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WVSOM - Infections

Bacterial Skin and Soft Tissue Infections

Bacterial skin flora Colonized by aerobic and anaerobic organisms ranging from 100-10,000 cfu/cm2
What factors effect distribution, composition, and density of bacterial skin flora? Climate, moisture, low pH (5.5), low temperature (33C), chemical composition of surface, exfoliation, bathing habits, antibacterial soaps
Characteristics of bacterial skin flora Help prevent infections by pathogens, are of low virulence, transient flora from mucous membrane "fallout" / environment
What types of bacteria colonize dry areas? Gram + cocci and aerobic & anaerobic diphtheroids
What types of bacteria colonize moist areas? Facultative and anaerobic gram - rods
What bacteria are more common in bedridden patients? Gram - rods
What are the most frequent pathogens of skin? Staphylococcus aureus and Streptococcus pyogenes
List some resident flora Propionibacterium acnes (gram+ rod), Staphylococcus epidermidis & Micrococcus sp. (gram+ cocci), Corynebacterium sp. (diphtheroids, gram+ rod), Lactobacillus sp. (gram+ rod), anaerobic grm+ cocci, aerobic gram-bacilli (low #), Pityrosporum ovale (yeast)
List some frequent transient bacterial flora and some of the diseases they cause Staphylococcus aureus (gram+ cocci) = abscesses, toxic shock syndrome, bacteremia; Streptococcus pyogenes (gram+ cocci) = cellulitis, lymphangitis
How do exogenous infections gain access to the body? Tiny abrasions in skin, trauma, hospital procedures, pressure injuries, compromised blood supply, excessive moisture, with/without breaks in skin allowing high / low # of pathogen to cause infection
What are some examples of how excessive moisture can induce skin maceration? Occlusive dressings / wet diapers; obese people (intertriginous folds); constant immersion; hot tubs
Decubitis ulcer Mixed infection of S. aureus, S. pyogenes, and enteric organisms
What infrequent transient bacterial flora causes cellulitis, conjuctivitis? Haemophilus influenzae (gram - rod)
What infrequent transient bacterial flora causes bed sores? E. coli (other enterics, gram - rod)
What infrequent transient bacterial flora causes gas gangrene? Clostridium perfringins (gram + rod)
What infrequent transient bacterial flora causes tularemia? Francisella tularensis (gram - rod)
What infrequent transient bacterial flora causes anthrax? Bacillus anthracis (gram + rod)
What infrequent transient bacterial flora causes hot tub infection? Pseudomonas aeruoginosa
What infrequent transient bacterial flora causes "foot rot"? Pseudomonas cepacia
What infrequent transient bacterial flora causes "fish tank cellulitis"? Mycobacterium marinum (acid fast)
What infrequent transient bacterial flora causes leprosy? Mycobacterium leprae (acid fast)
What type of infection is "diabetic foot"? Mixed infection
What causes primary and secondary syphillis Treponema pallidum
Endogenous infections Skin may become infected from blood stream or by direct extension of infection site deep w/i tissue
What causes meningococcemia? Neisseria meningitidis
What causes Rocky Mountain Spotted Fever? Rickettsia rickettsii
What causes gonococcal septicemia? Neisseria gonorrheoeae
Why are some endogenous infections accompanied by a rash? Due to toxin released into bloodstream
Toxic shock syndrome Toxin (TSST) produced from S. aureus
Scarlet fever Toxin from S. pyogenes
Scalded skin syndrome Toxin produced from S. aureus
Rashes that accompany endogenous infections are typically ... Non-infectious and secondary to septicemia / other systemic infections (hemorrhages, petechiae)
What is the most common skin disorder? Acne vulgaris
Features / characteristics of Acne vulgaris Excessive sebum production secondary to androgen stimulation; abnormal follicular keratinization -> follicular plugging; proliferation of Proprionibacterium acnes; inflammation & release of proinflammatory mediators
List 7 diseases caused by S. pyogenes Impetigo, erysipelas, lymphangitis, streptococcal cellulitis, cellulitis due to flesh eating bacteria, necrotizing fasciitis, ecthyma (also caused by enterics)
What causes erythrasma? Corynebacterium minutissimum; can be diagnosed by coral red appearance under woods lamp
List 5 disease caused by S. aureus Bullous impetigo, folliculitis, sycosis barbae (infection of coarse hairs of beard), furunculosis / boils, carbuncle, hidradenitis suppurativa (inflammation of apocrine sweat glands)
Besides S. aureus, what else causes folliculitis? Pseudomonas aeruginosa
What can happen if you eat raw oysters? Hemorrhagic cellulitis (due to Vibrio vulnificus = gram- rod)
Besides causing folliculitis, Pseudomonas aeruginosa can also cause ... Ecthyma gangranosum
What organism can cause infection if bitten by a dog / cat? Pasteurella multocida
Cat scratch fever is caused by? Bartenella henselae
Characteristics of Bartenella henselae Small, gram -, aerobic bacilli, difficult to grow in culture
What does Bartenella henselae cause in immunocompromised patient (HIV)? Bacillary angiomatosis
What treatment is available for cat scratch fever? Erythromycin, azithromycin (macrolide) - course of illness only marginally affected by antibiotics
Created by: JaneO