Studied by 6 people
Staph or Strep:
Catalase positive
Staph
Staph or Strep:
Catalase negative
Strep
What pathogen is the MCC of folliculitis?
Staph
What pathogen causes Hot tub folliculitis?
Pseudomonas A.
What abx are used to treat folliculitis?
Topical - Mupirocin, Clindamycin
What is the treatment for folliculitis caused by pseudomonas?
Good hygeine, Cipro if severe
What is an abscess?
circumscribed collection of pus appearing as an acute or chronic localized infection with tissue destruction
What is a furuncle?
acute, deep-seated, red, hot, tender nodule or abscess that evolves from a staphylococcal folliculitis
What is a carbuncle?
deeper infection composed of interconnecting abscesses usually arising in several contiguous hair follicles
What are boils?
furuncles
What is the treatment for furuncles?
Warm compress, I&D, Abx if >2cm
What is the treatment for carbuncles?
Swab for culture, I&D PLUS ABX
When is IV therapy/admission necessary for treatment of carbuncles?
systemic signs of toxicity, surrounding cellulitis, Immunocompromised, Unable to tolerate or failure of oral abx, Abscess is close to catheter
What are the preferred oral agents for treatment of skin/soft tissue infections due to MRSA?
Bactrim, Clindamycin, Doxycycline, Minocycline
What age range is impetigo most common in?
2-5 y/o
What pathogens cause nonbullous impetigo?
Staph aureus, GABHS
What pathogens cause bullous impetigo?
primarily staph aureus
How does Impetigo present?
pustules that progress to erosions covered by honey-colored crusts; painless
What is the treatment for mild/localized non-bullous impetigo?
Topical Mupirocin, Warm compress, Cephalexin or Docloxacillin
What is the treatment for bullous impetigo/extensive disease?
Same as non-bullous
PLUS Doxy/Bactrim/Clindamycin
What is Ecythyma?
ulcerative form of impetigo
How does Ecthyma present?
"Punched-out" ulcers covered with yellow crust surrounded by raised violaceous margins
Bullous impetigo can progress to what disease?
SSSS
What pathogens most commonly cause cellulitis?
Staph (MRSA/MSSA), Group A strep
What pathogen causes cellulitis due to meat/fish exposure?
Erysipelothrix rhusiopathiae
What pathogen causes cellulitis after saltwater exposure?
Vibrio vulnificus
In patients with cellulitis, you should NEVER take a culture from what area?
Intact skin; only from abscess or bullae
What IV therapy is used for cellulitis?
Vancomycin
What is another name for SSSS?
Ritter's disease
What age group is affected by SSSS?
Infants & children <6 y/o
Which disease would have a positive Nikolsky's sign?
SSSS
What is the only way to differentiate SSSS from SJS/TEN?
Skin biopsy
What is the treatment of SSSS?
ICU admission, IVF, IV abx directed towards staph aureus
What pathogen is the MCC of toxic shock syndrome?
Staph aureus (MSSA)
What is Toxic shock syndrome associated with?
tampon use, nasal packing, or wound packing
What are some symptoms of toxic shock syndrome?
Fatigue, Abdominal pain, Rash, HA, Sore throat, Hypotension, Orthostatic dizziness/syncope
How does Toxic shock syndrome present?
diffuse, red, macular rash with bullae formation resembling a sunburn, INVOLVING PALMS/SOLES, followed by desquamation
How many organ systems must be involved in order to dx TSS?
≥3
What is the MC complication of toxic shock syndrome?
Prolonged hypovolemic shock
What is the treatment for toxic shock syndrome?
IV abx: clindamycin + vancomycin + beta lactam
(need MRSA/MSSA coverage)
What pathogen is the MCC of erysipelas?
GABHS (S. pyogenes)
How does Erysipelas present?
butterfly pattern involving both cheeks/spread across the nose
How is strep throat transmitted?
Direct person to person contact
What is the first line treatment for strep throat?
PCN V po
What is Scarlet fever?
complication of strep pharyngitis that presents with strawberry tongue & rash
Where does the "sandpaper" rash associated with scarlet fever typically begin? Does it affect the palms & soles?
Axillae, groin, neck; spares palms and soles
How does Scarlet fever present?
fine, papular or punctate lesions that has a coarse, sandpaper texture + pastia lines
5 major manifestations of rheumatic fever
Carditis
CNS involvement (ie chorea)
Erythema marginatum
Polyarthritis (large joints)
Subcutaneous nodules
4 minor manifestations of rheumatic fever
Arthralgia
Fever > 100.4F
Elevated ESR/CRP
Prolonged PR interval (>0.2 secs)
Jones criteria for rheumatic fever
Initial episode with evidence of preceding GAS infection, PLUS:
Two major manifestations, OR
One major + two minor manifestations
What is the treatment for eradication of GAS for rheumatic fever?
IM PCN G
What is another name for Erythema infectiosum?
"Fifth disease"
What virus causes erythema infectiosum?
Parvovirus B19
How does Erythema infectiosum present?
"Slapped cheek" appearance with lace-like rash on body and circumoral pallor
Whats another name for Roseola?
"Sixth disease"
What is Pediculosis capitis?
Head lice
What is Pediculosis corporis?
Body lice
What is Pediculosis pubis?
Pubic lice/"crabs"
What is the drug of choice for treatment of pediculosis?
Permethrin
What causes the itching associated with Scabies?
delayed type IV hypersensitivity reaction to mites
How does Scabies present?
nocturnal pruritus, elevated S-shaped tracks on the skin at clothing lines
What is the treatment for scabies?
Permethrin cream; Remove by shower/bath after 8-14 hours, Repeat in 1-2 weeks
What are the two bedbug species that MC affect humans?
C. lectularius, C. hemipterus
When does peak activity of bedbugs occur?
Just before dawn
What type of infestation produces a peculiar pungent odor, and commonly affects environments that are in disarray?
Bedbugs
What is the treatment for bedbug bites?
Usually self-limiting; may use steroid cream or oral antihistamine
Note 
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