Podcast
Questions and Answers
Which of the following factors is most likely to increase the risk of developing cellulitis?
Which of the following factors is most likely to increase the risk of developing cellulitis?
What is the primary characteristic that differentiates cellulitis from erysipela?
What is the primary characteristic that differentiates cellulitis from erysipela?
Which species of Staphylococcus is most commonly associated with skin infections?
Which species of Staphylococcus is most commonly associated with skin infections?
How does the skin microbiome play a role in skin infections?
How does the skin microbiome play a role in skin infections?
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Which of the following is NOT a common symptom of cellulitis?
Which of the following is NOT a common symptom of cellulitis?
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What type of pathogen is primarily responsible for erysipelas?
What type of pathogen is primarily responsible for erysipelas?
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Which of the following is NOT a characteristic symptom of cellulitis?
Which of the following is NOT a characteristic symptom of cellulitis?
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What are common sources of infection for cellulitis?
What are common sources of infection for cellulitis?
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What distinguishes cellulitis from erysipelas?
What distinguishes cellulitis from erysipelas?
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What is a common risk factor for developing skin infections like cellulitis?
What is a common risk factor for developing skin infections like cellulitis?
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Which of the following pathogens is frequently associated with community-acquired MRSA?
Which of the following pathogens is frequently associated with community-acquired MRSA?
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What is a potential complication of untreated erysipelas?
What is a potential complication of untreated erysipelas?
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Which of the following is a crucial initial step in managing cellulitis?
Which of the following is a crucial initial step in managing cellulitis?
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Which of the following is a potential consequence of cellulitis if left untreated?
Which of the following is a potential consequence of cellulitis if left untreated?
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What is an indication of necrotizing fasciitis when assessing cellulitis?
What is an indication of necrotizing fasciitis when assessing cellulitis?
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Which class in the ERON Classification of cellulitis indicates the presence of systemic signs?
Which class in the ERON Classification of cellulitis indicates the presence of systemic signs?
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Which of the following is NOT a common symptom associated with severe cellulitis?
Which of the following is NOT a common symptom associated with severe cellulitis?
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In a patient with cellulitis, which of the following conditions may suggest the need for emergent surgical evaluation?
In a patient with cellulitis, which of the following conditions may suggest the need for emergent surgical evaluation?
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Which of the following statements is true regarding the spread of bacterial infections like cellulitis?
Which of the following statements is true regarding the spread of bacterial infections like cellulitis?
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What risk is present in patients with severe cases of cellulitis?
What risk is present in patients with severe cases of cellulitis?
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Which clinical finding would most likely suggest a diagnosis of cellulitis?
Which clinical finding would most likely suggest a diagnosis of cellulitis?
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Study Notes
Skin Microbiota
- Healthy skin, with an intact barrier, prevents infection by normal flora
- Normal flora plays a vital role in preventing potential pathogens from colonizing the skin
- Key factors controlling skin bacteria include moisture, acid pH (of the skin), surface temperature, secreted sebum, fatty acids, and urea, as well as microbiota competition
- Skin microbiota includes bacteria, fungi, mites, and viruses (not all regard viruses as part of the normal flora)
Skin Bacteriobiota
- Many different bacterial species live on the skin
- Distributions vary across different body areas
- Sebaceous areas are disproportionately populated by specific species of Actinobacteria, as well as Propionibacterium acnes.
- Moist areas have a higher diversity of bacteria (like Proteobacteria and Bacteroidetes)
- Specific bacterial groups dominate in different body areas.
Moisture and Fat Distribution
- Moisture and fat play a crucial role in skin microbiota distribution
- Sebaceous areas (e.g., scalp, face) show a higher proportion of certain bacteria
- Moist areas (e.g., armpits, groin) have different bacterial communities
- Different body sites have distinct microbiota compositions based on water and fat concentrations.
