Skin Infections and Infestations
Staphylococcus aureus
Staphylococcus aureus
Staphylococcus aureus
Staphylococcus aureus
Staphylococcus aureus
Staphylococcus aureus
Staphylococcus aureus
Staphylococcus aureus
Streptococcus pyogenes
Streptococcus pyogenes
Streptococcus pyogenes
Bacterial Diseases
- Streptococcal and Staphylococcal Infections
- Bacterial Diseases (continued)
Streptococcal and Staphylococcal Infections
| Non-bullous: | Face (nose/mouth) Spontaneous course 2-3 weeks; can have prolonged course |
| Bullous: | Face; anywhere |
| Post-strep. | Acute glomerulonephritis decreasing in
incidence Occurs 18-21 days post-skin infection; 10 days post-throat infection (scarlet fever) |
Ecthyma |
Crusts beneath which ulceration occurs Heals with scarring Buttocks/thighs/legs |
| Warm, intense erythema with poorly demarcated
borders. Leg and face often involved. Mainly Streptococcus, can be Staphylococcus |
|
| Cellulitis in children: | H. influenza Especially face |
| Complications: | A possibility, especially when it occurs on the face (e.g. cavernous sinus thrombosis) |
| Diagnosis: | Culture. Skin biopsy not recommended. |
| Follicular-based pustules (compare with miliaria) | |
| Hair follicle-based Staph. aureus abscess Diabetes associated (?) HIV (may coalesce into violaceous plaques) Sites: face/neck/buttocks |
| Strep. pyogenes pyrogenic exotoxin Upper respiratory tract usual portal of entry Ages 1-10 years most common |
|
| Incubation: | 2-5 days; fever, anorexia, vomiting, tonsillitis, lymphadenopathy |
| Rash: | 2nd day: Trunk - "sunburn with goose pimples" Arms - Pastia's lines Mouth - circumoral pallor 7th-10th day: "White strawberry tongue" -> "red strawberry" tongue |
| Epidermolytic toxin Abrupt onset - fever & skin tenderness Scarlatiniform rash present early |
Toxic Shock Syndrome (toxins) |
Fever, rash, and desquamation: required for
diagnosis Staph. aureus, severe infection with Strep. pyogenes After 1985 most cases not menstrual. Recent report from England: toxic shock after minor skin procedure |
| Clinical: | Acute onset fever, rash. Vomiting & diarrhea. |
| Rash: | Widespread macular erythema - clears 3 days Edema of hand/feet; purpura; desquamation - 10-21 days after onset (fingertips, palmar/plantar skin) Mortality from shock 7% |
