2010-Skin - Skin infection case q A 45 year old pastry chef...

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Skin infection case A 45 year old pastry chef, cut his left forearm with a knife during the  course of his work. Over the next week, he noticed swelling, redness and  warmth at the site. After 4 more days, he developed fever with shaking  chill and came to the emergency room with  severe low back pain . On  physical exam, he had a fever of 39.4 o C, his left forearm was swollen  with an area of central softness, indicating an abscess. He had  tenderness to pressure over his lower spine. The laboratory reported that he had a high white cell count. A Gram  stain of pus aspirated from the forearm showed  Gram positive cocci  in  clusters. 
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Questions What are the most common bacteria causing skin infections? Mechanisms of tissue damage? How forearm infection cause back pain? What are the predisposing conditions? Prevention and treatments
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DEFENSES Dry usual infection sites are wet areas, skin folds, armpit, groin Acidic (pH 5.0) Temperature less than 37 o C Some pathogens grow best <37 o C Lysozyme and toxic lipids pore, hair follicles, sweat gland Resident microflora mainly G + Skin-associated lymphoid tissue (SALT)
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SKIN AND WOUND INFECTIONS Entry Skin (pores, hair follicles) Wounds (scratches, cuts, burns) Diseases Localized infections with local and/or systemic effect Systemic infections Multiplication Extracellular Intracellular (??) Damage Toxins, exoenzymes Host immune response
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COMMON SKIN INFECTIONS Local infections Impetigo epidermis Folliculitis infection of hair follicles Furuncles (boil) extension of folliculitis Carbuncles furuncles coalesce and extend to the deeper subcutaneous tissue fever and chills Skin abscesses Localized infection of dermis and subcutaneous tissue Erysipelas - dermal lymphatics Cellulitis - subcutaneous fat layer Systemic effect Toxic shock Sepsis
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Impetigo
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Folliculitis
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Furuncles (boil)
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Erysipelas Caused by group A streptococci, is characterized by raised, bright- red plaques with sharply defined borders.
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Cellulitis
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Staphylococcus aureus Local skin infections
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This note was uploaded on 07/02/2011 for the course MMC 6500 taught by Professor Gulig during the Spring '11 term at University of Florida.

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2010-Skin - Skin infection case q A 45 year old pastry chef...

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