AUC: Skin and Soft Tissue Infections – Flashcards
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Unlock answersStreptococcus Pyogenes Beta Lactams or Macrolides
IA? |
Gram positive Chains of cocci Lancefield Group A Catalase negative
Name? Tx? |
Capsule M proteins Hyaluronic Acid Streptolysin S Streptolysin O Streptokinase Streptodornases
Name? |
Streptococcus Pyogenes
VFs?
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Streptococcus Pyogenes
CDs?
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Erysipelas Impetigo Streptococcal Toxin Shock Syndrome Myonecrosis/ Necrotizing Fasciitis/ Gangrene
Name? |
Tender, red, swollen lesions Most unilateral some bilateral Fever, chills, pain, leukocytosis May follow respiratory/ skin infections
Name? CD? Tx? |
Streptococcus Pyogenes Erysipelas Beta lactams or Macrolides
Symptoms?
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Streptococcus Pyogenes Erysipelas
Transmission? Dx?
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Respiratory droplet Direct contact Endogenous spread
Clinical presentation Anti-streptolysin O Rapid Strep Test
Name? CD with swollen lesions? |
Capsule, M proteins, Streptolysin O and S Lancefield Group A Pre-existing underlying diseases (diabetics, cancer, alcoholism, etc.)
Name? Dx? |
Streptococcus Pyogenes Anti-streptolysin O Rapid Strep Test Beta Hemolytic
VFs? Lancefield? Risk?[
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Pseudomonas aeruginosa Natural fluorescence (UV) Lactose non-fermentor
IA? |
Gram negative Rod Oxidase positive Strict aerobe
Name? Dx? |
Folliculitis Capsule, Biofilm, Efflux pumps Pyocyanin, Pyochelin Exotoxin A
Name? Symptoms? Other name for it?
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Pseudomonas aeruginosa Inflammation of hair follicles "Hot Tub Folliculitis"/ Dermatitis
CD? VFs?
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Pseudomonas aeruginosa "Hot Tub Dermatitis"
At Risk? Symptoms? Tx?
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Inflammation of hair follicle in normally healthy people Combo antibiotics "Vinegar Wash" on affected area
Name? Nickname for infection? |
Streptococcus pyogenes Contagious superficial pyoderma Vesicles --> Pustules --> Rupture and Crusting
CD? Contagious? Tx? |
Impetigo HIGHLY contagious Beta lactams or Microlides
Name? Symptoms? |
Erysipelas Impetigo Toxic Shock Syndrome Gram positive, Chained cocci, Lancefield Group A, Catalse positive
Name? Transmission? |
Streptococcus pyogenes Respiratory droplet Direct contact Endogenous spread
What CDs? IA?
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Impetigo LACK of fever or sepsis Anti-strep O test Beta hemolytic Lancefield Group A
Name? Virulence factors?
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Streptococcus pyogenes Capsule M proteins Hyaluronic Acid Strep O and Strep S Streptokinase, Streptodornases
CD? Fever or sepsis? Dx?
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Exogenous infection Soft tissue inflammation Bacteremia --> Septicemia Pain, fever, chills, malaise, nausea, vomiting, diarrhea Shock leads to organ failure Necrosis with HIGH mortality
Name? CD? |
Streptococcus pyogenes Streptococcal Toxin Shock Syndrome
Symtoms? Shock? Death? |
Pseudomonas aeruginosa Combo antibiotics
CDs?
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Keratitis/Keratoconjunctivitis --> Endophthalmitis Folliculitis Nail Infections Otitis externa Wound & Burn Infections Osteomyelitis
Name? Treatment? |
Nail turns green with secretions Inflammatory response triggered --> nail crumbles Gree colored pus Gram negative, rod, oxidase positive
Name? CD? |
Pseudomonas aeruginosa Nail infections
Symptoms? IA?
|
Otitis externa aka Malignant External Otitis Capsule, Biofilm, Efflux pumps
Name? Symptoms? Why is this bad?
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Pseudomonas aeruginosa Swimmer's Ear Usually harmless Could be life-threatening in older patients May lead to paralysis of facial muscles ; CD? Structural features? ; ; |
Wound and Burn Infections Combo antibotics Hyperimmune globulin ; ; Name? Symptoms? At Risk? |
Pseudomonas aeruginosa; Destroyed blood vessels limits phagocyte access Biofilm production blocks removal by phagocytes Exoenzymes damage tissue Burn patients Immunocompromised, poor health ; CD? Tx? ; ; |
Staphylococcus aureus; Mannitol positive fermentor Catalase positive Coagulase positive Beta-hemolytic ; CDs caused?; |
Styes/ Chalazion Folliculitis Impetigo Furuncles/Carbuncles Scalded Skin Syndrome (Ritter's Disease) Staphylococcal Toxic Shock Syndrome Osteomyelitis
Name? Dx? |
Furuncles/ Carbuncles Associated with spider bites
Name? Symptoms? VFs involved? |
Staphylococcus aureus Lesions/abscesses Involves subcutataneous tissue Hyaluronidase and Fibrinolysin
CD? Associated with?
