51 Questions
What is cellulitis?
A common type of skin infection causing redness, swelling, and pain
What results in a furuncle or boil?
Suppuration from skin entry by pathogenic bacteria
How does the skin usually heal if promptly treated?
By resolution
What causes an abscess in the skin?
Infection of deep skin tissue by pathogenic bacteria
What is the most common cause of abscesses?
Bacterial infections
What type of cells can be found in abscesses?
Macrophages
What can happen if an abscess ruptures?
It discharges into another organ
What may result from incomplete treatment of abscesses?
'Sterile abscess' or 'antibioma'
How is the diagnosis of cutaneous and subcutaneous abscesses typically made?
By physical examination
What is the recommended IV antibiotic combination for abscesses?
Benzylpenicillin and flucloxacillin
When are systemic antimicrobial drugs indicated as adjunctive therapy for abscesses?
If the abscess is deep, multiple, has significant surrounding cellulitis, or is > 2 cm in size
What is a common complication of untreated abscesses?
Bacteremic spread
What can render antimicrobial drugs usually ineffective for abscesses?
Lack of drainage
On what basis is empiric antimicrobial therapy determined for abscesses?
Location and likely infecting pathogen
What is a potential consequence of an abscess rupturing into adjacent tissue?
Bleeding from vessels eroded by inflammation
What indicates the need for systemic antimicrobial drugs as adjunctive therapy for abscesses?
Significant surrounding cellulitis
What can be ineffective without drainage for treating abscesses?
Antimicrobial drugs
Which bacterial species is commonly associated with cellulitis?
Streptococcus pyogenes
What is the characteristic feature of erysipelas, a superficial streptococcal infection?
Well-demarcated, palpable edge
When are blood cultures recommended for cellulitis patients?
For patients with malignancy on chemotherapy, neutropenia, severe cell-mediated immunodeficiency, and animal bites
What is the recommended action for purulent infections in cellulitis treatment?
Incision and drainage +/- antibiotics
In what type of infection does streptococcal necrotizing fasciitis occur?
Deep infection in the subcutaneous tissue
What is the main characteristic of Staphylococcal skin infections?
Presence of localized pus and abscesses
What results from skin entry by pathogenic bacteria?
Furuncle (boil)
What is a common type of skin infection that causes redness, swelling, and pain?
Cellulitis
What is the result of suppuration in the upper dermis?
Carbuncle (upper dermis)
What is the characteristic feature of erysipelas, a superficial streptococcal infection?
Well-defined raised edge
What is the main characteristic of erysipelas, a superficial streptococcal infection?
Well-demarcated, palpable edge
Which type of bacterial skin infection spreads widely along tissue planes without the presence of pus?
Cellulitis
In which scenario are blood cultures recommended for patients with cellulitis?
Patients with malignancy on chemotherapy
What is the recommended action for purulent infections in cellulitis treatment?
Incision and drainage + antibiotics
What is the characteristic feature of Staphylococcal skin infections?
Localized pus and abscesses
What type of infection is characterized by an expanding, painful redness with edema, fever, malaise, and leukocytosis?
Cellulitis
What is the recommended IV antibiotic combination for abscesses?
Benzylpenicillin and flucloxacillin
What is the main complication of untreated abscesses?
Bacteremic spread
When are systemic antimicrobial drugs indicated as adjunctive therapy for abscesses?
If the abscess is deep or intra-abdominal
What can render antimicrobial drugs usually ineffective for abscesses?
Absence of drainage
What indicates the need for systemic antimicrobial drugs as adjunctive therapy for abscesses?
> 2 cm size of the abscess
On what basis is empiric antimicrobial therapy determined for abscesses?
Location and likely infecting pathogen
What is the most common cause of abscesses?
Bacterial infections
What type of cells can be found in abscesses?
Polymorphonuclear neutrophils and macrophages
What can happen if an abscess ruptures?
It may discharge into another organ
What indicates the need for systemic antimicrobial drugs as adjunctive therapy for abscesses?
Incomplete treatment due to resistant organisms
What is a potential consequence of an abscess rupturing into adjacent tissue?
