRSA?

Back 14

mecA4

Front 15

Which form of MRSA (HA or CA) tends to cause severe and recurrent abscesses?

Back 15

CA-MRSA

Front 16

Where was CA-MRSA first described?

Back 16

in isolated populations, athletes, military, prisoners

Front 17

What genetic element led to the emergence of VRSA?

Back 17

- transposon from VRE

Front 18

Impetigo is typically caused by...

Back 18

- group A strep
- S. aureus

Front 19

Cellulitis is typically caused by...

Back 19

- Group A/B strep
- beta-hemolytic strep
- S. aureus

Front 20

The difference between cellulitis and impetigo...

Back 20

- cellulitis spreads and is deeper
- pts will look ill, toxic, febrile
- bacteremic
- classical signs of inflammation

Front 21

The difference between boils, furuncles, carbuncles...

Back 21

- b and f:
- localized, sub q
- not ill pts
- carbuncles
- multi-loculated, on neck, diabetics, needs to be drained

Front 22

Abscesses are typically caused by...

Back 22

- s. aureus
- will have localized polys and bugs
- pt bacteremic
- can be in organ or sub q

Front 23

necrotizing fasciitis is typically caused by...

Back 23

- group a / b strep

Front 24

How do you treat nec fas?

Back 24

surgery!!!

Front 25

What will you see in a tissue sample of nec fas?

Back 25

- no host response
- no neutrophils
- only bugs!!

Front 26

myonecrosis is typically caused by...

Back 26

- group a strep
- clostridium

Front 27

TSS is typically caused by...

Back 27

- S. aureus
- group A strep

Front 28

How can you determine if a pt has TSS?

Back 28

- will see faint rash
- white imprints left after touch
- not spreading rash
- no bacteremia

Front 29

scalded skin syndrome is typically caused by...

Back 29

- s. aureus

Front 30

To diagnos skin infections you would order...

Back 30

- WBC count
- gram stain
- culture
- blood culture
- x-rays and CT

Front 31

When is a blood culture helpful?

Back 31

- nec fas, myonecrosis
-NOT helpful for boils, impetigo, toxin diseases

Front 32

What might you see on a ct scan in nec fas?

Back 32

- air / gas in tissues

Front 33

Tx for impetigo

Back 33

- ointments
- penicillin V

Front 34

Tx for boils, furuncles

Back 34

- drain, warm compress

Front 35

Tx for cellulitis

Back 35

- IV antibiotics

Front 36

Tx for carbuncles, abscesses

Back 36

- IV antibiotics
- surgery

Front 37

Tx for nec fas and myonecrosis

Back 37

- surgery
- clindamycin to stop protein synthesis in bug

Front 38

When is surgery indicated in skin infections?

Back 38

- nec fas
- myonecrosis
- abscesses

Front 39

Tx TSS

Back 39

- support patient with fluids
- remove source