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bacterial infections Flashcards

0
Q

what tx is most appropriate for most bacterial infections

A

first generation cephalosporins

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1
Q

most common skin infectiosn in immunocomp pats

A

staphylococci and streptococci

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2
Q

impetigo is the most common

A

most common cutaneous bacterial infection in children

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3
Q

pathogens in impetigo

A

staph aureaus and/or group A (b hemolytic strep)

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4
Q

how is impetigo contagious

A

direct contact or auto-inoculation- source is usually intranasal, perianal, or under fingers

–heat, humidity, crowding, poor hygene

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5
Q

two variants of impetigo

A

nonbullous (crusted)

bullous

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6
Q

nonbullous impetigo pathogen

A

staph aureus > strep

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7
Q

what does nonbullous look like

A

honey colored cursts on face, extremities

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8
Q

secondary impetigization

A

skin trauma or disease often preceded infection

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9
Q

fever and systemic systems

A

rare- probs strep (esp if progresses to cellulitis)

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10
Q

bullous impetigo

A

only difference from non-bullus is that pathogens S.aureus, phage II, type 71 produces exotoxin (exfoliatin) that produces vesicles/bullae

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11
Q

what hapens when bullous impetigo erupts

A

shiny, shallow erosions

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12
Q

tx of impetigo

A

topical mupirocin

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13
Q

tx of complicated impetigo

A

penicillinase-resistant penicillins, 1st gen cephalosporin

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14
Q

tx recurrent case

A

target nares, oral abx, bleech bath

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15
Q

complications of bacterial skin infections

A

ecthyma if untreated (deeper skin infection)
GN (esp with strep A)
staphylococcal scalded skin syndrome

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16
Q

how does SSSS happen

A

s aureus II strain producing exofoliating toxins (ET) A, B–>split skin at superficial granular layer

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17
Q

SSSS is preceded by

A

fever and systemic sx

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18
Q

clinical picture of SSSS

A

tender skin
symmetrical sunburn erythema around facial orifices, neck, flexures
skin superficially blisters–>sloughs off–>moist skin, scales

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19
Q

how does SSSS heal

A

without scarring in 10-14 days

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20
Q

px in SSSS

A

good in healthy children

bad for adults with underlying disease

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21
Q

to dx SSSS

A

clinical
you can do culture, but negative culture does not rule out infection because cause could be bacteria secreting toxin from antoher site

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22
Q

hot tub folliculitis

A

p aeruginosa

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23
Q

folliculitis

A

bacterial infection superficial

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24
Q

furncle

A

bacterial infection of entire follicle and surrounding tissue (boil)

25
Q

what is a furncle like

A

red, warm, painful, nodule

26
Q

carbuncle

A

multiple coalescing furuncles, deep tissue

27
Q

tx of furnucles

A

compress and rupture may be enough or may need to drain

28
Q

tx of superficial folliculitis

A

topical mupirocin and antibacterial soap

29
Q

hot tub folliculitis

A

ciprofloxacin instead of cephalexin or acetic acid soap

30
Q

what to do if you have a painful duruncle

A

cultures-could be community acquired mRSA

31
Q

5 haracteristics that increase mrsa transmission

A 
crowding
skin-skin contact
compromised skin (abrasion)
contaiminaed surface
decreased cleanliness
32
Q

tx for MRSA

A

incision + drain for simple furuncle
topical antibiotics, bleach bath
abx
nasal w/ muciprocin

33
Q

cellulitis

A

infection of deep dermis and subcutaneous tissues caused by s pyogenes or s aureus

34
Q

how do you get infected by cellulitis

A

infects skin from inside or outside

  • -immunocompetent pts: break in skin barrier allows bacterial entry
  • -immunosupp pts: infection may arise from bloodborne route
35
Q

what can predipsose to recurrent infections

A

damage to lympahtic system (pts who have had a lymph node dissection for breast cancer or melanoma)

36
Q

clinical presentation cellulitis

A

red, warm, painful ,swollen
ill-defined painful erythema and swelling
vesicles and bullae
associated fever, chills, malaise

37
Q

dx of cellulitis

A

clinical appearance

blood culture usually negative

38
Q

tx of cellulitis

A

oral abx

39
Q

streptococal perianal disese

A

recurrent bright perianal erythema in otherwise healthy children

40
Q

erysipelas

A

more superficial cellulitis with significant lympathic involvment
s. pyogenes

41
Q

erysipelas sometimes caused by

A

hemophilus influenza–>facial infection in non-immunized children
requires IV antibiotics

42
Q

erysipelas presents as

A

well-demarcated, painful erythema, rapidly progressive

usually on face with peau d’orange texture

43
Q

necrotizing fasciitis

A

flesh eating bacteria syndrome- life threatening, rapidly progressive necrotic infection of subcutaneous tissue, fascia

44
Q

most cases of necrotizing fasciitis are..

A 
strep
s aureus
e coli
bacteroides
clostridium
45
Q

underlying illness includes

A

alcoholism
DM
vascular disease
cardiac disease

46
Q

clinical course of necrotizing fasciitis

A

resembles cellulitis early on but with severe pain
necrosis within 24-36 hours; blue-grey skin- blisters, thin watery discharge
systemic illness can be profound
usually involves extremities

47
Q

Fournier’s gangrene (post-circumcission)

A

involvment of perineum and genitalia

48
Q

mortality of necrotizing fasciitis

A

20-40%

49
Q

dx of necrotizing fasciitis

A

MRI with surgical exploration

50
Q

tx of necrotizing fasciitis

A

extensive surgical debridement
broad spectrum abx
hyperbaric oxygen therapy controversial

51
Q

lyme disease

A

erythema migrans- classic rash

52
Q

borrelia burgdorferi

A

caused by deer tick

53
Q

complications of lyme

A

bell’s palsy, arthritis, myocarditis, encephalitis

54
Q

tx of lyme

A

doxycycline for 1 month (10-21 days)

55
Q

syphilis

A

treponema pallidum

56
Q

how is syphilis transmitted

A

sexual contact, mother to fetus in utero, blood transfusion, skin contact wtih damage skin

57
Q

four stages of syphilis

A

primary
secondary
latent
tertiary

58
Q

testing for syphilis

A

non-treponemal serology (VDRL, RPR)–>treponemal test to confirm + (FTA-ABS)

59
Q

tx of syph

A

penicillin G benzathine for alls tages

Derm (15 decks)

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