Microbiology - Exam 2 Pt. 1 (Skin and Wounds)

What are pus filled pockets in the skin resulting from bacterial infection?

abscesses

What are the 3 categories of abscesses?

pimple

furuncle/boil

carbuncle

What are skin abscesses that involve the hair follicle resulting from bacterial infection?

folliculitis

What is folliculitis called when it occurs at the eyelid base?

sty

What are hallmark features of bacterial abscesses/folliculitis?

red, swollen, itching, burning, pus, blood, or both

What the is the MOST common pathogen associated with bacterial abscesses/folliculitis?

staphylococcus aureus

Which pathogen associated with bacterial abscesses/folliculitis is MORE predominant on the SKIN?

staphylococcus epidermis

Which pathogen associated with bacterial abscesses/folliculitis is MORE virulent?

staphylococcus aureus

How are bacterial abscesses/folliculitis transmitted?

direct contact/fomites

auto-inoculation

toxins increase virulence

What are the 2 drug resistant strains associated with bacterial abscesses/folliculitis?

MRSA (methicillin)

VRSA (vanomycin)

What is the MOST common transmission of MRSA and VRSA?

nosocomial

All patients presenting with a spider bite should be evaluated for...

MRSA

We are seeing an increase in MRSA and VRSA as community acquired strains, this makes it a(n)...

emerging disease

How is MRSA diagnosed?

gram (+) stain

T/F? You can differentiate between MRSA and an abscess just by looking?

False - must be diagnosed with gram (+) stain

What is common treatment for bacterial abscess/folliculitis?

What is the BEST prevention method?

warm compress to ease itching/swelling

handwashing

Can you adjust someone with bacterial abscess/folliculitis?

Yes

Which bacterial disease is characterized by small "pimples" on stomach, buttocks, arms, and legs?

Hot Tub Folliculitis

What is the pathogen associated with hot tub folliculitis?

pseudomonas aeruginosa

Can you adjust a patient with hot tub folliculitis?

Yes

Which bacterial disease is characterized reddening of skin, large blisters containing fluid with NO WBC, and eventually skin peeling off in sheets?

Staphylococcal Scalded Skin Syndrome

Who is at the HIGHEST risk for staphylococcal scalded skin syndrome?

infants and children less than 5, medical emergency

What is the incubation period for staphylococcal scalded skin syndrome?

less than 24 hours** (rapid!)

What is the pathogen associated with staphylococcal scalded skin syndrome?

What does it secrete?

staphylococcus aureus

exfoliative toxins

How is staphylococcal scalded skin syndrome transmitted?

person-to-person via spread of bacteria

How is staphylococcal scalded skin syndrome diagnosed?

characteristic sloughing of skin

How is staphylococcal scalded skin syndrome treated?

antibiotics and hospitalization

Are you adjusting a patient with staphylococcal scalded skin syndrome?

No, medical emergency

Which bacterial disease is characterized by honey-colored sticky crust, pus-filled vesicles, and red patches?

Impetigo Contagiosum AKA Pyoderma

What is the MOST common pathogen associated with Impetigo Contagiosum (Pyoderma)? (80%)

What is the second most common? (20%)

staphylococcus aureus (80%)

streptococcus pyogenes (20%)

What is the MOST common population affected by Impetigo Contagiosum (Pyoderma)?

children 2-5, immune system not fully developed

How is Impetigo Contagiosum (Pyoderma) transmitted?

person to person or via fomites

The presence of what is diagnostic for Impetigo Contagiosum (Pyoderma)?

vesicles filled wit bacteria and WBC's

Are you adjusting someone with Impetigo Contagiosum (Pyoderma)?

Yes

Which bacterial disease is characterize by a fiery red rash with raised borders most commonly found on the legs?

Erysipelas

In severe cases, Erysipelas can progress to what?

swollen lymph nodes, leukocytosis, sepsis

What is the pathogen associated with Erysipelas?

streptococcus pyogenes

How is Erysipelas transmitted?

person to person contact or via fomites

Which 2 populations are at an increased risk for Erysipelas?

infant and elderly patients (60-80)

Are you adjusting someone with Erysipelas?

if symptoms of sepsis NO - refer

If not, yes

How can you tell the difference between Erysipelas and Lupus rashes on face?

Lupus spares nasolabial folds

Erysipelas covers nose

Which bacterial disease is characterized by purplish-red blisters that are very painful and destroy muscle fat and tissue?

Necrotizing Fasciitis (AKA flesh-eating bacteria)

In necrotizing fasciitis, the bacteria enters through breaks in skin and secretes ______ and ______ that destroy tissues

enzymes and exotoxins

How does necrotizing fasciitis spread along the body?

along fascia

Which pathogen causes MOST cases of necrotizing fasciitis?

streptococcus pyogenes (Group A Strep)

Are you adjusting someone with necrotizing fasciitis?

No - medical emergency

Which bacterial disease is associated with a hair follicle and a normal microbiota that becomes opportunistic from sebum blockage?

Acne

Which pathogen causes MOST cases of acne?

propionibacterium acnes AKA cutibacterium acnes

The incidence rate of acne is _____% of adolescents and young adults

75%

Which bacterial disease is characterized by a bump (papule) or blister (pustule) and lymphadenopathy near the site of scratch/bite?

