Cellulitis and Soft Tissue Infections. Sally Williams MD
|
|
- Alexander Barker
- 6 years ago
- Views:
Transcription
1 Cellulitis and Soft Tissue Infections Sally Williams MD
2 Cellulitis: A very common infection 25 cases per 1000 patient years More common in men, obese patients 60% occurs in the lower extremities 74% handled as outpatients 82% of patients have just a single episode High cause of hospital readmissions
3 Cellulitis: definition A nonspecific term that includes a large collection of skin & soft tissue infections Can include: Erysipelas (the most common cellulitis) Cellulitis associated with abscesses Gangrenous cellulitis Secondary infection of pre-existing skin lesions Cutaneous involvement of systemic illness
4 Normal Skin Structure
5 Locations of Skin Infections Impetigo and ecthyma: upper epidermis Erysipelas and cellulitis: lower epidermis and dermis Carbuncles, furuncles, boils : deep dermis and hair follicles Necrotizing fasciitis: deep, next to muscle
6 Microbiology of Cellulitis The vast majority are strep and staph More unusual etiologies: Cat bite: Pasteurella Dog bite: Capnocytophaga (splenectomized) Rat bite: Streptobacillus Fresh water: Aeromonas Salt water:vibrio and Mycobacterium marinum Hot tubs: Pseudomonas
7 Classic hot tub folliculitis
8 Mix and Match
9 Impetigo Very common skin infection in kids Has appearance of honey colored crusts, often on face Etiology is always staph or strep Treat with topical bactroban or oral abx Bullous impetigo is always staph, forms vesicles and bullae Impetigo quite infectious!
10 Impetigo
11 Erysipelas: Clinical Features Often of rapid onset Etiology is always streptococcal Often preceded by fevers, chills and groin pain (for lower extremity cellulitis) Often blisters after a few days Usually has lymphangitic streaking Almost always worsens in appearance before improving on antibiotics
12 Classic Leg Cellulitis
13 Facial Cellulitis
14 Erysipelas continued Risk factors for erysipelas/strep cellulitis: Leg edema Previous leg surgery Obesity Previous breast surgery (for arm and breast cellulitis) Tinea pedis (NOT onychomycosis) Uncontrolled diabetes
15 Natural History of Erysipelas Is almost always preceded by fevers, chills, and rapid increase in erythema ALWAYS gets worse before better Will extend outside drawn borders Almost always has fever and elevated wbc Can take WEEKS to get better if has underlying edema, history of surgery etc Will often blister
16 Is this Cellulitis??
17 Is this Cellulitis?
18 Rule #1 There is no entity of BILATERAL lower extremity cellulitis. These are usually all chronic stasis dermatitis True cellulitis almost always has: 1. Elevated wbc 2. Erythema above the knee 3. Fever, and often preceding chills 4. Often patches of cellulitis on upper thigh
19 Rule #2: Please do not culture this
20 Wound Cultures Never culture a chronic open wound The wounds will ALWAYS be colonized with multiple bacteria A wound without PMNs on gram stain is probably not an infected wound Countless unnecessary courses of antibiotics are used, predisposing pts to C difficile If you can unroof an abscess or express pus from something then culture that
21 Rule #3: Vancomycin not needed for cellulitis without boil Classic cellulitis is streptococcal Strep releases a streptozyme to dissolve layer underneath the skin, causing rapid spread. Multiple different strep species may cause cellulitis (A,B,C,F,G) Strep almost always causes lymphangiitis Staph cellulitis is almost always associated with a boil or abscess
22 Staph skin boils
23 Cellulitis continued Treatment of non-boil, non-nec fasc cellulitis is strep targeted- Rx cefazolin or ceftriaxone As soon as they let the leg down will get bigger, redder, hotter this is NOT treatment failure, just dependent edema. We need to prepare patients that the leg may look abnormal for months in some cases History of MRSA irrelevant if looks streptococcal Please do NOT use vancomycin for diffuse cellulitis
24 Cellulitis Treatment Most heavy weight people fail oral antibiotics due to insufficient blood levels may need a course of iv antibiotics or high bioavailability oral antibiotic. Failing keflex is not a reason to use vancomycin they just need iv cefazolin Strep itself is easy to kill but the infection causes a lot of leftover damage as the lymph system is often damaged. We have to prepare patients for slow improvement
25 Summary: Leg Cellulitis Occurs most commonly in the obese or persons with a history of surgery in that leg Warn them of worsening when they start ambulating, leg will get redder, hotter If you use po antibiotic, need very high doses, e.g g cephalexin qid If they truly failed high dose keflex could consider oral levoflox, has high blood levels
26 MRSA: Not a spider bite (courtesy of GiantMicrobes.com)
27 MRSA Epidemiology First described in 1961 Previously hospital associated, now widely community acquired since 2002 Most C.A. MRSA strains are US 300 and carry the PVL (panton valentine leukocidin) gene, causes necrosis C.A. most commonly skin/soft tissue infections, less likely bacteremia
28 Staphylococcal Cellulitis & Boils Risk Factors Young age Immunocompromised Contact sports Crowded conditions Sharing towels, sheets etc Prior antibiotics, especially quinolones
29 Antibiotics for Staph skin boilsdo they help? Randomized studies are conflicting Many studies show no benefit to antibiotics after incision and drainage The studies that did show a benefit related a small one with using TMP-S + I&D. Drainage is likely 95% of the battle-if the pt has extensive induration oral Rx may be helpful, especially if >2 cm.
