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Skin & Soft Tissue Infection - Coggle Diagram
Skin & Soft Tissue Infection
Pathogenesis
Breach of Intact Skin
Major Trauma
Skin Manifestations of Systemic Infections
Blood-Borne Spread from Infected Focus to Skin/Direct Extension
Toxin-Mediated Skin Damage
Production of Microbial Toxin at Another Site in Body
Bacteria
Classification
Abscess Formation
Boils
Carbuncles
Spreading Infection
Impetigo
Area - Epidermis
Causative Agent - S. Aureus, Strep. Pyogenes
Clinical Manifestation
Nonbullous - Honey-Coloured Crust/Lesion
Bullous - Bullae
Risk Factor
Children (Boys) - MOST Common
Summer
Developing Countries
Atopic Dermatitis, Scabies, Skin Trauma, Chickenpox, Insect Bite, Thermal Burn
Treatment - Oral Antibiotics
Complication:
Bacteremia - Osteomyelitis, Septic Arthritis, Pneumonia, Scalded Skin Syndrome, Toxic Shock Syndrome, PSGN, Rheumatic Fever
Lab Diagnosis
Clinically
Confirmed by Bacterial Swabs
Erysipelas
Area - Upper Dermis & Extends into Superficial Cutaneous Lymphatic
Causative Agent - Strep. Pyogenes
Clinical Manifestation
Blockade of Dermal Lymphatics
Well-Defined, Spreading, Erythematous Inflammation
Infants - Umbilicus/Diaper/Napkin Region
Face, Legs, Feet
Risk Factor
Insect Bite, Ulcer, Chronic Skin Conditions (Psoriasis, Athlete's Foot & Eczema), Trauma, Surgical Wounds, Radiotherapy
Infants & Older Group
Treatment
Oral/IV Penicillin
Erythromycin (if Allergic)
Vancomycin (MRSA)
Complication
Abscess, Gangrene, Thrombophlebitis, Chronic Leg Swelling, Toxic Shock Syndrome (RARE)
Lab Diagnosis
Diagnosed by Characteristic Rash
Cellulitis
Area - Dermis & Deeper Than Erysipelas
Causative Agent - Strep. Pyogenes (Common), S. Aureus (Uncommon), H. Influenzae (Rare)
Risk Factor
Previous Episodes of Cellulitis, Fissure of Toes/Heels - Athlete's Foot/Tinea Pedis, Venous Disease, Eczema, Leg Ulceration, Trauma, Radiotherapy, Surgical Wounds
Clinical Manifestation
Bacteremia, Malaise, Chills, Fever, Peau D'Orange
Treatment
Antibiotics
Complication
Necrotizing Fasciitis, Gas Gangrene, Severe Sepsis, Pneumonia, Infective Endocarditis
Lab Diagnosis
Clinically
Leukocytosis, Elevated CRP
Necrotizing Infections
Gangrene/Myonecrosis
Fungus
Tinea
Peidra
Dermatophytes
Example - Microsporum Sp., Trichosporum Sp., Epidermophyton Sp.
Pathogenesis
Has Keratinase - Ability to Utilize Keratin as Nutrient Sources
Invade, Infect, Persist in Stratum Corneum
Rarely Penetrate below Epidermis & Its Appendages
Presence of Fungus & Its Metabolic Products
Allergic & Inflammatory Eczematous Response in Host
Skin Responds to Irritation - Increased Proliferation in Basal Cell Layer, Scaling & Epidermal Thickening
Lab. Diagnosis
Specimen - Skin Scraping/Nodules
Microscopy (KOH) - Fungal Elements
Culture on SDA - Macroconidia, Conidia, Yeast Cells
Treatment
Topical
Clotrimazole
Selenium Sulfide
Terbinafine
Oral
Itraconazole
Parasite
5 Layers of Epidermis
Stratum Corneum
Keratinized Cells, Lost Nuclei & Organelles
Water Repellant
Stratum Lucidum
Only in Thick Skin
Thin, Translucent Layer
Stratum Granulosum
Flattened Cells, Granules
Stratum Spinosum
Thickest
Polyhedral Cells w/ Central Nuclei
Spines between Cells
Stratum Basale
At Dermal-Epidermal Junction