Microbiology Quiz on Skin Infections
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Questions and Answers

Which of the following is NOT a bacterial skin infection?

  • Impetigo
  • Gas gangrene
  • Boils
  • Tinea (correct)

What factor increases the risk of fungal skin infections?

  • Wearing tight clothing
  • Consuming dairy products
  • Wearing sweaty or moist clothes (correct)
  • Exposure to sunlight

Which pathogen is primarily responsible for necrotizing fasciitis?

  • Streptococcus pyogenes (correct)
  • Clostridium perfringens
  • Staphylococcus aureus
  • Bacillus anthracis

What characteristic feature is associated with Staphylococcus aureus?

<p>Gram-positive cocci in grape-like clusters (C)</p> Signup and view all the answers

Which of the following infections is MOST likely to be hospital-acquired due to antibiotic-resistant Staphylococci?

<p>Hospital-acquired wound infections (C)</p> Signup and view all the answers

What mode of infection involves the direct introduction of a microbe into epithelium?

<p>Surface penetration (B)</p> Signup and view all the answers

Which biochemical reaction is positive for Staphylococcus aureus?

<p>Coagulase (A)</p> Signup and view all the answers

What is a common outcome of focal suppuration associated with Staphylococcus aureus?

<p>Abscess formation (C)</p> Signup and view all the answers

What is the primary factor leading to the reactivation of the varicella-zoster virus?

<p>Decreased cell-mediated immunity (D)</p> Signup and view all the answers

Which symptom is a characteristic of herpes zoster?

<p>Severe unilateral pain (A)</p> Signup and view all the answers

Which mechanism primarily causes the maculopapular rash in measles?

<p>Action of cytotoxic T cells (A)</p> Signup and view all the answers

What is the usual incubation period for measles?

<p>10 days (B)</p> Signup and view all the answers

What type of infections are caused by HSV-1 in immunocompromised patients?

<p>Disseminated infections like pneumonia (A)</p> Signup and view all the answers

What is the primary mode of transmission for rubella virus?

<p>Airborne respiratory secretions (D)</p> Signup and view all the answers

What triggers recurrent infections of HSV-1?

<p>Emotional stress and menstruation (B)</p> Signup and view all the answers

Which age is typically recommended for the first dose of the measles vaccination?

<p>15 months (A)</p> Signup and view all the answers

What condition is most commonly associated with recurrent HSV-1 infections?

<p>Herpes labialis (A)</p> Signup and view all the answers

How does chickenpox primarily spread among children?

<p>Airborne transmission and contact with lesions (B)</p> Signup and view all the answers

What type of virus causes measles?

<p>Negative-sense ssRNA virus (B)</p> Signup and view all the answers

What characterizes the rash of chickenpox?

<p>All stages of the rash present at the same time (A)</p> Signup and view all the answers

What is the result of the initial infection with HSV-1?

<p>Vesicular lesions heal without scarring and can recur (A)</p> Signup and view all the answers

What is a common post-infectious complication experienced by patients older than 65 years with herpes zoster?

<p>Post herpetic neuralgia (D)</p> Signup and view all the answers

What is the incubation period for chickenpox?

<p>14-21 days (C)</p> Signup and view all the answers

Which type of lesions does HSV-1 cause in normal individuals?

<p>Vesicles that may change to ulcers but heal without scars (C)</p> Signup and view all the answers

What is a primary characteristic of Toxic Shock Syndrome (TSS)?

<p>It can be caused by wound or localized infections. (A)</p> Signup and view all the answers

What is the main reason for Staphylococcus aureus' resistance to penicillin?

<p>It produces b-lactamase, which destroys the b-lactam ring. (B)</p> Signup and view all the answers

Which toxin is associated with Scalded Skin Syndrome in infants?

<p>Exfoliative toxins A and B (A)</p> Signup and view all the answers

What percentage of Staphylococcus aureus strains show resistance to methicillin?

