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Questions and Answers
What is the first line of treatment for Necrotizing Fasciitis?
What is the first line of treatment for Necrotizing Fasciitis?
Which of the following types of bacteria is classified under Type 1 Necrotizing Fasciitis?
Which of the following types of bacteria is classified under Type 1 Necrotizing Fasciitis?
Which antibiotic combination is used as empirical therapy for treating Necrotizing Fasciitis?
Which antibiotic combination is used as empirical therapy for treating Necrotizing Fasciitis?
What is a characteristic symptom of Gas Gangrene?
What is a characteristic symptom of Gas Gangrene?
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Which of the following is NOT a common pathogen associated with Gas Gangrene?
Which of the following is NOT a common pathogen associated with Gas Gangrene?
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Which imaging technique is used to detect abscesses in cases of purulent infection?
Which imaging technique is used to detect abscesses in cases of purulent infection?
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What is the duration of treatment for moderate Purulent Infections after incision and drainage?
What is the duration of treatment for moderate Purulent Infections after incision and drainage?
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Which antibiotic regimen is recommended for the targeted therapy of Vibrio vulnificus?
Which antibiotic regimen is recommended for the targeted therapy of Vibrio vulnificus?
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Which oral medications are used for moderate SSTIs if MSSA is confirmed?
Which oral medications are used for moderate SSTIs if MSSA is confirmed?
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What is the recommended duration of treatment for animal bite wounds?
What is the recommended duration of treatment for animal bite wounds?
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In cases of human bites, which bacteria is NOT typically involved?
In cases of human bites, which bacteria is NOT typically involved?
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Which intravenous medication is NOT effective against empiric or confirmed MRSA for severe SSTIs?
Which intravenous medication is NOT effective against empiric or confirmed MRSA for severe SSTIs?
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What is a common pathogen associated with surgical site infections?
What is a common pathogen associated with surgical site infections?
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Which of the following is NOT considered a common treatment for human bites?
Which of the following is NOT considered a common treatment for human bites?
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What is a key consideration for managing SSTIs effectively?
What is a key consideration for managing SSTIs effectively?
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Which vaccination is recommended for post-exposure prophylaxis after an animal bite?
Which vaccination is recommended for post-exposure prophylaxis after an animal bite?
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Which of the following are characteristics of a furuncle?
Which of the following are characteristics of a furuncle?
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What is the primary coverage for mild non-purulent infections such as erysipelas?
What is the primary coverage for mild non-purulent infections such as erysipelas?
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In non-purulent infections, which of the following symptoms indicates a moderate severity?
In non-purulent infections, which of the following symptoms indicates a moderate severity?
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Which treatment is recommended for a carbuncle?
Which treatment is recommended for a carbuncle?
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What is a common risk factor for Pseudomonas aeruginosa infection?
What is a common risk factor for Pseudomonas aeruginosa infection?
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Which treatment is appropriate for a severe non-purulent infection?
Which treatment is appropriate for a severe non-purulent infection?
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What feature distinguishes necrotizing fasciitis from other non-purulent infections?
What feature distinguishes necrotizing fasciitis from other non-purulent infections?
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Which antibiotic is preferred for oral therapy of mild infections confirmed to be caused by streptococci?
Which antibiotic is preferred for oral therapy of mild infections confirmed to be caused by streptococci?
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What is an essential characteristic of cellulitis?
What is an essential characteristic of cellulitis?
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What is a typical presentation of impetigo?
What is a typical presentation of impetigo?
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What is the first-line treatment for acute otitis media in children?
What is the first-line treatment for acute otitis media in children?
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Which condition does NOT require antibiotic therapy?
Which condition does NOT require antibiotic therapy?
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What indicates a need for antibiotics if the child has an acute ear infection?
What indicates a need for antibiotics if the child has an acute ear infection?
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In which situation would you prescribe Amoxicillin Clavulanate instead of Amoxicillin?
In which situation would you prescribe Amoxicillin Clavulanate instead of Amoxicillin?
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What must be monitored before initiating antibiotics in non-severe unilateral acute otitis media in children aged 6 months and older?
What must be monitored before initiating antibiotics in non-severe unilateral acute otitis media in children aged 6 months and older?
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What is the recommended dosage of Cefdinir for children?
What is the recommended dosage of Cefdinir for children?
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Which symptom does NOT warrant immediate initiation of antibiotics for acute otitis media?
Which symptom does NOT warrant immediate initiation of antibiotics for acute otitis media?
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What would you expect in the physical findings of a skin and soft tissue infection?
What would you expect in the physical findings of a skin and soft tissue infection?
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What type of skin infection is monomicrobial and involves previously healthy skin?
