Types of Skin & Soft Tissue Infections
Soft Tissue Infections
Minor:
▪ 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
o Typical Antibiotics:
▪ Beta Hemolytic Strep- Keflex or Clindamycin
▪ Staph Aureus- Bactrim, Clindamycin, or Doxycycline
▪ Pseudomonas- Ciprofloxacin, Ampicillin, or Bactrim
Major:
▪ Necrotizing Fasciitis: infection of the deep soft tissues, spreads through the fascial layer
• Typical pathogens:
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• Type 1: Polymicrobial- typically anaerobe plus Enterobacteriaceae andanaerobic streptococci
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• Type 2: Monomicrobial- Group A strep or MRSA
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• Type 3: Vibrio Species
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o Treatment:
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• Emergency surgery!
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• Zosyn + Vancomycin + Clindamycin
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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
- Strep Toxic Shock Syndrome: Group A strep
- Toxin- exotoxins A and B, superantigens
- Increased mortality than staph toxic shock syndrome
Resources:
Chu, V. H. (2019, October 1). Staphylococcal toxic shock syndrome. Retrieved April 10, 2020, from https://www.uptodate.com/contents/staphylococcal-toxic-shock-syndrome?se... toxic shock&source=search_result&selectedTitle=1~42&usage_type=default&display_rank=1
Jackson, J. D. (2019, August 30). Infectious folliculitis. Retrieved April 10, 2020, from https://www.uptodate.com/contents/infectious- folliculitis?search=folliculitis&source=search_result&selectedTitle=1~150&usage_type=default &display_rank=1#H19981454
Spelman, D., & Baddour, L. M. (2019, April 1). Cellulitis and skin abscess in adults: Treatment. Retrieved April 10, 2020, from https://www.uptodate.com/contents/cellulitis-and-skin-abscess- in-adults-treatment?search=soft tissue infection&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
Stevens, D. L. (2019, March 5). Invasive group A streptococcal infection and toxic shock syndrome: Epidemiology, clinical manifestations, and diagnosis. Retrieved April 10, 2020, from https://www.uptodate.com/contents/invasive-group-a-streptococcal-infecti... shock-syndrome-epidemiology-clinical-manifestations-and- diagnosis?search=abscess&topicRef=110529&source=see_link#H28998789
Stevens, D. L., & Baddour, L. M. (2020, February 28). Necrotizing soft tissue infections. Retrieved April 10, 2020, from https://www.uptodate.com/contents/necrotizing-soft-tissue- infections?search=abscess&topicRef=110529&source=see_link#H22