<p>20% (B)</p> Signup and view all the answers

What type of bacteria typically causes necrotizing fasciitis?

<p>Streptococcus pyogenes (D)</p> Signup and view all the answers

Which of the following properties is true for Group A beta-hemolytic streptococci?

<p>They produce beta hemolysis on blood agar. (B)</p> Signup and view all the answers

What is the function of pyrogenic exotoxin A from group A streptococci?

<p>It serves as a superantigen causing cytokine release. (D)</p> Signup and view all the answers

Which of the following statements is true regarding Staphylococcus aureus and antibiotic resistance?

<p>Some strains show complete resistance to methicillin. (D)</p> Signup and view all the answers

What is the main cause of acute bacterial endocarditis related to Str. pyogenes?

<p>Deformed heart valves (B)</p> Signup and view all the answers

What characterizes the skin infection known as erysipelas?

<p>Redness and edema with advancing margins (A)</p> Signup and view all the answers

Which of the following is a possible outcome of pyoderma?

<p>Acute glomerulonephritis (C)</p> Signup and view all the answers

What is a common consequence of invasive diseases caused by Str. pyogenes?

<p>Streptococcal septicaemia (D)</p> Signup and view all the answers

Which strain of streptococcus is primarily associated with streptococcus toxic shock syndrome?

<p>M type 1, 3, 12 &amp; 28 (B)</p> Signup and view all the answers

What symptom is commonly associated with scarlet fever?

<p>Sore throat with an erythematous rash (C)</p> Signup and view all the answers

What shows a common laboratory finding in acute glomerulonephritis?

<p>Presence of granular casts in urine (A)</p> Signup and view all the answers

What is the primary effect of alpha toxin from Clostridium perfringens?

<p>Increases vascular permeability and causes tissue destruction (A)</p> Signup and view all the answers

What is necrotizing fasciitis primarily characterized by?

<p>Destruction of fascia and fat (D)</p> Signup and view all the answers

Which toxin produced by Clostridium perfringens is associated with necrotizing lesions in the intestinal tract?

<p>Theta toxin (A)</p> Signup and view all the answers

What method is used to diagnose superficial mycosis caused by Malassezia furfur?

<p>KOH mount of skin scales (D)</p> Signup and view all the answers

What are the clinical manifestations of superficial mycosis primarily characterized by?

<p>Cosmetic symptoms such as hypo- or hyperpigmented skin patches (D)</p> Signup and view all the answers

Which species of dermatophyte is NOT mentioned as a common cause of cutaneous mycosis?

<p>Candida (C)</p> Signup and view all the answers

What is the purpose of adding chloramphenicol to Sabouraud's dextrose agar?

<p>To inhibit bacterial contaminants (C)</p> Signup and view all the answers

What is a characteristic feature of subcutaneous mycosis, such as Madura foot?

<p>Swelling and abscess formation with drainage through sinus tracts (D)</p> Signup and view all the answers

Which enzyme is NOT produced by Clostridium perfringens as an extracellular enzyme?

<p>Amylase (C)</p> Signup and view all the answers

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Flashcards

Skin and soft tissue infections

An infection of the skin and soft tissues caused by various germs, ranging from mild to severe. Some cases require medical attention.

Routes for Skin Infection

The entry point for bacteria into the skin, often through minor wounds, follicles, or sweat glands.

Boils

A type of skin infection caused by the bacterium Staphylococcus aureus, characterized by pus-filled bumps or boils.

Staphylococcus aureus Habitat

Staphylococcus aureus often lives in the nostrils and on the skin, causing various infections.

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Staphylococcus aureus Infections

The most common cause of localized pus-filled lesions in humans, often due to the bacteria's ability to produce coagulase, which forms a wall around the infection.

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Focal Suppuration and Abscess Formation

Characteristic infection caused by Staphylococcus aureus, where coagulase forms a fibrin wall around the infection, preventing the spread of bacteria but also making it difficult to treat.

