Types of Skin & Soft Tissue Infections

Soft Tissue Infections



▪ Folliculitis- pustules with surrounding erythema at site of hair follicles

          • Typical pathogens: Staph aureus or Pseudomonas

▪ Erisipelas- Superficial infection including only the epidermis, well demarcated area of warmth and erythema

          • Typical pathogens: beta hemolytic strep

▪ Cellulitis- Deep infection including dermis

          • Typical Pathogens: beta hemolytic strep or MSSA

▪ Abscess- collection of pus within the dermis or subcutaneous space

          • Typical pathogens: MSSA or MRSA


Typical Antibiotics: 

  ▪ Beta Hemolytic Strep- Keflex or Clindamycin

  ▪ Staph Aureus- Bactrim, Clindamycin, or Doxycycline

  ▪ Pseudomonas- Ciprofloxacin, Ampicillin, or Bactrim



▪ Necrotizing Fasciitis: infection of the deep soft tissues, spreads through the fascial layer

     • Typical pathogens: 

  •      •  Type 1: Polymicrobial- typically anaerobe plus Enterobacteriaceae andanaerobic streptococci

  •      •  Type 2: Monomicrobial- Group A strep or MRSA

  •      •  Type 3: Vibrio Species

  • Treatment:

  •      •  Emergency surgery!

  •      •  Zosyn + Vancomycin + Clindamycin

  •               Note- Clindamycin is given for its anti-toxin effects in staph and strep infections


Toxic Shock Syndromes

  • Staph Toxic Shock Syndrome: Staph Aureus

          - Toxin- exotoxin (TSST-1), superantigen

          - Causes: 50% tampon use, 50% surgical/post-partum infections, osteomyelitis, mastitis, burns, etc
          - Treatment: Vancomycin plus Clindamycin
  • Strep Toxic Shock Syndrome: Group A strep

          - Toxin- exotoxins A and B, superantigens

          - Typically associated with necrotizing fasciitis or myositis
          - Increased mortality than staph toxic shock syndrome
          - Treatment: Zosyn or Carbapenam plus Clindamycin




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