Spread of infection to adjacent tissue
What can render antimicrobial drugs usually ineffective for abscesses?
Incomplete treatment due to resistant organisms
What is a common complication of untreated abscesses?
Chronic abscesses
What can be ineffective without drainage for treating abscesses?
Antibiotics alone
How is the diagnosis of cutaneous and subcutaneous abscesses typically made?
By physical examination
What results in a furuncle or boil?
Bacterial infection at a hair follicle or oil gland
What is the characteristic feature of erysipelas, a superficial streptococcal infection?
Localized swelling and redness with well-defined edges
What is cellulitis?
A bacterial skin infection involving deeper layers of skin and subcutaneous tissues.
Study Notes
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Abscesses can develop anywhere in the body, including skin abscesses and internal abscesses.
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Most often caused by bacteria Staphylococcus aureus, which enters the body through cuts, abrasions, punctures, or insect bites. Other risk factors include chronic skin conditions, diabetes, weakened immune systems, and poor hygiene.
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Contain polymorphonuclear neutrophils, macrophages, lymphocytes, bacteria, and liquefied tissue products.
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May rupture, discharge into another organ, or open onto another epithelial surface.
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Incomplete treatment due to resistant organisms or poor treatment may lead to chronic abscesses.
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Complete elimination of organisms in a chronic abscess without drainage can result in a 'sterile abscess' or 'antibioma'.
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Diagnosis of cutaneous and subcutaneous abscesses is by physical examination, while deep abscesses often require imaging for diagnosis.
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Treatment includes draining the pus through incision and drainage, CT-guided drainage, closed surgical drainage, and surgical drainage and debridement.
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Cellulitis is a bacterial infection of the subcutaneous tissue.
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Common pathogens are gram positive, specifically betahemolytic Streptococcus and Staphylococcus aureus including MRSA.
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Cellulitis is characterized by an expanding, painful redness with edema, fever, malaise, and leukocytosis.
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Erythema may track along lymphatic drainage, leading to lymphangitis.
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Diagnosis is based on clinical manifestations.
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Cultures of blood, needle aspirations, or punch biopsies are not routinely recommended.
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Blood cultures are recommended for patients with malignancy on chemotherapy, neutropenia, severe cell-mediated immunodeficiency, and animal bites.
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Streptococcal skin infections spread widely along tissue planes, with no pus present. Erysipelas is a superficial streptococcal infection with a well-demarcated, palpable edge.
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Staphylococcal skin infections produce localized pus and abscesses with a small area of surrounding erythema.
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Streptococcal necrotizing fascitis is a deep infection in the subcutaneous tissue, which can lead to tissue death.
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Treatment includes determining if the infection is purulent or non-purulent, and if it is mild, moderate, or severe.
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For purulent infections, incision and drainage +/- antibiotics are necessary.
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Hospitalization is recommended for deeper or necrotizing infections, poor adherence to therapy, severely immunocompromised patients, or when outpatient treatment is failing.
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An abscess is a collection of pus, usually caused by a bacterial infection.
-
Abscesses can develop anywhere in the body, including skin abscesses and internal abscesses.
-
Most often caused by bacteria Staphylococcus aureus, which enters the body through cuts, abrasions, punctures, or insect bites. Other risk factors include chronic skin conditions, diabetes, weakened immune systems, and poor hygiene.
-
Contain polymorphonuclear neutrophils, macrophages, lymphocytes, bacteria, and liquefied tissue products.
-
May rupture, discharge into another organ, or open onto another epithelial surface.
-
Incomplete treatment due to resistant organisms or poor treatment may lead to chronic abscesses.
-
Complete elimination of organisms in a chronic abscess without drainage can result in a 'sterile abscess' or 'antibioma'.
-
Diagnosis of cutaneous and subcutaneous abscesses is by physical examination, while deep abscesses often require imaging for diagnosis.
-
Treatment includes draining the pus through incision and drainage, CT-guided drainage, closed surgical drainage, and surgical drainage and debridement.
Learn about the development and causes of abscesses, which can occur in skin or internally in the body. Understand how internal abscesses develop in organs or between organs, and the common bacteria responsible for causing abscesses.
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