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WVSOM - Infections
Bacterial Skin and Soft Tissue Infections
| Question | Answer |
|---|---|
| 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
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