30 Antibiotic treatment for MRSA Vancomycin for the hospitalized patient, Daptomycin also useful but expensive Clindamycin resistance up to 33% Bactrim is still sensitive >90% of the time Doxycyline resistance actually quite low Linezolid effective, but has rare drug interactions Serotonin syndrome <.1%, still black box warning Dalbavancin/Oritavancin: likely to not be used due to >$1000 per dose of antibiotic
31 Does antibacterial soap help? Antibacterial Soap? You Can Skip It, Use Plain Soap and Water (FDA November 2017) Most contain triclosan, a pesticide No proven efficacy Potential to cause antibiotic resistance Potential to affect hormones Hand sanitizers ARE effective
32 Recurrent skin lesions Most common in young overweight women Essentially acquisition is bad luck, can be very difficult to eradicate Nasal mupiricin for household sometimes effective, with mass washing For severe cases Bactrim suppression for a few months is an option
33 Necrotizing Fasciitis Uncommon severe infection Etiologies may be: Streptococcal (most common) Polymicrobial usually associated with gut flora (e.g. perirectal abscess, Fourniers) or trauma Staphylococcal usually post op, needs to be differentiated from necrotizing staph soft tissue infection which is very common.
34 Strep necrotizing fasciitis
35 Clinical Picture of Necrotizing Fasciitis These patients are very ill febrile, hypotensive, tachycardic, delerious Pain out of proportion to exam Cutaneous anesthesia Very rapid spread May have skin bullae (often black), ecchymoses, usually edema
36 Example of Leg Nec Fasc
37 Necrotizing Fasciitis WBC almost always very high or very low Cr usually about 2, pt often in toxic shock Nec fasc is a SURGICAL EMERGENCY Antibiotics are targeted toward strep, staph or polymicrobic- Vanco + Piptazo Clindamycin is added as inhibits toxin production, but surgery is life saving
38 How does Necrotizing fasciitis/ toxic shock happen? BAD LUCK It requires a toxin producing strain of strep (rare) often in the setting of uncontrolled DM AND a lack of immunity to the toxin (also rare) IVIG is often used with toxic shock to give patient a large antibody load -someone in the large pool of donors likely has an antibody to the toxin
39 Summary: Skin Infections Cellulitis is common and is usually strep Most cellulitis gets worse before better Boils are almost always staph/mrsa and need to be drained to achieve cure Chronic stasis dermatitis is incredibly common and should not be mistaken for cellulitis Nec fasciitis is rare and pts are very ill
40 IDSA SSTI guidelines
41 Antibiotic humor
42 Superbugs coming
SKIN AND SOFT TISSUE INFECTIONS
SKIN AND SOFT TISSUE INFECTIONS ZAIN CHAGLA SEA COURSES - PATAGONIA COPYRIGHT 2017 BY SEA COURSES INC. All rights reserved. No part of this document may be reproduced, copied, stored, or transmitted in
More informationMRSA: A TEAM APPROACH
Eric Bosley, MD Laura Stadler, MD John MD J h Draus, D MRSA: A TEAM APPROACH PART I: OUTPATIENT ISSUES AND MANAGEMENT NOT REQUIRING I&D OR HOSPITALIZATION Eric L. Bosley, MD, FAAP Pediatric Associates,
More informationCommon bacterial skin infections
Common bacterial skin infections Cellulitis A localized area of soft tissue inflammation with skin infiltration with white cells, capillary dilatation and proliferation of bacteria. Staph aureus and Strep
More information13/10. Microbiology Bacterial Skin Infections Dr Hani Masaadeh Areej al-arqan
13/10 Microbiology Bacterial Skin Infections Dr Hani Masaadeh Areej al-arqan Salam soul, this is the first Microbiology lecture of this system given by Dr.hani masaadeh. I ll do my best to make it easy
More information(NATO STANAG 2122, CENTO STANAG 2122, SEATO STANAG 2122)
(NATO STANAG 2122, CENTO STANAG 2122, SEATO STANAG 2122) Bacteria Bacteria are microscopic, single-celled forms of plant life, containing no chlorophyll. They live on the skin, on the surface of the stratum
More informationObjectives. Define classes of uncomplicated skin and soft tissue infection (SSTI) that drive empiric antimicrobial selection
