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Skin Pathogens


Normal Flora of skin Staphylococci (esp. coag neg); Corynebacteria; Propionibacteria; Streptococci (only transient inhabitants); Clostridium perfringens
Viral skin infxns assoc with exanthems/fever Measles, rubella, roseola, fifth disease
Mucocutaneous herpes simplex HSV, pharyngitis, whitlow, gladiotorum
Molluscum contagiosum pox virus
Chicken pox/shingles VZV
Herpetic whitlow = ? HSV of the fingers
“vesicular lesion on erythematous base” herpes
Evolution of herpes Starts as vesicle, then erosion, then crusting & scabbing
Large DNA virus (poxvirus); strictly human pathogen with worldwide distribution Molluscum contagiosum
Pearl-like, umbilicated papules Molluscum contagiosum
Molluscum contagiosum is spread by: Direct (including sexual) contact; auto-inoculation
Bacterial bite infxns: relative seriousness of cat vs human vs dog cat bites > human bites (40%) > dog bites (10%)
Bacterial bite infxns: relative seriousness of extremities vs head and neck extremities > head and neck
Bacterial bite infxns: relative seriousness of puncturesvs lacerations punctures > lacerations
Superficial bacterial infections include: Acne (Proprionibacterium acnes); Rosacea; Bites
Likely cause of early infections from bites Pasturella multocida
Likely cause of late infections from bites Staphylococcus spp.; Streptococcus spp.
Implicated in bite infxns Capnocytophaga canimorsus; Eikenella corrodens; Haemophilus spp; Pseudomonas spp.
Boils, furuncles, carbuncles Staph aureus
Cutaneous infections: Cellulitis: Group A Strep (rare: Staph. aureus) [Cellulitis: infxn of subcutaneous tissue]
Erysipelas: Group A Streptococcus
Impetigo: Classic = Group A Strep; Bullous = Staph. Aureus
Folliculitis usu caused by: Staph. aureus
Hot tub folliculitis: Pseudomonas aeruginosa
Rare bacterial causes of cellulitis and abscesses: Nocardia, Vibrio vulnificus
Skin infxn with Nocardia is often the result of: penetrating trauma
Cause of cellulitis seen after Hurricane Katrina (from standing in water) Vibrio vulnificus
superficial fungal infxns are found in: outermost layer of skin/hair
cutaneous fungal infxns are found in: deeper epidermis/integuments
subcutaneous fungal infxns are found in: dermis/subcutaneous tissues, muscles, and fascia
hypopigmented/hyperpigmented macular lesions especially on trunk Tinea versicolor/Malassezia furfur
Etiologic Agents of Superficial Fungal Syndromes Tinea versicolor/Malassezia furfur; Candida spp
yeast is normal flora of: skin, oropharynx, GI tract, and female GU tract
Signs of superficial Candida infxn intertrigo, diaper rash, paronychia, onychomycosis
Tx for superficial Candida infxn is: topical, except for onychomycosis
Dermatophytes are generally restricted to keratinized layers of integument
geophilic, zoophilic, or anthropophilic Dermatophytes (cutaneous fungal infxn)
Madura foot caused by Mycetoma
Treatment for mycetoma infxn Dapsone, SMZ/TMP
Normal flora of mouth & mucous membranes Streptococci (viridans group and Group D); many anaerobes (Peptostreptococci, Lactobacilli, Fusobacterium, Actinomyces israelii, Neisseria spp., Haemophilus spp)
Normal flora of mouth & mucous membranes Streptococci (viridans group and Group D); many anaerobes (Peptostreptococci, Lactobacilli, Fusobacterium, Actinomyces israelii, Neisseria spp., Haemophilus spp)
Viral Oral Syndromes/Etiologic Agents Stomatitis/HSV; Herpangina, hand/foot/mouth disease: Coxsackie; Apthous ulcers (?); Mucocutaneous ulcers/HSV
Gingivitis/bacterial plaque Gram positive cocci and bacilli
Bacterial agents of parapharyngeal space infections / polymicrobial infection Strep. spp., Eikenella corrodens, anaerobes
Bacterial agents of peridontitis / polymicrobic Mostly gram negative
Dental caries Strep. spp.; esp. Strep. mutans
Muscle infxns usually caused by ____; incidence limited to ____ Cl spp, esp C. perfringens; patients with severe traumatic injuries
Bone infxns usually due to: Staph aureus (but any organism possible)
Mechanism of action of bone infection infection by hematogenous spread from cutaneous site
Infxns of Kingella kingae most commonly involve the: femur, talus or calcaneus
Non-skeletal sites of Kingella kingae infxn Lower respiratory tract, bloodstream, and heart valves
Bone infxm/osteomyelitis in Sickle Cell patients likely to be: Salmonella
Bone infxm/osteomyelitis in IVDU’s: Sternoclavicular joint and ribs also site of infection, P. aeruginosa common
Bone infxm/osteomyelitis in prosthetic valves, joints: Staph. epidermidis
Chronic bone infection Implanted orthopedic hardware
Mastitis is a common ____ infxn, usually due to _____ postpartum; Staph. aureus
Caused by various dematiaceous fungi; generally slow growers Chromoblastomycosis/Phaeohyphomycosis
Deadly dematiaceous fungi Xylohypha (formerly Cladosporium)
Created by: Abarnard



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