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Walled off "marble-like" HARD abscesses Chills and fever indicate systemic disease
Name? Associated with? What are they and do they coalesce? |
Staphylococcus aureus Spider bites Furuncles/boils coalesce to form Carbuncles
What are furuncles? Systemic disease indicated by? |
Staphylococcus aureus Impetigo Furuncles/ Carbuncles
Dx? Tx? |
Mannitol positive fermentor Catalase positive Coagulase positive Beta-hemolytic Wound cleansing, draining Mupirocin (Bactraoban)
Name? Mid grade CDs? |
Impetigo Polymicrobial infection Lacks fever or sepsis
Names of two causative agents? |
Staphylococcus aureus Streptococcus pyogenes
CD? Fever or sepsis? |
Bartonella henselae
IA? |
Facultative intracellular Gram negative Rod
Name? |
Bartonella henselae Bite scratch, lick from infected animal
Disease why? Which animal? CDs? |
Diseases are a consequence of intracellular growth Cats Cat-Scratch Disease Bacillary Angiomatosis
Name? Transmission? |
5-10 days after bite or scratch pustules at site which persist for weeks Regional lymphadenopathy
Name? CD? Tx? |
Bartonella henselae Cat-Scratch Disease Needle aspiration; no antibiotics
Symtoms? |
Bartonella henselae Bacillary Angiomatosis Silver stain, biopsy
Symptoms? Blood supply? Risk? |
Proliferative, neo-vascular, cutaneous and visceral lesions Triggers it's own angiogenic factor HIV/Transplants/Chemo/ Leukemia ; Name? CD? Dx? ; |
Bartonella henselae; Facultative intracellular Gram negative rod ; CD? Dx? Tx? |
Cat-Scratch Disease Bacillary Angiomatosis Silver stain, biopsy Needle aspiration for CSD PROLONGED Macrolides for BA; ; Name? IA? |
Nocordia brasiliensis; ; IA? |
Gram positive branching rods Weakly acid fast Member of Actinomycetes ; Name? |
Gram positive rods Weakly acid fast Cell wall contains trehalose dimycolate Found in environment/soil ; Name? CD? |
Nocordia brasiliensis; Cutaneous Nocardiosis ; IA? Structural features? Reservoir? |
Pustules, fever, and tender lymphadenitis Macrocolonies of sulfer granules under microscope ; Name? CD? Tx? |
Nocordia brasiliensis; Cutaneous Nocordiosis Sulfonamides ; Symptoms? Microscopy? |
Nocordia brasiliensis; Cutaneous Nocardiosis Soil contamination of wounds, animal or insect bites ; Risk? Dx? |
Immunocompromised Aspirates show branching gram positive rods which are partially acid fast Macrocolonies (sulfer granules) in exudate Culture shows waxy, chalky colonies in 3-5 days ; Name? CD? Transmission? |
Cell wall contains trehalose dymycolate Microscopy shows macrocolonies Found in soil ; Name? CD? Tx? |
Nocordia brasiliensis; Cutaneous Nocardiosis Suflonamides |
Streptobacillus moniliformis; ; IA? |
Gram negative Pleomorphic rod Forms filaments which appear as tangles ; Name? |
Gram negative pleomorphic rod; Found in the nose/throat of rodents Transmitted from bites or scratches ; Name? CD? Tx? |
Streptobacillus moniliformis; Rat Bite Fever Penicillin ; IA? Reservoir? Transmission? |
Relapsing fever IP:1-22 days after intitial wound Chills, headache, migratory arthralgias and myalgias Nonpuritic rash over palms, soles, extremities Asymmetrical polyarthritis (knees) ; Name? CD? Dx?; |
Streptobacillus moniliformis; Rat Bite Fever Positive exposure Hx Pleomorphic rods in microscopy ; Symptoms?; |
Streptobacillus moniliformis; ; ; CD? Same name as CD caused by _______? |
Rat bite fever Spirillum minus ; ; What other agent causes Rat bite fever? ; |
Streptobacillus moniliformis; Gram negative Pleomorphic rod Forms filaments ; CD? Fever? Cell wall? |
Rate Bite Fever RELAPSING FEVER Cell wall less form can spontaneously occur during infection ; Name? IA? |
Streptobacillus moniliformis; Rat Bite Fever ; Transmission? Complications? |