Objectives Define classes of uncomplicated skin and soft tissue infection (SSTI) that drive empiric antimicrobial selection Purulent SSTI Non-purulent SSTI Recognize conditions that suggest complications
More informationStaph Infections. including MRSA
Staph Infections including MRSA What is a Staph infection? STAPH Staphylococcus aureus, often referred to simply as staph, are bacteria commonly carried on the skin or in the nose of healthy people. SYMPTOMS
More information-> Education -> Excellence
Quality Conference 5/2557 Extravasations: Event -> Education -> Excellence รศ.นพ. รว ศ เร องตระก ล สาขาว ชาก มารศ ลยศาสตร ภาควชาศลยศาสตร Extravasations: Event 1. Thrombophlebitis - superficial vein 2.
More informationAbscess. A abscess is a localized collection of pus in the skin and may occur on any skin surface and be formed in any part of body.
Abscess A abscess is a localized collection of pus in the skin and may occur on any skin surface and be formed in any part of body. Ethyology Bacteria causing cutaneous abscesses are typically indigenous
More informationS t a p h i n f e c t i o g r o i n p i c t u r e s
S t a p h i n f e c t i o g r o i n p i c t u r e s When someone is under an infection either in any area of the body or in the groin to be specific, the lymph nodes will swell up. Lymph nodes are located
More informationIn the absence of underlying edema or other skin abnormalities, erysipelas
ERYSIPELAS Erysipelas is a distinct type of superficial cutaneous cellulitis with marked dermal lymphatic vessel involvement caused by group A β-hemolytic streptococcus (very uncommonly group C or G streptococcus)
More informationComplicated Skin and Soft Tissue Infection diagnosis and severity stratification
Complicated Skin and Soft Tissue Infection diagnosis and severity stratification Muhammad Hussein Gasem Div Infectious Disease, TropMed, and Immunology Dr. Kariadi Hospital, Diponegoro University Semarang,
More informationRochester Patient Safety C. difficile Prevention Collaborative: Long Term Care Antimicrobial Stewardship (funded by NYSDOH)
Rochester Patient Safety C. difficile Prevention Collaborative: Long Term Care Antimicrobial Stewardship (funded by NYSDOH) Clinical Practice Guideline* for the Diagnosis and Management of Acute Bacterial
More informationSkin & Soft Tissue Infections: Classic Case Presentations
Skin & Soft Tissue Infections: Classic Case Presentations Mark Beilke, M.D. Professor of Medicine Chief of Infectious Diseases Clement J. Zablocki VA Medical Center Objectives Diagnose and treat water
More informationSkin and Soft Tissue Infections (SSTI): More than a skin deep review. Vicky Parente, MD Sea Pines Conference July 12th, 2018
Skin and Soft Tissue Infections (SSTI): More than a skin deep review Vicky Parente, MD Sea Pines Conference July 12th, 2018 Objectives To review the anatomy and classification of SSTIs To understand the
More informationCellulitis: a practical guide
Cellulitis: a practical guide Dr John Day Consultant in Infectious Diseases & General Medicine Southend University Hospital NHS Foundation Trust 77 yr old retired civil servant A&E presentation c/o rigors
More informationAbscess cellulitis pus
Abscess cellulitis pus An abscess is a collection of pus that has built up within the tissue of the body.. If the condition is thought to be cellulitis rather than abscess,. 13-2-2018 Patients with skin
More informationCase 2. Case 3 - course. PE: uncomfortable, but NAD T 38.0 R 22 HR 120 BP130/60
Case 2 42 y/o man c/o painful right arm and shoulder x 3 days. Hx of IDU ( skin popping heroin ). No other trauma or bite. PE: uncomfortable, but NAD T 38.0 R 22 HR 120 BP130/60 PMH: HCV, HBV, HIV negative,
More informationMethicillin-resistant Staphylococcus aureus for Athletes What YOU Need to Know
Methicillin-resistant Staphylococcus aureus for Athletes What YOU Need to Know Methicillin-Resistant Staphylococcus aureus (MRSA) Outbreaks of skin infections caused by Staphylococcus aureus resistant
More informationStaph infection groin pictures
Staph infection groin pictures Search TheBody.com fills you in on the topic, staph infections on the groin, with a wealth of fact sheets, expert advice, community perspective, the latest news/research.
