Term
| Infections happen with break in skin. what cause breaks |
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Definition
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Term
| What bact. is now increasingly causing skin and soft tissue infection |
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Definition
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Term
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Definition
- resident- S epidermis, micrococcus, diptheroids, anaerobic GPC
- transient (usually cause trouble)
- S aureus (MRSA)
- Strep pyogens (group A)
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Term
| Impetigo (pathology, causative organism, clinical features, epidemiologic features) |
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Definition
- pathology- intraepidermal viscopustule
- causative agents- S aureus and Group A strept.
- epidemiology- mostly in kids
- clinical features
- golden "stuck on" crusts, not painful
- highly communicable
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Term
| folliculitis (pathology, causative microorganisms, clinical features) |
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Definition
- pathology- occur within hair follicle and apocrine sweat glands
- pruitic papule often with pustle
- causative organism- S aureus
- clinical features- acute and or chronic (esp. buttocks, axillae)
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Term
| furnucles (pathology, causative organism, epidemiology, clinical features) |
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Definition
- pathology- deep inflammatory nodule developing from folliculitis
- causative organism- S aureus
- epidemiology- skin with hair follicles subject to friction and persperation
- clinical features
- firm tender nodule progressing to painful fluctuant lesion
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Term
| carbuncle (pathology, causative agent, epidemiology, clinical features) |
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Definition
- pathology- more extensive furnucle, extending into subQ fat
- multiple abscesses drain along hair follicle
- causative agent- S aureus
- epidemiology- occur in the nape of neck, back of the thighs (thin, inelastic skin)
- clinical features
- patient often acutely ill
- can be complicated by bacteremia or cellulitis if undrained
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Term
| ecthyma (pathology, clinical features, causative agents) |
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Definition
- pathology- starts intradermal, penetrates epidermis and dermis
- causative agent- Group A strept.
- clinical features- punch out look
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Term
| erysipelas (pathology, causative agent, epidemiological features w/predisposing factors) |
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Definition
- pathology- superficial cellulitis w/lymphatic mov't
- causative agent- group A strep
- epidemiological features
- occur at sites of trauma, ulcers, abrasions
- predisposing factors
- venous stasis/lymphatic obstruction
- lymphedema secondary to radical masectomy
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Term
| erysipelas (clinical features) |
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Definition
- painful, bright red lesion
- advancing, raised border which is sharply demarcated from normal skin
- fever common
- potential to spread to deeper dermis
- subQ abscess
- cellulitis
- necrotizing fascitis
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Term
| cellulitis (pathology, causative agents) |
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Definition
- pathology- spreading infection of the skin involving subQ tissue
- causative agents
- most common
- rare- bact. seeding
- other- epidemiologic clues
- sea water = Vibrio
- fresh water = Aeromonas
- salt water seafood = Erysipelo
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Term
| cellulitis (epidemiological features) |
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Definition
- occurs freqeuntly at site of previous trauma(laceration, puncture) or skin lesion (furnucle, ulcer)
- post op wound infection
- IV drug use (skin popping)
- assoc. with sites of abnormal drainage
- often recurrent
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Term
| cellulits (clinical features) |
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Definition
- acute
- rapid development of local tenderness
- site is erythematous, swollen, and warm to touch
- assoc. with fever, chills, malaise
- commonly associated with lymphangitis
- local abscess may develop
- diagnosis via history, exam findings
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Term
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Definition
- most therapy is empiric (rare to ID causative organism)
- supportive therapy (ex: elevation)
- antibiotics
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Term
| necrotizing fasciitis (pathology, causative agents of type I and type II) |
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Definition
- pathology- involves subQ soft tissue including superficial and deep fascia
- causative agents
- type I
- polymicrobial infection
- usually anaerobes
- type II
- group A strep.
- alone or polymicrobial
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Term
| necrotizing fasciitis (epidemiologic features) |
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Definition
- usually at site of trauma (laceration, burn, abrasian, bite) also post op sites
- predisposing factors- DM, PVD, alcoholism and IV drug abuse (skin popping)
- if forms on scrotum/perineum- Fournier's gangrene (usually in men with DM)
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Term
| necrotizing fasciitis (clinical features) |
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Definition
- starts as diffuse redness, warm, and tender
- progresses rapidly (hours to days)
- fluid filled bullae
- cutaneous necrosis
- creptitus- subQ gas (touch and you hear snap, crackle, pop)
- pain out of proportion to physical findings
- loss of pain may be clue to deeper injury
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Term
| necrotizing fasciitis (clinical complications) |
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Definition
- compartment syndrome due to swelling and edema (may require fasciotomy)
- systemic toxicity
- blood cultures often positive
- hypocalcemia due to necrosis of subQ fat
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Term
| necrotizing fasciitis (tx) |
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Definition
- early recog. and tx needed
- prompt surgical intervention
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Term
| clostridial myonecrosis aka "gas gangrene" (pathology, causative agent) |
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Definition
- pathology- skeletal musc. necrosis due to histotoxic Clostridia species
- muscle disintegrates (coagulative necrosis)
- pale, edematous on inspection
- when you cut, it will not bleed
- causative agent- clostridia perfringenes via its alpha toxin
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Term
| Clostridial myonecrosis (epidemiology) |
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Definition
- contamination with soil or material with clostridial spores
- trauma
- war wounds
- post surgery (bowel, biliary tract surgery)
- spontaneous, nontraumatic (bacteremia)
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Term
| Clostridial myonecrosis (clinical features, tx)) |
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Definition
- life threatening
- incubate one to two days and rapidly progress (hrs)
- X rays will show subQ air
- severe pain is common (important early sign)
- toxic appearance (shock and renal failure follow)
- tx- prompt surgical intervention and antibiotics
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Term
| clostridial myonecrosis (exam findings) |
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Definition
- fever, delirium, stupor
- local tenderness, tense edema, crepitus
- skin bronzed with dark green-black areas of necrosis and fluid filled bleebs
- discharge serosanguinous, dark color ("coca cola") with a foul odor and you may or may not have gas bubles
- gram stain- large box car gram positive rods with few leukocytes
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Term
| epidemiological research findings and practices with MRSA |
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Definition
- there has been a huge increase in community acquired infections
- usually, in the hospitial, they will swab the nose for potential S. aureus
- practice is to treat a skin infection like MRSA until proven otherwise because it probably is MRSA
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