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Superficial Staph Infections

Superficial infections caused by Staphylococcus aureus, including folliculitis, carbuncles, boils, and abscesses.

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Deep Seated Staph Infections

Staph. aureus can spread to deeper tissues, causing infections such as osteomyelitis, pneumonia, endocarditis, and meningitis.

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What is TSST-1?

A toxin produced by Staphylococcus aureus associated with toxic shock syndrome (TSS). Causes fever, vomiting, diarrhea, muscle pain, rash, and may lead to life-threatening complications like hypotension, heart failure, and kidney failure.

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What is 'bullous exfoliation' or 'scaled skin syndrome'?

A condition caused by Staphylococcus aureus characterized by widespread peeling of the skin, often seen in babies and young children. Occurs due to toxins A and B produced by the bacteria.

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How does Staphylococcus aureus become resistant to penicillin?

A common mechanism by which Staphylococcus aureus becomes resistant to penicillin. This enzyme breaks down the structure of penicillin, rendering it ineffective.

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What is Streptococcus pyogenes?

A Gram-positive bacteria typically found in chains. They are known for causing various infections, including scarlet fever, strep throat, and skin infections.

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What are 'pyrogenic exotoxins'?

Toxins produced by Streptococcus pyogenes that cause various symptoms like rashes and fever. These toxins act as superantigens, triggering an excessive immune response.

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What is 'pyrogenic exotoxin A'?

A pyrogenic toxin (erythrogenic toxin) responsible for causing Scarlet fever and streptococcal toxic shock syndrome (STSS). It acts as a superantigen, over-activating the immune system.

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What is 'pyrogenic exotoxin B'?

A protease toxin produced by Streptococcus pyogenes that rapidly breaks down tissues. It's often involved in necrotizing fasciitis, also known as 'flesh-eating bacteria'.

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What is 'necrotizing fasciitis'?

A rare but dangerous condition caused by the Streptococcus pyogenes bacteria. It involves the rapid destruction of soft tissues, often leading to serious complications.

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Pyoderma (impetigo)

A bacterial infection of the skin characterized by blisters that break, leaving a raw surface with pus or crusts.

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Invasive diseases caused by Str. pyogenes

A group of rapidly spreading infections involving the lymphatic system with minimal localized pus formation.

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Erysipelas

A skin infection characterized by redness, swelling, and a rapidly expanding border, often on the face or legs.

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Streptococcal toxic shock syndrome (STSS)

A condition that occurs when group A Streptococcus (Str. pyogenes) releases toxic substances called pyrogenic exotoxins A and B, leading to a serious and life-threatening infection with shock, bacteremia, and multi-organ failure.

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Scarlet fever

A childhood illness characterized by a sore throat and a red rash, caused by a strain of Str. pyogenes that produces erythrogenic toxin.

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Acute glomerulonephritis (AGN)

A condition that occurs 2-3 weeks after a throat or skin infection with specific strains of Str. pyogenes, causing inflammation of the kidneys.

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Acute bacterial endocarditis

A serious complication that can arise after an infection with Str. pyogenes, where bacteria in the blood stream infect the heart valves.

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Soft tissue sepsis

A collection of infections involving various tissues, including wounds, skin, fascia, and lymph nodes. These infections can be caused by different strains of Str. pyogenes and range in severity.

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Primary HSV-1 infection

The initial infection with herpes simplex virus 1 (HSV-1), where the virus multiplies in the mucous membrane or abraded skin and causes vesicular lesions that turn into shallow ulcers and eventually heal without scarring.

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Latent HSV-1 Infection

The stage of HSV-1 infection where the virus travels through nerves to the trigeminal ganglia, causing acute infection followed by latency, meaning the virus remains dormant in the body.

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Recurrent HSV-1 Infection

Reactivation of the HSV-1 virus after latency, leading to recurrent outbreaks of lesions, potentially triggered by factors like sunlight, fever, menstruation, or emotional stress.