More informationSkin and so* +ssue infec+on. N.Nuntachit MD.
Skin and so* +ssue infec+on N.Nuntachit MD. Non purulent SSTI Impe+go, ecthyma Celluli+s, Erysipelas Erysipeloid Necro+zing infec+on Etc eg Glanders, bubonic plaque Purulent SSTI Furuncle Carbuncle Abscess
More informationSkin and Soft Tissue Infections. Masoud Mardani MD, MPH,FIDSA Prof of Infectious Dis Shahid Beheshti Medical University
Skin and Soft Tissue Infections Masoud Mardani MD, MPH,FIDSA Prof of Infectious Dis Shahid Beheshti Medical University Usual Skin Flora Skin flora consists of those microbes able to adapt to the high salt
More informationGeneral surgery department of SGMU Lecturer ass. Khilgiyaev R.H. Anaerobic infection. Gas gangrene
Anaerobic infection Gas gangrene Anaerobic bacteria Anaerobic bacteria are the most numerous inhabitants of the normal gastrointestinal tract, including the mouth Bacteroides fragilis and Clostridium The
More informationID Emergencies. BGSMC Internal Medicine Edwin Yu
ID Emergencies BGSMC Internal Medicine Edwin Yu Learning Objectives Bacterial meningitis IDSA guidelines: Clin Infect Dis 2004; 39:1267-84 HSV encephalitis IDSA guidelines: Clin Infect Dis 2008; 47:303-27
More informationHealthy Skin and Skin Infections. Prepared by the Midland Region Child Health Action Group Skin Subgroup
Healthy Skin and Skin Infections Prepared by the Midland Region Child Health Action Group Skin Subgroup Objectives of this presentation This presentation will: Support health professional knowledge development
More informationCOMMON SKIN INFECTIONS. Sports Medicine
COMMON SKIN INFECTIONS Sports Medicine IMPETIGO IS A SUPERFICIAL BACTERIAL INFECTION CAUSED BY: STREPTOCOCCI OR STAPHYLOCOCCUS AUREUS BOULOUS IMPETIGO IMPETIGO COMES IN TWO FORMS: BOULOUS OR NON- BOULOUS
More informationDEFINITION Cellulitis is an acute, spreading inflammation of the dermis and subcutaneous tissue, often complicating a wound or other skin condition.
