Skin, Bone, and Soft Tissue Infections

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Questions and Answers

What is the approximate surface area of human skin?

  • 1.5-2.0 m² (correct)
  • 3.5-4.0 m²
  • 0.5-1.0 m²
  • 2.5-3.0 m²

Which type of bacteria are most abundant in normal skin flora?

  • Gram-negative bacteria
  • Anaerobic bacteria
  • Acid-fast bacteria
  • Gram-positive bacteria (correct)

Which of the following is a characteristic of Staphylococcus aureus?

  • Coagulase positive and catalase positive (correct)
  • Coagulase positive and catalase negative
  • Coagulase negative and catalase positive
  • Coagulase negative and catalase negative

Which of the following best describes the morphology of staphylococci?

<p>Grape-like clusters of cocci (A)</p> Signup and view all the answers

What role do sweat glands and hair follicles play in the skin's bacterial ecosystem?

<p>They help to reestablish the bacterial flora. (B)</p> Signup and view all the answers

Which characteristic is NOT associated with Staphylococcus aureus?

<p>Catalase-negative reaction (B)</p> Signup and view all the answers

What type of hemolysis is associated with Streptococcus pyogenes?

<p>Beta (β)-hemolysis (A)</p> Signup and view all the answers

Which of the following describes the catalase test result for all streptococci?

<p>Catalase-negative (C)</p> Signup and view all the answers

Which of the following does NOT produce coagulase?

<p>Both <em>Staphylococcus epidermidis</em> and <em>Streptococcus pyogenes</em> (A)</p> Signup and view all the answers

Which of the following is associated with partial hemolysis of red blood cells?

<p>Alpha (α)-hemolysis (C)</p> Signup and view all the answers

According to the Lancefield classification, which group does Streptococcus pyogenes belong to?

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

What is the shape of Streptococcus bacteria?

<p>Spherical (cocci) in chains (C)</p> Signup and view all the answers

Which of the following is a characteristic of an anaerobic bacteria as noted in this content?

<p>Grows in the absence of oxygen. (A)</p> Signup and view all the answers

Which of the following is a characteristic of a vesicle?

<p>A small, fluid-filled lesion in the epidermis (C)</p> Signup and view all the answers

Which bacterial species would likely be found in an infection of necrotic tissue?

<p>Bacteroides fragilis (B)</p> Signup and view all the answers

What is a key differentiating factor between cellulitis and erysipelas?

<p>Erysipelas shows prominent lymphatic involvement and is a type of superficial cellulitis. (A)</p> Signup and view all the answers

A patient presents with a deep inflammatory nodule that developed from a previous folliculitis infection. Which condition is most likely?

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

Which of the following is a characteristic of a bulla?

<p>A large, fluid-filled lesion in the epidermis. (A)</p> Signup and view all the answers

Which of these bacteria is NOT classified as an anaerobe?

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

What is the initial presentation of impetigo?

<p>Vesicular superficial infection. (A)</p> Signup and view all the answers

Which condition is associated with a generalized sunburn-like eruption alongside an acute febrile illness?

<p>Staphylococcal Toxic Shock Syndrome (A)</p> Signup and view all the answers

Which of the following is the primary causative agent of gas gangrene?

<p>Clostridium perfringens (B)</p> Signup and view all the answers

What is the primary characteristic of necrotizing fasciitis?

<p>Severe infection of subcutaneous soft tissue and fascia (D)</p> Signup and view all the answers

Which of these conditions is specifically caused by a Staphylococcus aureus strain that produces an exfoliative exotoxin?

<p>Staphylococcal Scalded Skin Syndrome (A)</p> Signup and view all the answers

What predisposing factor is commonly associated with necrotizing fasciitis?

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

Which of the following is NOT a common causative organism of diabetic foot infections?

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

Which of the following is a common location for septic arthritis?

<p>Joint spaces (D)</p> Signup and view all the answers

Which of these factors primarily increases the risk of osteomyelitis in a diabetic patient?