Cat Scratch Disease/Fever

What is the MOST common pathogen associated with Cat Scratch Disease/Fever?

What is the primary virulence factor?

Bartonella Henslae

Endotoxin

How is Cat Scratch Fever/Disease transmitted?

cat bites or scratches

Are you adjusting someone with Cat Scratch Fever/Disease?

Yes

Which bacterial disease is characterized by purulent matter in infected wounds and a blue-green pigment called pyocyanin?

Pseudomonas Infection

Who is at an increased risk of developing Pseudomonas Infection?

burn victims

What is the pathogen associated with Pseudomonas Infection?

pseudomonas aeruginosa

T/F? Pseudomonas Infection does NOT typically occur in healthy individuals

True

Which bacterial disease is associated with a non-itchy spotted rash on the soles of feet and palms of hands?

Rocky Mountain Spotted Fever

50% of individuals with Rocky Mountain Spotted Fever develop what?

petechiae

Which pathogen is associated with Rocky Mountain Spotted Fever?

What is the MOST severe and MOST common consequence?

rickettsia rickettsii

rickettsial illness

For Rocky Mountain Spotted Fever:

What is the vector?

What is the reservoir?

vector = tick

reservoir = rodent

Which months is Rocky Mountain Spotted Fever MOST prevalent?

June/July (summer months)

Approximately ___% of patients die from Rocky Mountain Spotted Fever, even with treatment which is why early dx is crucial

5%

Are you adjusting someone with Rocky Mountain Spotted Fever?

Yes - BUT if you see rash on palms/soles refer

[REVEIW] What 2 bacterial species can form endospores?

Bacillus

Clostridium

Which bacterial disease is characterized by a painless black, crusty ulcer called an eschar?

Cutaneous Anthrax

Cutaneous Anthrax releases anthrax into blood causing ________

This is why if untreated, it is fatal in _____% of patients

toxemia (3 toxins)

20%

What pathogen is associated with Cutaneous Anthrax?

bacillus anthracis (endospore)

How is cutaneous anthrax transmitted?

direct contact with anthrax spores, soil, animals/animal products

How long would a patient with Cutaneous Anthrax need to take antibiotics for? WHY?

60 days, takes 60 days to germinate endospore

Are you adjusting someone with Cutaneous Anthrax?

Yes - BUT if you see eschar, refer

Also on list of reportable disease/category A bioterrorist

Which bacterial disease is characterized by very painful necrosis, a foul-smell, and gas bubbles?

Gas Gangrene

What is the incubation period for Gas Gangrene?

6-48 hours (rapid)*

death within 1 week

What is the pathogen associated with Gas Gangrene?

How many toxins does it secrete that cause IRREVERSIBLE damage to the body?

clostridium perfringes (endospores)

11 toxins

How is Gas Gangrene transmitted?

traumatic event to introduce endospores into dead tissue

Clostridium Perfringes is a normal microbiota BUT becomes opportunistic due to what primary factor?

ischemia

How is Gas Gangrene usually treated?

antitoxin and penicillin

Which population is at a greater risk for Gas Gangrene? Why?

diabetic patients, ischemia and peripheral neuropathy

Are you adjusting someone with Gas Gangrene?

NO - medical emergency

Which poxviruses CAN causes human diseases?

smallpox

monkeypox (mpox)

cowpox

molluscum contagiosum

T/F? Chickenpox is a poxvirus

False!

What are the stages os lesions in a poxvirus infection?

macule (flat)

papule

vesicle

pustule

crust

scarring

Which viral disease is characterized by a fever and headache first and progresses to pox lesions on face and body?

smallpox

Patients with smallpox are contagious until...

last scab falls off (~5 weeks)

When are patients with smallpox the MOST contagious?

onset of rash, usually very sick at this stage

What pathogen is associated with smallpox?

smallpox virus (orthopoxvirus) AKA variola virus

How is smallpox transmitted?

inhalation or direct contact

What is the #1 Category A Bioterrorist threat?

smallpox

Treatment of smallpox requires...

immediate vaccination

Smallpox was declared "eradicated" worldwide in ______ by World Health Organization

1980

Which viral disease is characterized by pox lesions AND lymphadenpoathy?

Monkey Pox (mpox)

What pathogen is associated with Monkeypox?

monkeypox virus

What is the reservoir for Monkeypox?

monkey or rodent

How is Monkeypox transmitted?

primarily inhalation, also direct contact including bodily fluids

What is the treatment for Monkeypox?

vaccination within 2 weeks of exposure

Are you adjusting someone with Monkeypox?

Yes BUT masks would be required to avoid inhalation

Also a reportable disease

Which viral disease is characterized by pearl-like, waxy papules on the face, trunk, or external genitalia?

Molluscum Contagiosum

Which pathogen is associated with Molluscum Contagiosum?

molluscum contagiosum virus (molluscipoxvirus)

How is Molluscum Contagiosum transmitted?

direct contact and fomites

Which population(s) are at an increased risk for Molluscum Contagiosum?

What is the MOST common?

children 1-10 (MC!!)

sexually active individuals

immunocompromised