DEFINITION Cellulitis is an acute, spreading inflammation of the dermis and subcutaneous tissue, often complicating a wound or other skin condition. Cellulitis may be further classified by the unique area
More informationID Emergencies. BUMC-P Internal Medicine Edwin Yu
ID Emergencies BUMC-P Internal Medicine Edwin Yu Learning Objectives Bacterial meningitis IDSA guidelines: Clin Infect Dis 2004; 39:1267-84 HSV encephalitis IDSA guidelines: Clin Infect Dis 2008; 47:303-27
More informationPAEDIATRIC ACUTE CARE GUIDELINE. Impetigo. This document should be read in conjunction with this DISCLAIMER
Princess Margaret Hospital for Children PAEDIATRIC ACUTE CARE GUIDELINE Impetigo Scope (Staff): Scope (Area): All Emergency Department Clinicians Emergency Department This document should be read in conjunction
More informationBacterial Infections in Pediatric Dermatology. Patrick McMahon, MD Children s Hospital of Philadelphia
Bacterial Infections in Pediatric Dermatology Patrick McMahon, MD Children s Hospital of Philadelphia Fill In The Blank When you see on the skin, you think of a bacterial skin infection SEND SWABS VIRAL
More informationDisclosure. Patient Case. Objectives. Patient Case. Patient Case 7/25/2015. An update on the treatment of skin and soft tissue infections
Disclosure 49th Annual Meeting An update on the treatment of skin and soft tissue infections I do not have a vested interest in or affiliation with any corporate organization offering financial support
More informationThe Curious Intersection of HIV and Staphylococcus aureus with a Focus on MRSA
The Curious Intersection of HIV and Staphylococcus aureus with a Focus on MRSA Franklin D. Lowy, MD Columbia University College of Physicians & Surgeons New York, NY Topics to Be Covered Background Some
More informationAntibiotic Stewardship for Skin and Soft Tissue Infection and Respiratory Tract Infections
Antibiotic Stewardship for Skin and Soft Tissue Infection and Respiratory Tract Infections Ghinwa Dumyati, MD Professor of Medicine Center for Community Health and Infectious Diseases Division University
More informationClinical Case. ! 2am: Call from Surgeon, Ballarat Hospital. ! Suspicion of Necrotizing Fasciitis: ! Need of HBOT?
Clinical Case! 2am: Call from Surgeon, Ballarat Hospital! Suspicion of Necrotizing Fasciitis:! 59y, Police Officer, diabetic, overweight! 4pm: pain in right arm! 8pm: pain worsening " ED! HD instability
More informationCRACKCast Episode 137: Skin Infections (Ch th )
CRACKCast Episode 137: Skin Infections (Ch. 129 9 th ) Episode Overview Key Concepts: Skin infections are common and are rarely life-threatening. Deadly necrotizing skin and soft tissue infections are
More informationCore Content: Toxic Shock, Necrotizing Fasciitis, Erysipelas, Cellulitis, Tetanus Keith Conover, M.D., FACEP /11/2008 Tetanus 78-year old
Core Content: Toxic Shock, Necrotizing Fasciitis, Erysipelas, Cellulitis, Tetanus Keith Conover, M.D., FACEP 1.01 11/11/2008 Tetanus 78-year old Russian man, speaks fair English, smoker, no past medical
More informationMethicillin-Resistant Staphylococcus aureus (MRSA) in schools and among athletes
Methicillin-Resistant Staphylococcus aureus (MRSA) in schools and among athletes Frequently asked questions What is Staphylococcus aureus?...2 What is Methicillin Resistant Staphylococcus aureus (MRSA)?...2
More informationDEFINITION Impetigo vulgaris is a highly contagious, superficial bacterial infection of the skin.
DEFINITION Impetigo vulgaris is a highly contagious, superficial bacterial infection of the skin. Nonbullous impetigo Formation of vesiculopustules that ruptures, leading to crusting with a characteristic
More informationSkin and soft tissue (SSTI) sepsis (surgery, antimicrobial therapy and more)
Skin and soft tissue (SSTI) sepsis (surgery, antimicrobial therapy and more) Christian Eckmann Antibiotic Stewardship Expert ECDC Chief of Staff Department of General, Visceral and Thoracic Surgery Klinikum
More informationMidwifery Management Process for Common Health Problems
StudentL 1 Lower Limb Cellulitis University of Washington School of Nursing Nurse- Midwifery Education Program NCLIN 512 Fall 2012 Midwifery Management Process for Common Health Problems 1. Common Health
More informationNecrotizing Fasciitis. By Lisa Banks
Necrotizing Fasciitis By Lisa Banks Foot infections are the most common softtissue infections in pts with diabetes Necrotizing fasciitis is the most important soft tissue infection in DM pts involving
More informationUpdate in Management of Skin and So1 Tissue Infec7ons. Disclosures. None 4/23/15
