Skin soft tissue infection micro

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  • Created by: Amh
  • Created on: 19-03-16 10:37
What is the word for an infection that forms pus?
Pyogenic
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What are some common soft skin and tissue infections
Impetigo, folliculitis, furuncles, adn carbuncles, cellulitis, ersipelas
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What are the main organsisms involved in SSTI
Staphylococuus aureus, Strep pyrogenes, GAS strep, maybe some clostridium
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What are the layers of the skin
Ouuterlayer epidermidis, dermis, hypodermis
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Where does imepetigo occur?
infection of the epidermis
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What is a risk factor for impetigo
Minor trauma, dermatitis, staph aureus in normal flora, most commo nin infants
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What organisms cause this
Staphylococcus aureus and / or Streptococcus pyogenes
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What is the treatmenr?
topical mupirocin or oral flucloxacillin
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What is a common cause of impetigo
breast feeding, and unsterlised bottles and trauma from mother being ooo rough
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What is the similarites/differences between strep pygogens and staph aureus
Both gram posititve cocci by aureu is in clusters and pyrogens is in chains, S aureus is cat positive, S epidermis is cat negative
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What is folliculitis?
Infection of the hair follicle
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who is is most common in?
kids
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What are the clinical features
papules and pustules around hairs, occurring in crops
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What organism causes folliculitis
Staph aureus Pseudomonas aeruginosa (assoc. with contaminated jacuzzis)
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What is the treaTMENT
flucloxacillin for prolonged or severe folliculitis.
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What are cutaneous abscesses
boils, furuncles carbuncles
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Where do these cutanous abscesses form an how do they get there?
in sunncutaneous tissue, when infection spreads from hair follicle
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Are they pyogenic
yes
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What is a furuncle
isolated boil – usually no fever
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what are carbuncles?
several adjacent furuncles draining pus through multiple orifices – fever more likely
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What organsims cause these cutaneous abesses
usually Staph aureus, groin abscesses often polymicrobial (coliforms, anaerobes, gram-positive cocci)
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What is the treatment for cutanous abcsesses
flucloxacillin Incision and drainage often required
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Who is most likely to get cutanous abcesses?
immunocomprimised, and poor hygiene, IV drug users
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What is cellulitis
a rapidly spreadin infection at the top of the subcutaneous tissue
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What will be the clinical presentation?
redness, hot to touch, patient ill be unwell and febrile (Erythema, tenderness and warmth. Bullae and desquamation possible. Fever)
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What are the common organisms that cause this
Staph aureus, GAS strep (this includes strep pyrogens)
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What are the risk factors for cellulitis
Minor trauma, peripheral vascular disease, impaired lymphatic drainage
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What is the treatment?
oral flucloxacillin (mild cases) or iv flucloxacillin and benzylpenicillin for severe cases, potentially surgical
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What is Erysipelas?
A form of cellulitis with a sharply demarcated raised edge. Bacteremia common
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What layer of the skin do Erysipelas form in
Subcutaneous
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Where do Erysipelas arise
Face and limbs
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What organsims cause Erysipelas
Streptococcus pyogenes
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what layer of the skin do wound infection spread
Epidermis or subcutanous tissue
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What is arisk factor for a wound infection
: damage to physical integrity of skin can follow trauma or surgery. Staph aureus nasal carriage diabetes, cirrhosis or alcoholism
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What are the clinical features of wound infections
erythema, warmth, tenderness, swelling and purulent exsudate. Fever. Failure to heal
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What organisms cause wound infections
S aureus, GAS, could also be coliforms anearobes and clostridia
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What organism causes tetnus
Clostridium tetani
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How is clostridium spread
spores in the soil/animal faeces
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What doesC tetani mae that causes symptoms
ehen is germinates and releases bacteria it produces a neurotoxin that blocks inhibitory nerve transmission from spinal cord to muscles
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What is the classical presentation of tetanus
Begins with small muscle pasm in jaw which rapidly turns into chest, back and abdominal muscles and sometimes the laryngeal muscles tetany) cause sudden, powerful, and painful contraction of muscle groups fractures can occur
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In what countries and scenarios is tetanus most prevalent
In developing countaries, in child birth when straw and stuff is used to claer afterbirth ans the umbillicus is infected and neonate dies
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Treatment for tetnus
intubate,paralyse and sedate in ITU
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Without treatment what is the morality rate?
1 in 3 adults die, 2 in 3 neonates die
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How is tetnus prevented?
active immunisation DT X3, and boosters every 10 years, and would cleaning
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What is gas gangrene?
A really nast infection by clostriduim perfingens, the bacteria buries deep and releases gas and destroys tissues
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What are some characteristics of clostridium perfingens?
Gram positive rod, anaeroic and sporulates, and releases a toxin called lesitanase
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How do you get gas gangrene
usually after direct inoculation of contaminated, ischaemic wound
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What are some key features of this disease
myonecrosis - when respiring anaerobiclly gas is produced which destroys tissues, all patients will be septic, very rapid
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What is the clinical presentation
browny oedema, foul-smelling, discharge, dead muscr, loads of pain
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What is the mortality rate for gas gangrene
25%
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How do you doagnose gas gangrene
clinical presentation, radiologicly (you can see tissue beeing destroyed) and microbiologicly
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what is the treatment for gas gangrene
 fasciotomy, debridement, amputation  antibiotics (penicillin and metronidazole or clindamycin)  ?hyperbaric oxygen chamber
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What is Necrotising Fasciitis
Similar to gas gangene but not caused by an anaerobe
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What is Necrotising Fasciitis caused by
Streptococcus pyogenes (Group A Strep) and/or Staph. aureus, often in combination with anaerobes
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what is the mortality rate for Necrotising Fasciitis
30-50%
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What is the treatment Necrotising Fasciitis
debridement, amputation  antibiotics (sensitivity testing microbial analysis)
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What is scalded skin syndrome caused by
Staph aureus
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Where do we see scalded skin syndrome
young children, immuno-compromise
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what does scalded skin syndrome cause
widespread superficial exfoliation
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What is the first step in the lab
culture the bacteri, see what is looks like, what type of haemolysis
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Next step after insepecting bacteria
gram stain it in SSTI we are looking at gram positives
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After identifying gram postive organisms whatwould you do
Catalase then coagulast tests
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Which is catalase positive Staph aureus or Strep
Staph
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How do we identify between Staph aureus and staph epidermidis?
Coagulase test
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What other tests can we do to identify staph aureus
DNAase tests (staph has DNAase and will digest dna)
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How do we know what antibiotics to give
Sensitivty tests
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In SSTI what type of strep are we looking for
Beta heamolytic strep
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What are some caharectersitics of beta haemolytic strep
gram positive, in chains, beta haemolytic, cat negative, and have laancefeild antigens
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Which group does streptococcus pyrogns belong to
A
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How would we test for clostridium perfingens
old test is CAMP test (lesistanse breaks down fat) reverse CAMP test
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Card 2

Front

What are some common soft skin and tissue infections

Back

Impetigo, folliculitis, furuncles, adn carbuncles, cellulitis, ersipelas

Card 3

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What are the main organsisms involved in SSTI

Back

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Card 4

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What are the layers of the skin

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Card 5

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Where does imepetigo occur?

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