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39 Cards in this Set
- Front
- Back
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What is impetigo also known as?
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School sores.
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In what environment is impetigo best spread?
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* warm, moist environments
* close physical contact * poor hygiene * Areas where the skin is broken by insect bites, superficial injury & excoriated eczema |
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What bug most commonly causes impetigo?
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1. Staph aureus, and less commonly:
2. Strep pyogenes |
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What are the 3 ways in which impetigo presents?
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1. Crusted or nonbullous: red base with golden yellow crusts & erosions, itchy but not painful: most common and subacute.
2. Bullous: (always s.aureus), mildly irritating blisters that erode rapidly leaving a brown crust 3. ulcerative lesions: always s.pyogenes. |
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What kidney condition might follow impetigo within 8 weeks, and which bug is this related to?
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Glomerulonephritis (s. pyogenes)
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What antibiotics can you give for methicillin resistant s. aureus?
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Based on susceptibility testing, however, generally:
* clindamycin or * trimethoprim + sulfamethoxazole * vancomycin Can ask the lab or an ID specialist before treating. |
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In recurrent cases of impetigo, what should you look out for & treat?
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Nasal carriage of s.aureus.
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If impetigo is mild, what can you treat it with?
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Topical Muciprocin 2% ointment tds for ten days.
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If impetigo is severe and widespread, what can you treat with?
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Cephalexin (oral).
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What does folliculitis look like?
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Inflammatory papule centred on a follicule (a hair shaft can be seen in the centre, with a magnifying glass)
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What are some common differential diagnoses for folliculitis?
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* Miliaria rubra (heat rash)
* Insect bites Note; none of these are centred primarily on the hair follicle. |
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What are some common causes of folliculitis?
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1. Physical: e.g. shaving/waxing, occlusive clothing, grease
2. Patients who are colonised with s.aureus (nasal) may need prolonged decontamination regime using antiseptic washes, nasal muciprocin, oral a/b & washing clothes & linen in hot water to prevent occurences 3. Fungal causes |
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What is the deeper form of folliculitis known as?
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Boils. They are usually tender and painful.
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What is generally the causative organism in boils?
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S. aureus, occasionally in concert with strep pyogenes.
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How do you treat small boils?
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Drainage. Usually you treat them the same as with folliculitis or impetigo.
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What is the technical term for:
a. boils b. boils that have coalesced & extend to deeper tissue |
a. furuncles
b. carbuncles |
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How do you treat patients with larger abcesses?
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* Drainage under local anaesthetic
* Lodoform gauze packing of the larger abcess cavities * Daily cleansing & replacement of dressings * When indicated, systemic treatment with anti-staph antibiotic for at least 10 days |
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What are the likely causes of:
a. acute paronychia b. chronic paronychia |
a. Acute: usually s. aureus
b. Chronic: usually chronic dermatitis, sometimes with with C. albicans superinfection |
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How do you normally treat acute bacterial paronychia?
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The pustule can be easily drained by lifting the nail fold with a sterile needle. Topical treatment with muciprocin is usually effective.
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What are the characteristics of cellulitis?
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* pain
* redness * edema * Blistering with progression * lymphadenopathy |
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What is cellulitis?
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Bacterial infection of the dermis and subcutaenous tissues.
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What is erysipelas?
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More superficial, well-demarcated infection (than cellulitis) with lymphatic streaking.
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What is the usual pattern of erysipelas?
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1. usually affectrs face
2. butterfly pattern of erythema 3. Well defined with a sharp edge 4. May be accompanied by lymphadenopathy, high fever & malaise |
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What are some known underlying causes of cellulitis?
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1. Tinea of the feet
2. Lymphoedema 3. Chronic dermatitis 4. Poor lower leg circulation 5. Wounds 6. Herpes infection 7. Dental caries 8. Chronic sinus infection |
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What are some differential diagnoses for cellulitis?
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* Stasis dermatitis
* DVT * Erythema nodosum (lower legs) * Contact dermatitis |
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Where do children often get cellulitis?
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Periorbital.
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How do you treat cellulitis?
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Often oral antibiotics, however the following categories may need IV:
* obese pts * diabetic pts * lymphoedema * post-animal bite * post-surgical * burns * immunosuppressed pts |
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What is a simple cause of recurrent cellulitis that you should always look for?
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Tinea of the feet.
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What agent often is the cause of acute balanitis (often in uncircumcised males) and vulvovaginitis in children?
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Strep pyogenes. May occur in conjunction with perianal lesions or in isolation.
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What may cause a persistent perianal eruption in children?
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Streptococcal perianal dermatitis. the rash is tender, itchy & may be accompanied by painful fissuring.
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What are some agents which often cause otitis externa?
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1. Staph aureus
2. Pseudomonas aeruginosa 3. Fungi e.g. c. albicans |
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How do you treat otitis externa?
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* Swabs to determine if bacterial infection is playing a role + antibiotics if so
* Corticosteroid ear drops |
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What factors play a part in developing otitis externa?
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1. Environmental: heat, humidity, swimming
2. Trauma (stop pt picking ear canal with cotton buds, hairpins etc) 3. Genetic/constitutional: shape of external auditory canal, type & amount of wax etc |
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What are some symptoms of otitis externa?
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* Inflammation fo the outer ear canal epithelium
* Pain * Itch * Deafness * Discharge |
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What is verruca vulgaris another name for?
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Common wart.
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What is molluscum contagiousum?
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Common contagious DNA poxvirus infection. The virus is spread in water.
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What are the 2 peaks in onset of molluscum contagiousum?
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Children: 3-9 years
Young adults: 16-24 |
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In the immunocompromised host, why might you biopsy what looks like molluscum contagiosum?
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To determine whether it is in fact cryptococcosis or histoplasmosis.
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What is a chemical therapy that might help in molluscum contagiosum (if you can't wait a couple of years for it to resolve by itself)?
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Imiquimod.
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