What type of skin infection is monomicrobial and involves previously healthy skin?
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What is a common lab finding for skin and soft tissue infections?
What is a common lab finding for skin and soft tissue infections?
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Study Notes
Otitis Media
- Otitis media is an inflammation of the middle ear.
- There are three types of otitis media: acute otitis media, otitis media with effusion, and chronic otitis media.
- Acute otitis media is a common infection in children, often occurring after a viral respiratory illness (common cold).
- It can be caused by bacteria such as Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.
- Symptoms of acute otitis media include ear pain (otalgia) and ear drainage (otorrhea).
- Diagnosis is made by observing the tympanic membrane for bulging or erythema.
- High dose amoxicillin is the first-line treatment for acute otitis media in children.
- Amoxicillin-clavulanate is used if certain criteria are met, such as previous amoxicillin use or a history of recurrent infections.
- Observation without antibiotics may be considered for children 6 months or older with non-severe, unilateral otitis media without otorrhea.
- Observation without antibiotics may also be considered for children 24 months or older with bilateral otitis media without otorrhea.
Skin and Soft Tissue Infections (SSTIs)
- SSTIs are categorized based on site, depth, presentation, and clinical setting.
- They can be primary (involving healthy skin) or secondary (involving damaged skin).
- Physical findings include erythema, induration, swelling, discharge, warmth, and pain.
- Laboratory findings include elevated white blood cell count (WBC) and C-reactive protein (CRP).
- Imaging (CT/MRI) can reveal soft tissue edema, fascial thickening, fluid collection, and soft tissue air.
- Cultures and sensitivities are used to identify the causative organisms.
- Common skin organisms include coagulase-negative Staphylococcus, Cutibacterium, Micrococcus, Corynebacterium, Staphylococcus aureus, and Streptococcus pyogenes.
Types of SSTIs
-
Superficial SSTIs:
- Impetigo: Characterized by honey-colored crusts, fluid-filled lesions, and a preference for topical treatment.
- Folliculitis: Inflammation of hair follicles.
- Furuncle (boil): Painful, pus-filled nodule developing in a hair follicle.
- Carbuncle: Multiple furuncles that coalesce, forming a deep follicular mass.
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Non-superficial SSTIs:
-
Non-purulent:
- Erysipelas: Bright red, well-demarcated area with lymphatic involvement.
- Cellulitis: Superficial infection that can spread deeper, potentially accompanied by an abscess.
- Necrotizing fasciitis: Rapidly spreading infection causing tissue death, characterized by skin discoloration.
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Purulent:
- Abscess: Localized fluid collection with pain, fever, and malaise.
-
Non-purulent:
Treatment Considerations
- Treatment of SSTIs depends on the severity of the infection and the presence of systemic signs.
- Mild infections are typically treated with oral antibiotics.
- Moderate infections require intravenous antibiotics.
- Severe infections often necessitate broad-spectrum coverage and IV antibiotics.
- Source control is crucial in treating SSTIs, often requiring incision and drainage (I&D) of abscesses.
- Empiric antimicrobial therapy is selected based on the infection site, risk factors, local susceptibility patterns, and likely pathogens.
Other SSTIs
-
Animal Bite Wounds:
- Polymicrobial in nature.
- Common organisms include Pasteurella, Streptococcus, and Staphylococcus.
- Treatment includes amoxicillin-clavulanate, doxycycline, or moxifloxacin.
- Prophylactic vaccinations for rabies and tetanus are recommended.
- Human Bite Wounds:
- Often clenched fist injuries.
- Common organisms include Viridians Streptococci, S. aureus, and Fusobacterium.
- Treatment includes amoxicillin-clavulanate, doxycycline, clindamycin + ciprofloxacin, or IV options like ampicillin-sulbactam, cefoxitin, ertapenem, or moxifloxacin.
-
Surgical Site Infections:
- Exogenous source contamination.
- Common organisms include S. aureus, coagulase-negative Staphylococcus, and Enterococci.
- Prophylaxis with cefazolin is used for MSSA coverage.
- MRSA coverage is recommended for high-risk surgeries.
General Treatment Guidelines
- Not all SSTIs require antimicrobial treatment.
- Source control is crucial when achievable.
- Consider IV to PO conversion, if applicable, once source control is obtained and clinical stability achieved.
- Empiric antimicrobials should be selected based on infection site, risk factors, local susceptibility patterns, history, and likely pathogens.
- Most causative pathogens for SSTIs include Group A Streptococcus (non-purulent) and S. aureus (purulent).
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Description
This quiz covers the essential aspects of otitis media, including its types, symptoms, causes, and treatment options. Understand the differences between acute, chronic, and effusion types, as well as the management strategies for children affected by this condition.