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Herpes Labialis (Fever Blisters or Cold Sores)

A common form of recurrent HSV-1 infection, resulting in clusters of vesicles appearing on the lips or nose, at the junction between skin and mucous membranes.

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Disseminated HSV Infection

A complication of HSV-1 or HSV-2 infection that can occur in individuals with weakened immune systems, where the virus spreads to the lungs, causing inflammation and potential respiratory distress.

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Varicella (Chickenpox)

The initial infection with varicella-zoster virus (VZV), causing chickenpox, a highly contagious childhood illness characterized by a rash that spreads from the trunk to the limbs and face.

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Primary Viremia

The stage of VZV infection where the virus spreads through the bloodstream to the reticuloendothelial system, the body's network of immune cells.

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Secondary Viremia

The second stage of VZV infection, where the virus spreads again through the bloodstream, causing a rash on the skin.

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Gas Gangrene

A bacterial infection caused by Clostridium perfringens, characterized by the release of toxins after sporulation. Its clinical manifestations can include soft tissue infections like cellulitis, fasciitis and myonecrosis (gas gangrene), as well as food poisoning.

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Alpha Toxin

The primary toxin produced by Clostridium perfringens, responsible for the destruction of red blood cells, platelets, white blood cells, and endothelial cells. It causes increased vascular permeability, bleeding, and tissue damage.

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Theta Toxin

A toxin produced by Clostridium perfringens that is associated with causing necrotic lesions in necrotizing enterocolitis.

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Enterotoxin

A heat-labile toxin produced by Clostridium perfringens responsible for causing food poisoning. It is produced in the colon after ingestion of contaminated food.

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Tinea Versicolor

A fungal infection that affects the outermost layer of skin and hair, resulting in hypo- or hyperpigmented skin patches, usually on the trunk of the body. It is caused by the fungus Malassezia furfur.

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Dermatophytes

A group of fungi that cause skin infections. They include Trichophyton, Microsporum, and Epidermophyton floccosum. Infections are spread through direct contact with humans or animals.

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Subcutaneous Mycosis

A type of fungal infection that affects the subcutaneous tissue, characterized by swelling, abscess formation, and drainage through sinus tracts. These infections often produce granules, small, colored bodies, in the exudates.

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Madura Foot

A type of fungal infection that affects the subcutaneous tissue, often affecting the foot. It is characterized by swelling, abscess formation, and drainage through sinus tracts. The infection often results in granules, usually colored, in the exudates.

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Shingles (Herpes Zoster)

VZV reactivation, often after times of weakened immune system or localized injury. It affects sensory nerves leading to severe pain, followed by a cluster of blisters typically on one side of the body.

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Chickenpox (Varicella)

Caused by the varicella-zoster virus (VZV), a highly contagious virus leading to a characteristic rash with itchy blisters. Infection can also occur by contact with contaminated objects.

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Measles Encephalitis

Inflammation of the brain caused by a viral infection, most commonly by the measles virus. It can cause serious complications like encephalitis and seizures.

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Measles

An acute, highly contagious viral disease caused by the measles virus. It is characterized by fever, cough, runny nose, conjunctivitis, and a distinctive rash, often preceded by Koplik's spots.

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Rubella (German Measles)

A viral infection caused by the rubella virus, which is characterized by a mild rash, low-grade fever, and swollen lymph nodes. It can be particularly harmful for pregnant women.

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Congenital Rubella Syndrome

A serious complication of rubella infection in a pregnant woman, leading to various congenital defects in the fetus, including deafness, eye defects, and heart problems.

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Post-Herpetic Neuralgia

A chronic pain syndrome that can occur after shingles infection. It can persist for months or years, causing significant pain and discomfort.

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Incubation Period

The period between exposure to the virus and the appearance of symptoms. For measles, it is approximately 10 days.