Bite or scratch from rodent or other animal Untreated causes endocarditis myocarditis and degenerative disease of kidneys and liver ; Name? CD? |
Eikenella corrodens; ; IA? Transmission? |
Gram negative Anaerobic rod Human bites; polymicrobial wound infections,;opportunisit in immunocompromised Name? |
Human bites; polymicrobial wound infections,;opportunisit in immunocompromised Pustules Pain at site, stifness with inflammation IP is a week Foul smelling discharge from pustules ; Name? Reservoir? Tx? |
Eikenella corrodens; Normal flora in mouth Penicillins, Cephalosporins or Tetracyclines ; Transmission? CD? Symptoms? |
; Eikenella corrodens; Pustules ; If underlying disease could cause? Dx? ; |
Could cause osteomyelitis Dx is X-rays showing swelling and air pockets Small, graying colonies that ERODE medium (turn green) Smells like bleach ;(hypochlorite) ; Name? CD? |
Occurs in "Clenched fist" injuries, cancer patients, diabetics, nail biters, and IDUs ; Name? IA?;;CD? |
;Eikenella corrodens; Gram negative Anaerobic rod Pustules ; Risk? |
Candida albicans; Budding yeast and pseudohyphae on microscopy SDA ; Skin CD? Variations? |
Candidiasis Mucous membrane or oral --> Thrush Skin --> Diaper rash, folliculitis Between fingers Under nails
Name? Dx? |
Local inflammatory disease; most damage is bystander Diabetics or those with weakened immune systems Yeast producing pseudohyphae
Name? CD? Can it become systemic? |
Candida albicans Candidiasis YES --> septicemia, endocarditis, and meningitis
Symptoms? Risk? IA? |
Candida albicans Candidiasis
If systemic becomes? Tx? |
Systemic becomes septicemia, endocarditis, and meningitis Amphotericin B for systemic disease
Name? CD? |
Actinomyces israeli
IA? Similar Dx as ____? |
Gram positive Filamentous Anaerobic NON ACID FAST
Nocordia brasillensis
Name? |
Abscess-fibroses --> woody feel, uneven, lumpy Sinus tract formation (maybe granulomas too) Hematogenous spread
Name? CD? Tx? |
Actinomyces israeli Cutaneous Actinomycosis Penicillin G for weeks to months!
Symptoms? |
Actinomyces israeli Normal flora Filamentous gram positive rod Anaerobic Non acid fast
Risk? Dx? Similar to? |
Trauma, dental work, surgery Branching gram positive NOT ACID FAST on micro Presence of sulfer granules in pus "Molar tooth" shaped colony Nocordia brasilliensis
Name? Reservoir? IA? |
Pasteurella multocida Capsule, Fimbrae/pili Leukotoxin, ToxA protein
IA? Reservoir? |
Gram negative rod Bipolar staining Zoonotic, oral cavity of healthy animals
Name? Structural Features? VFs? |
Pasteurella multocida Leukotoxin ToxA protein
CD? Dx? |
Soft Abscess BAP (will not grow on Mac) Bipolar staining - looks like "safety pins"
Name? VFs? |
Bite, scratch or lick of an open wound by an animal Acute inflammatory response Swelling and tenderness after 24 hours Regional lymphadenopathy May become systemic
Name? CD? Tx? |
Pasteurella multocida Soft Abscess Amoxicillin-clavulantate; resistant to Macrolides
Transmission? Symptoms? Systemic? |
Capsule Fimbrae/pili BAP (will not grow on Mac) Bipolar staining - looks like "safety pins" Amoxicillin-Clavulanate; resistant to Macrolides Name? CD? |
Pasteurella multocida Soft abscess
Structural features? Dx? Tx? |
Scalded Skin Syndrome Exfoliative toxins found on lysogenized phage Serine proteases
Name? Other name for CD |
Staphylococcus aureus Ritter's Disease
CD? What are the VFs?
|
Skin of young children or adults with skin diseases Large bullae or cutaneous blisters Covers entire body in 48 hours FEVER Positive Nokolsky's sign
Name? CD? Tx?
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Staphylococcus aureus Scalded Skin Syndrome (Ritter's Disease) Treat infection and shock, no antitoxin used
Symptoms?
|
Staphylococcus aureus Scalded Skin Syndrome (Ritter's Disease)
VFs? Desquamation? Scarring?
