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Lecture 7: Skin and soft tissue infections (SSTIs) - Coggle Diagram

- - - - Usually in children
      - Vesicular then pustular
      - Due to S.aureus or S.pyogenes
      - Highly contagious
      - Bacterial skin infection
    - - Infection within hair hair follicles
      - S.aureus usually
      - P.aeruginosa implicated in outbreaks
        (e.g. contaminated swimming pools)
      - Carbuncles/furuncles
  - - - Infection along epidermis and upper dermis
      - S.pyogenes usually
      - Prominent inflammation and lymphatic involvement,
        sharp demarcation and raised edges
      - 70-80% on lower limbs, 5-20% on face
      - Risk factors
        
        venous stasis
        
        diabetes
        
        lymphoedema
    - - Acute infection spreading along the lower dermis and
        subcutaneous tissues.
      - S.aureus most common pathogen
      - Clinical features
        
        Pain
        
        Tenderness
        
        Erythema
        
        Malaise
        
        Fever
        
        Chills
      - Margins may be less clearly demarcated
      - Complications
        
        regional lymphadenopathy (common)
        
        bacteraemia (severe cases)
      - Most commonly in the lower limbs (can also occur elsewhere)
    - - Types (I-IV)
        
        Type IV
        
        Associated with fungal pathogens
        
        Type III
        
        Associated with marine organisms ie. Vibrio spp.
        
        Type II
        
        Group A streptococcus (S. pyogenes)
        
        Life-threatening infection with high mortality if
        untreated.
        
        Type I
        
        Polymicrobial aetiology
      - Most extensive inflammation and necrosis in
        subcutaneous tissues & fascia.
      - Severe infection involving the subcutaneous tissues
    - - Insect or animal bites/scratches
        
        Animal bites: tissue injuries, bleeding, transmission of systemic
        infections
        
        Transmission of infections carried by insects
      - Secondary infection of ulcers
        
        Classically in the lower limbs especially lower leg or foot
      - Surgical site
        infections
        
        Complications
        
        Bacteraemia and/or sepsis
        
        Further extension to deeper spaces
        
        Local abscess formation
        
        Impaired healing
      - Breaching of the skin/soft tissue barrier + secondary infection
        of the wound