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Study Notes

MUSKULOSKELETAL BLOCK

  • Skin and soft tissue infections are caused by various germs, symptoms vary from mild to severe.
  • Minor trauma damages the integrity of the skin, allowing microbes to enter.
  • Surface openings like hair follicles and sebaceous glands are entry points for microbes.
  • Wearing sweaty or moist clothes increases the risk of fungal infections.
  • Infection severity is graded according to anatomical depth.

MODES OF INFECTION

  • Direct entry of microbes into epithelial tissue.
  • Circulating microbes.
  • Circulating toxins.

TYPES OF SKIN INFECTIONS

  • Bacterial infections: Boils (Staphylococcus aureus), Impetigo (Streptococcus pyogenes & Staphylococcus aureus), Cellulitis (Streptococcus pyogenes), Necrotizing fasciitis (Streptococcus pyogenes), Anthrax (Bacillus anthracis), Gas gangrene (Clostridium perfringens), Burn infection (Pseudomonas), Leprosy (Mycobacterium leprae).
  • Fungal infections
  • Viral infections

STAPHYLOCOCCUS AUREUS

  • Natural Habitat: Nostrils, skin
  • Morphology: Gram-positive cocci (grape-like clusters), non-motile, non-encapsulated, non-spore forming.
  • The most common cause of localized suppurative lesions in humans.
  • Specific symptoms include boils, cellulitis, impetigo, and paronychia.

CULTURAL CHARACTERISTICS

  • Facultative anaerobic bacteria.
  • Grow on nutrient and blood agar, forming large, yellow to creamy colonies.
  • Often hemolytic on blood agar.
  • Mannitol salt agar is a selective medium.
  • Grows at 15-45°C and high NaCl concentrations.

BIOCHEMICAL REACTIONS

  • Catalase: Positive
  • Coagulase: Positive
  • DNase: Positive
  • Oxidase: Negative
  • Ferments glucose, lactose, sucrose, mannitol to produce acid.

VIRULENCE FACTORS OF S. AEREUS

  • Structural Components:

    • Protein A: major cell wall protein, disrupts immune defenses, binds to Fc region of IgG, disrupts phagocytosis
    • Polysaccharide Capsule: Antiphagocytic, facilitates attachment to foreign bodies
  • Enzymes:

    • Coagulase: coagulates plasma and blood, diagnostic
    • Hyaluronidase: degrades connective tissue
    • Staphylokinase: digests blood clots
    • DNase: digests DNA
    • Lipases: digest oils, enhance colonization
    • Penicillinase: inactivates penicillin
  • Toxins:

    • Hemolysins (alpha, beta, gamma, delta): lyse red blood cells
    • Leukocidin: lyses leukocytes (neutrophils and macrophages).
    • Enterotoxin: causes gastrointestinal distress.
    • Exfoliative toxin: separates epidermis from dermis
    • Toxic shock syndrome toxin (TSST): induces fever, vomiting, shock, and organ damage.

DISEASES CAUSED BY S. AUREUS

  • Focal suppuration and abscess formation
  • Superficial infections (e.g., folliculitis, carbuncles, boils)
  • Deep-seated lesions (e.g., osteomyelitis, bronchopneumonia, empyema, endocarditis, meningitis).
  • Bacteremia with multiple abscesses.
  • Hospital-acquired wound infections.
  • Septicemia (sepsis)
  • Toxigenic diseases (e.g., toxic shock syndrome, scaled skin syndrome).

STREPTOCOCCUS PYOGENES

  • Morphology: Gram-positive cocci in chains, non-motile, non-spore forming.
  • Group A beta-hemolytic streptococci.
  • Catalase-negative
  • Pathogenesis: adhesion, invasion, escape from phagocytes, enzyme and toxin production.