<p>Vascular disease impairing blood supply (D)</p> Signup and view all the answers

What is the primary treatment for necrotizing fasciitis?

<p>Surgical debridement and antibiotics (C)</p> Signup and view all the answers

Flashcards

Epidermis

The outermost layer of skin, providing a protective barrier against microorganisms and external elements.

Dermis

The layer of skin below the epidermis, containing blood vessels, nerves, and hair follicles.

Staphylococcus spp.

A group of bacteria commonly found on human skin, often in the nose and throat.

Staphylococcus aureus

A type of Staphylococcus bacteria that is coagulase positive, meaning it can cause blood clots.

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Coagulase reaction

A test used to identify Staphylococcus aureus, based on its ability to clump (coagulate) rabbit blood plasma.

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Alpha-hemolytic Streptococci

Gram-positive cocci in pairs or chains that produce a greenish discoloration on blood agar plates. They are responsible for infections such as pneumonia, meningitis, and endocarditis.

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Beta-hemolytic Streptococci

Gram-positive cocci in pairs or chains that lyse red blood cells completely on blood agar. They are known for causing infections like strep throat, scarlet fever, and necrotizing fasciitis.

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Gamma-hemolytic Streptococci

Gram-positive cocci in pairs or chains that don't cause any change in the blood agar. They are less commonly associated with infections.

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Antimicrobial Resistance in Streptococci

A group of Streptococcus species that are resistant to many common antibiotics.

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Catalase Test

A test used to identify bacteria that produce catalase, an enzyme that breaks down hydrogen peroxide. Staphylococcus species are catalase-positive, while Streptococcus species are catalase-negative.

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Coagulase Test

A test used to identify bacteria that produce coagulase, an enzyme that clots blood plasma. Staphylococcus aureus is coagulase-positive, while most other staphylococci are coagulase-negative.

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Protein A

A protein produced by Staphylococcus aureus that binds to the Fc portion of antibodies, interfering with the immune response.

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Pyrogenic Toxins

A group of toxins produced by Staphylococcus aureus that cause fever and inflammation.

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Staphylococcal Scalded Skin Syndrome (SSSS)

A serious skin infection caused by Staphylococcus aureus strains producing an exfoliating toxin, leading to widespread blistering and peeling of the skin.

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Furuncle

A pus-filled, painful infection of a hair follicle, typically caused by Staphylococcus aureus.

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Carbuncle

A cluster of interconnected furuncles, forming a larger, deeper infection. Usually caused by Staphylococcus aureus.

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Necrotizing Fasciitis

A severe bacterial infection that spreads rapidly in the subcutaneous tissue, causing tissue death. Often referred to as 'flesh-eating disease'.

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Gas Gangrene

A life-threatening infection of skeletal muscle, usually caused by Clostridium species, notably C. perfringens. It is characterized by rapid progression and gas production.

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Myositis

Inflammation of skeletal muscle, a rare bacterial infection. Often caused by Staphylococcus aureus or Streptococcus pyogenes.

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Septic Arthritis

Infection within the joint space. Can be caused by various bacteria like S. aureus, Streptococcus, or Gram-negative bacilli.

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Osteomyelitis

Infection of bone tissue. Often caused by S. aureus, S. pyogenes, H. influenzae, or Gram-negative bacilli.

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Folliculitis

A type of bacterial infection that typically affects the skin, causing small, fluid-filled lesions. These lesions are commonly referred to as "pimples" or "boils", although they can be more serious.

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Impetigo

A contagious skin infection that often manifests as red, itchy, and crusty patches, usually around the nose, mouth, or fingers. It's typically caused by bacteria from the Streptococcus or Staphylococcus family.

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Cellulitis

A widespread bacterial infection that can deeply affect skin tissues, becoming quite red and swollen. It may spread quickly and is often caused by bacteria like Staphylococcus aureus or Streptococcus.

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Erysipelas

A specific type of skin infection, often caused by Streptococcus pyogenes, that involves the upper layers of skin with prominent lymph involvement. It presents as bright red, tender patches, often on the face or legs.

