Bacterial Skin Infections

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What is a common infection occurring in up to 3% of people per year?

What does it result from? How does it present? Where is it most commonly found? Where do the streaks of lymphangitis spread?

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Name some of the risk factors for cellulitis:

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80% of cellulitis is cause by what organism type?

What are the most common casual pathogens?

What are two organisms if there have been unusual exposures? (animal bites and human bites)

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Why should you treat cellulitis early? For outpatients with non purulent cellulitis, what do you empirically treat for? What do some clinicians also choose?

For outpatients with purulent cellulitis (purulent drainage or exudate in the absence of a drainable abscess), what do you empirically treat for?

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What do you do if there is a poor response to treatment of cellulitis? Do you raise or lower the involved area? Should you treat tine pedis? What empiric therapy should you consider for hospitalized patients? Cultures from abscesses and other purulent skin and soft tissue infections (SSTIs) are recommended in which patients?

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What are some risk factors of healthcare-assocaited MRSA and community associated MRSA?

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Match:

1. Expensive, no cross-resistance with other classes

2. Unreliable for S. Pyogenes (will need to combine with amoxicillin to cover for group A strep)

3. Parenteral drug of choice for treatment of infections caused by MRSA

4. Excellent tissue and abscess penetration (risk for C. difficult, inducible resistance in MRSA)

5. Unreliable for S. pyogenes (need to combine with amoxi to cover group A strep), DO NOT USE in children < 8

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Does this person have cellulitis? If so, what is the type?

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YES!

Type = Erysipelas

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What is a superficial cellulitis with marked dermal lymphatic involvement (causing the skin to be edematous or raised)? What is the main pathogen? Where does it usually present? How does it present? What may the plaques develop into? What type of white cell count is it associated with? What may precede it?

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What is this an example of?

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Should immediate empiric antibiotic therapy be started in erysipelas? What common pathogen should you try to cover? What do you do if there is a poor response initially? Do you elevate the area? What should you also treat if it is present?

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What is the diagnosis? Define. How does it present? What is it often surrounded by? Spontaneous drainage of what may occur?

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How do experts recommend to incise and drain an abscess?

Which abscesses also receive antibiotics? (think disease state, progressions, symptoms, immunosuppression, ages, location, septic condition, response)

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Should wound cultures in an abscess always be sent? What do you do with patients who have recurrent skin infection?

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Diagnose, describe, and define.

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Describe and diagnose.

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Furnucles and carbuncles are a subtype of what?

Where do they usually occur? What are these areas usually exposed to?

Usual pathogen? How are patients commonly treated? How do you treat a solitary, small furuncle? What about larger furuncles and carbuncles?

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What is shown here?

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Furuncle and carbuncle

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What is a superficial bacterial infection of the hair follicles? How does it present (small or large, color, pustule size)? What type may be sexually transmitted? What is the main pathogen? What is the possible cause if there has been hot tub exposure? What is the type if the pustules are associated with marked erythema and scaling?

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What do you do for the treatment of folliculitis (nothing too complicated)? Do superficial pustules rupture and drain spontaneously? What other agent can you use? What do deep lesions of folliculitis represent? Should they be drained?

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What is shown here?

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Folliculitis

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Non-bullous impetigo

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What is another common superficial bacterial skin infection? In what ages do you usually see it? Is it contagious? What are most cases due to? What are the remainder due to?

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What is shown here? Another name? How do the lesions begin? How do they progress?

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What is shown here? In what ages is it seen? How is it characterized? What do ruptured bullae leave?

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What is an ulcerative form of impetigo in which the lesions extend through the epidermis and deep into the dermis? What do they consist of?

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What are some of the oral antibiotics used to treat impetigo? In which one will some strains of staph aureus and strep progenies be resistant?

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Do the dosing guidelines of impetigo vary according to age? What topical therapy may be equally effective to oral antibiotics IF the lesions are localized in an otherwise healthy patient?

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What is a life threatening infection of the fascia just above the muscle? How rapidly does it progress? What does it often follow? Will it sometimes not have a preceding visible lesion? Describe the lesion. What colors does it often turn? What is a characteristic finding? What is it often caused by?

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Is necrotizing fasciitis considered a medical emergency? What do you do if you suspect it? What does treatment include? What are some poor prognostic factors (age, diagnosis, diseases, infection locations)?

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