VIRULENCE FACTORS OF S. PYOGENES

  • Structural Components:

    • M protein: binds the complement, prevents phagocytosis and opsonization.
    • Lipoteichoic acid and F protein: adhesion and invasion.
    • Hyaluronic acid capsule: camouflage and acts as a defense mechanism.
  • Enzymes: -Streptokinase: digests blood clots -Deoxynucleases: degrade DNA -C5a peptidase: inhibits complement activation

  • Pyrogenic toxins: contribute to various diseases.

DISEASES CAUSED BY S. PYOGENES

  • Pyogenic local infections (e.g., pyoderma, erysipelas)
  • Invasive diseases (e.g., streptococcal toxic shock syndrome)
  • Post-streptococcal immunologic diseases (e.g., acute glomerulonephritis)

BACILLUS ANTHRACIS

  • Morphology: Gram-positive, rectangular, large organisms in chains, encapsulated in vivo. Capsulated cells stain pink when viewed in certain dyes.
  • Aerobic bacteria, can grow on nutrient agar at 37°C
  • Virulence factors: polypeptide capsule, toxin production (antiphagocytic).
  • Pathogenesis: capsule and toxin (anthrax toxin -made up of 3 fractions:Edema factor (EF), Protective antigen (PA), Lethal factor (LF)).

PSEUDOMONAS AERUGINOSA

  • Morphology: Gram-negative bacilli, non-spore forming, non-capsulated, motile by polar flagella.
  • Obligate aerobic.
  • Can grow on simple media, with sweet grape odor, causing greenish discoloration.
  • Contains pyocyanin (blue) and pyoverdin (greenish yellow) pigments.
  • Oxidase-positive.

CLOSTRIDIUM PERFRINGENS

  • Morphology: Large Gram-positive bacilli, non-motile, encapsulated, and have central or subterminal spores
  • Anaerobic
  • Pathogenesis: produce toxins after sporulation, various toxins include alpha toxin, theta toxin, and enterotoxin.

PATHOGENESIS OF C. PERFRINGENS

  • Spores germinate, vegetative cells multiply and ferment carbohydrates, resulting in tissue distension, interference
  • Hemolytic and toxic effects
  • Associated diseases include soft tissue infection (cellulitis, fasciitis, myonecrosis (gas gangrene)) and food poisoning

FUNGAL SKIN INFECTIONS

  • Superficial mycoses (e.g., tinea versicolor)
  • Cutaneous mycoses (e.g., ringworm)
  • Subcutaneous mycoses (e.g., madura foot)
  • Sporotrichosis (e.g., from thorns)
  • Candidiasis (e.g., yeast-like fungus)

VIRAL SKIN INFECTIONS

  • Herpes simplex type 1: oral or genital cold sores
  • Chickenpox(varicella): highly contagious
  • Shingles (Herpes zoster): reactivation of latent virus, characteristic pain and rash
  • Rubella(German Measles): airborne transmission.
  • Measles: airborne transmission
  • Hand-foot-and-mouth disease: Viral infection mostly affecting children, common symptoms include fever, sores in mouth, sores or rash on hands/feet/buttocks.
  • Genital warts(human papillomavirus): common in children/immunocompromised individuals, sexually transmitted

CANDIDIASIS

  • Candida albicans is a common species
  • Extremes of age, chronic debilitating diseases, diabetes mellitus, malnutrition, excessive moisture, pregnancy, and long-term antibiotic or steroid use predispose to infections.
  • Skin lesion signs include areas of red itchy skin, or inflammation of the nails/skin folds/groin regions.

MOLLUSCUM CONTAGIOSUM

  • Benign skin nodules, usually on arms, face, and genitals.
  • Virus is transmitted through close contact and sexually
  • Common in children and immunocompromised individuals.

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Test your knowledge on bacterial skin infections and their causes, along with the implications of antibiotic resistance. This quiz covers various pathogens, their characteristics, and modes of infection associated with Staphylococcus aureus. Perfect for students studying microbiology or healthcare professionals.

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