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Exfoliative toxins - Serine proteases Desquamation of epithelium Returns to normal in 7-10 days No scarring
Name? CD? |
Staphylococcal Toxic Shock Syndrome Infection through vaginal or wound Quorum sensing induces toxin production SuperAg toxins released into bloodstream
Name? VFs? Endogenous or Exogenous? |
Staphylococcus aureus
Toxic Shock Toxins (TSST): Superantigens Endogenous
CD? How does it happen? Toxin release? |
Staphylococcus aureus Staphylococcal Toxic Shock Syndrome Desquamation of skin after 1-2 weeks
Presentation?
|
Fever Capillary leak syndrome with hypotension Diffuse macular red rash PAIN RARE
Name? CD? Desquamation? |
Streptococcus pyogenes Patients with current bad disease Similar presentation to a CD of S. aureus
CD? |
Streptococcal Toxic Shock Syndrome (M Type 1 and 3)
Name? Risk? Similar to? |
Exogenous infection Bacteremia --> Septicemia Pain, fever, chills, malaise, GI issues SHOCK --> organ failure PAINFUL
Name? CD? |
Streptococcus pyogenes Streptococcal Toxic Shock Syndrome (M Type 1 and 3)
Endogenous or Exogenous? Symptoms? Pain? |
Staphylococcal TSS
Origin? Pain? Rash? Bacteremia? Necrosis? Mortality?
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Endogenous RARE pain Rash COMMON LOW frequency of bacteremia RARE tissue necrosis LOW mortality
Name? |
Exogenous COMMON pain LESS common rash HIGH frequency of bacteremia COMMON necrosis HIGH mortality
Name? |
Streptococcal TSS
Origin? Pain? Rash? Bacteremia? Necrosis? Mortality?
|
Clostridium perfringens Alpha toxin - Lecithinase Fermentative toxins
CD? IA? |
Myonecrosis = Gas Gangrene Gram positive Spore former Anaerobic rod
Name? VFs?
|
Clostridium perfringens Myonecrosis = Gas Gangrene Soil and human colon
Transmission? Symptoms? Sounds? |
Spores introduced into wounds Begins as cellulitis - mottled (splotchy red/purple) Gas from microbial fermentation of skin and tissue Crackling or Popping sound
Name? CD? Reservoir? |
Clostridium perfringens Gram positive Spore former Anaerobic Rod
Dx? Tx? |
Clinical presentation Alpha AND Beta hemolysis Egg yolk agar (Nagler Rxn) for toxin Empirical treatment Surgical debridement High dose penicillin Hyperbaric oxygen
Name? IA? |
Egg yolk agar Alpha and Beta hemolysis Alpha toxin (Lecithinase) Fermentative toxins
Name? CD? Risk? |
Clostridium perfringens Myonecrosis = Gas Gangrene Trauma, Diabetics, poor peripheral circulation
Dx? VFs? |
Streptococcus pyogenes Myonecrosis/ Necrotizing Fasciitis/ Gangrene
Active VFs? What's different from Clostridium? |
Streptolysin S and Streptolysin O Streptokinase Streptodornases (DNase)
Fluid filled bullae; NO gas filled lesions
Name? CD?
|
Deep tissue infection - damage to fat and muscle Initial cellulitis followed by gangrene and systemic problems --> organ failure Fluid filled bullae; NO gas filled lesions
Name? CD? Tx? Dx? Is Dx culture? |
Streptococcus pyogenes Myonecrosis/ Necrotizing Fasciitis/ Gangrene Surgical debridement and Penicillin G
Normal culture and biotyping BUT culture often NEGATIVE so test for Abs
Symptoms? Anything unique? |
Vibrio vulnificus
IA? VFs? |
Motile Gram negative curved rod Capsule RTX toxin Cytolysin and other extracellular enzymes
Name?
|
Necrotizing Fasciitis Motile, gram negative curved rod Culture and biotyping
Name? Reservoir? Transmission |
Vibrio vulnificus Estuarine or marine water Direct Contact Eating of contaminated oysters in those with underlying Liver disease
CD? IA? Dx? |
Vibrio vulnificus Necrotizing Fasciitis
Symptoms? Sepsis? |
Infected skin lesions within 24-48 hours after exposure erythema, edema, bullous lesions, ulcers --> tissue destruction and sepsis
Sepsis has fever, chills, dec. BP (septic shock) and blistering skin lesions 50% are fatal
Name? CD? |
RTX toxin forms holes in plasma membranes Contaminated oysters Necrotizing Fasciitis
Name? Tx? Risk? |
Vibrio vulnificus Doxycycline and a Beta-Lactam Immunocompromised are at higher risk of sepsis |