Mycobiome
- Candida is a common fungi in certain body areas
- Other fungi, like Malassezia, are prominent and vary by skin location
- The presence of certain fungi like Staphylococci and Corynebacteria is linked to particular locations on the body
Skin Infections: Treatment Overview
- Treatment for skin infections depends on their type
- Purulent infections (abscess, carbuncle) may require incision and drainage (I&D) or antibiotics such as Vancomycin, TMP/SMX, or Clindamycin
- Non-purulent infections (cellulitis, necrotizing fasciitis) require intravenous antibiotics like penicillin, ceftriaxone, or vancomycin, and may need surgical intervention to address infection
- Clinical assessment is key to appropriate treatment selection
Skin Infections: Diagnostic Assessment
- Diagnostic evaluation typically involves a patient history and physical examination
- Culture tests, when indicated, can identify specific microbes and provide information useful in antibiotic selection
Activity on Skin, Muscle, Joint, and Bone Infections
- Key points and definitions of common infectious diseases, including pathophysiology, prevalence, etiology, signs and symptoms, diagnoses, and treatments should be understood, e.g, for skin, muscle, joints, and bones
Anatomy of the Skin and Pathogens
- Skin has several layers that provide a barrier, and pathogens breach this barrier
- Different layers of the skin and the routes these pathogens can traverse it were demonstrated
- Various pathogens may enter the body via breaks in the skin
Sites of Infections & Infections Spreading
- Different sites of infection are affected in different ways
- Infections can spread through various tissue layers, including cells, subcutaneous tissue, and muscles.
Bacterial Skin Infections (Folliculitis, Impetigo)
- These infections result from different pathogens, such as Staphylococcus aureus
- Folliculitis involves hair follicle inflammation but typically has a mild response
- Impetigo is a superficial skin infection, commonly in newborns due to bacteria (exfoliating toxins A and B)
Bacterial Skin Infection (Cellulitis)
- Cellulitis is a skin infection involving subcutaneous tissue inflammation and can spread from the affected area
- Various microbes, such as Streptococcus pyogenes and Staphylococcus aureus, are implicated in cellulitis
Bacterial Skin Infection (Abscesses)
- Abscesses result from inflammatory responses to microorganisms
- Commonly caused by Staphylococcus aureus, abscesses form when microbes accumulate at local skin sites
- Abscess treatment often involves drainage and antibiotics
Bacterial Skin Infection (Scarlet Fever)
- Scarlet fever is characterized by a specific rash and high fever, usually in young children
- It's caused by pyrogenic exotoxins produced by Streptococcus pyogenes
Fungal Skin Infections (Mycoses)
- Fungi can cause skin infections like Tinea capitis, Tinea versicolor, and Pityriasis versicolor
- Infections may appear as a rash or scaly patches in affected areas
- Various pathogens cause fungal skin infections depending on the skin presentation
Parasitic Skin Infections (Cercarial Dermatitis)
- Cercarial dermatitis is the result of a parasitic infection
- Austrobilharzia variglandis is the most commonly implicated species involved in swimmers itch
- The skin is the main site of parasitic entry, and the parasite can potentially spread systemically
Viral Skin Infections (Herpes Simplex Virus (HSV))
- Herpes simplex virus (HSV) causes oral infections, such as cold sores, and can also spread systemically, leading to life-threatening risks in infants.
- HSV1 is primarily linked to oral infections
- HSV2 is sexually transmitted
Viral Skin Infections (Coxsackievirus A)
- Coxsackievirus A is usually transmitted by the faecal-oral route
- It is mostly prevalent in the summer
- The virus typically produces mouth ulcers, and rarely causes complications
Viral Skin Infections (Measles & Mumps)
- Measles and mumps are highly contagious respiratory infections
- Measles leads to widespread, rash-producing infections that can affect the lungs, among other organs
- Mumps mainly affects salivary glands, with few reported complications, although it can potentially lead to meningitis
Learning Outcomes Summary Information
- Understanding of skin, muscle, joint, and bone infections
- Knowledge of common skin infections, including their basic pathophysiology, prevalence, etiology, signs & symptoms, diagnoses, and treatments.
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