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Staphylococcal Toxic Shock Syndrome (TSST)

A serious bacterial infection that can affect the whole body, often caused by Staphylococcus aureus. It can cause fever, rash, and low blood pressure, and requires immediate medical attention.

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Scalded Skin Syndrome (SSS)

A serious skin infection that typically affects newborns and infants, causing blistering and peeling of the skin. It's usually caused by Staphylococcus aureus and requires prompt treatment.

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Study Notes

Skin, Bone, and Soft Tissue Infections

  • Skin infections are a significant health concern, affecting skin, soft tissues, and bones.
  • Normal skin flora is primarily gram-positive bacteria, including Staphylococcus spp., Micrococcus spp., Corynebacterium spp., and Cutibacterium (Propionibacterium) acnes.
  • Vigorous washing reduces but does not fully eliminate normal skin flora. Sweat glands and hair follicles help re-establish the bacterial flora after washing.
  • Staphylococcus aureus is a spherical, gram-positive coccus that forms grape-like clusters.
  • It forms pale to golden-yellow colonies on blood agar. All Staphylococci are catalase positive, breaking down hydrogen peroxide.
  • Staphylococcus aureus is also coagulase positive.
  • Coagulase is a specific enzyme that causes rabbit plasma to coagulate (clotting). Subtypes of staphylococcus are categorized based on coagulase activity (positive or negative).
  • Staphylococcus aureus produces multiple virulence factors, including coagulase, hemolysins (various types of toxins that destroy red blood cells), enterotoxins, and pyrogenic (febrile) toxins. Also, exfoliatins, leukocidin, and protein A
  • Streptococcus species are spherical, gram-positive cocci that form chains.
  • They are catalase negative and are broadly classified by their hemolytic activity (alpha, beta, or gamma).
  • Alpha-hemolytic species partially lyse red blood cells; beta-hemolytic species completely lyse red blood cells; and gamma-hemolytic species do not lyse red blood cells. Examples of these species include Streptococcus pyogenes (beta-hemolytic) and Streptococcus pneumoniae (alpha-hemolytic).
  • Group A Streptococcus (GAS) is a gram-positive bacteria in short chains, hemolytic, and does not produce coagulase.
  • Anaerobes are bacteria that thrive in the absence of oxygen. These include facultative species (e.g., Staphylococcus aureus), obligate species (e.g., Bacteroides fragilis), and Fusobacterium species.
  • Common species of gram-positive and gram-negative cocci and bacilli are listed for anaerobes.
  • Skin lesions are described via different morphological terms, including vesicles (small fluid-filled blisters), bullae (larger fluid-filled blisters), macules, and papules (raised lesions). Pustules are sores that have pus inside.
  • Bacterial skin diseases include folliculitis (infection of hair follicles), impetigo (superficial skin infection), cellulitis (spreading skin infection), erysipelas (superficial cellulitis with lymphatic involvement), furuncles (deep, inflamed nodules), carbuncles (more extensive than furuncles, involving subcutaneous fat), staphylococcal toxic shock syndrome (sudden onset fever, sunburn rash), and scalded skin syndrome (widespread and painful blisters).
  • Organisms associated with these specific skin diseases are also listed
  • Soft-tissue infections (e.g., necrotizing fasciitis, myositis, gas gangrene) may cause significant tissue damage.
  • Necrotizing fasciitis is a severe infection of the connective tissue.
  • Myositis is an infection of skeletal muscle.
  • Gas gangrene results from the infection of Clostridium bacteria.
  • Bone infections, including septic arthritis (infection of joint spaces) and osteomyelitis (infection of the bone), are also discussed.
  • Diabetic foot infections are a significant complication of diabetes. Infections may involve cellulitis, bone infections (osteomyelitis), and soft-tissue infections.
  • The risk factors include vascular disease, peripheral neuropathy, and poor foot care.
  • The infectious organisms that cause foot infections are also noted.

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