Update in Management of Skin and So1 Tissue Infec7ons Catherine Liu, MD Associate Professor UCSF, Division of Infec7ous Diseases None Disclosures 1 Overview Purulent SSTI (abscesses) Non- purulent SSTI
More informationAlabama Medicaid Pharmacist
Alabama Medicaid Pharmacist Published Quarterly by Health Information Designs, LLC, Winter 015 edition A Service of Alabama Medicaid PDL Update Effective January 5, 015, the Alabama Medicaid Agency will
More informationSEPTIC ARTHRITIS. Dr Ahmed Husam Al Ahmed Rheumatologist SYRIA. University of Science and technology Hospital Sanaa Yemen 18/Dec/2014
SEPTIC ARTHRITIS Dr Ahmed Husam Al Ahmed Rheumatologist SYRIA University of Science and technology Hospital Sanaa Yemen 18/Dec/2014 Objectives be able to define Septic Arthritis know what factors predispose
More information5/1/2010. Jan K Horn, MD, FACS San Francisco General Hospital University of California, San Francisco
Necrotizing Soft Tissue Infections Jan K Horn, MD, FACS San Francisco General Hospital University of California, San Francisco Soft Tissue Infections Anatomical Layer Infection Epidermis Abscess Dermis
More informationFebruary
February 2009 www.srhd.org For more copies or if you have questions, contact: Spokane Regional Health District Disease Prevention & Response (509) 324-1442 or TDD (509) 324-1464 This booklet uses information
More informationDr Janakan Natkunarajah (Dr Jana)
Dr Janakan Natkunarajah (Dr Jana) Diagnosis Furuncle (Boil) Deep follicular abscess Anti-staph antibiotics Systemic & topical Carbuncle Deep abscess formed in a group of follicles Incise and Drain Recurrent
More informationSevere β-lactam allergy. Alternative (use for mild-moderate β-lactam allergy) therapy
Recommended Empirical Antibiotic Regimens for MICU Patients Notes: The antibiotic regimens shown are general guidelines and should not replace clinical judgment. Always assess for antibiotic allergies.
More informationMINISTRY OF HEALTH OF UKRAINE Higher medical educational institution of Ukraine "Ukrainian medical stomatological academy"
MINISTRY OF HEALTH OF UKRAINE Higher medical educational institution of Ukraine "Ukrainian medical stomatological academy" Approved On the meeting chair Of Pediatric Surgical Stomatology and Propaedeutics
More informationGroup B streptococcal infection;. Bacteremia without a focus occurs in 80-85%,. July has been recognised as Group B Strep Awareness Month,.
Group B streptococcal infection;. Bacteremia without a focus occurs in 80-85%,. July has been recognised as Group B Strep Awareness Month,. 12-10-2017 Group B streptococci are uniformly sensitive to penicillin
More informationStaph Infection Fact Sheet
What is Staphylococcus aureus (staph)? Staphylococcus aureus, often referred to simply as staph, are bacteria commonly carried on the skin or in the nose of healthy people. Approximately 25% to 30% of
More informationOmar Sami. M.Madadha. 1 P a g e
4 Omar Sami M.Madadha 1 P a g e Studying microbiology might not seem so appealing to many of us; yet no one denies how important it is. However, microbiology is one of the, if not the most medical sharpening
More informationPimples and Boils!! Dr Nathan Harvey Anatomical Pathology, PathWest
Pimples and Boils!! Dr Nathan Harvey Anatomical Pathology, PathWest Overview & Learning Objectives Review the cardinal signs/symptoms of acute inflammation Review the histological features of acute inflammation
More informationOsteomyelitis and Septic Joints; Practical Considerations. Coleen K. Cunningham
Osteomyelitis and Septic Joints; Practical Considerations Coleen K. Cunningham Goals/objectives To improve understanding of the diagnosis, treatment, and follow-up of pediatric bone and joint infections
More informationSkin and soft tissue infections Introduction/overview
Skin and soft tissue infections Introduction/overview M Al Madadha Sources : Harrisons infectious diseases 2 nd edition, Oxford Handbook of Infectious Diseases and Microbiology 2 nd edition Anatomic relationships:
More informationHere is the first Microbiology lecture in this system given by our lovely Dr Hani Masaadeh.
Here is the first Microbiology lecture in this system given by our lovely Dr Hani Masaadeh. This sheet is complete slides + Dr Comments, so you don t need to go back to the slides. Here is some dermatological
More informationMorbidity & Mortality Conference Downstate Medical Center. Daniel Kaufman, MD
Morbidity & Mortality Conference Downstate Medical Center University Case Presentation Hospital of Brooklyn Daniel Kaufman, MD Necrotizing Fasciitis and Soft- Tissue Infections Necrotizing Fasciitis Deep
More informationPSEUDO-CELLULITIS - ALL THAT S RED IS NOT INFECTION
JAN 18 2018 ASP ECHO CLINIC CHARLES KRASNER, M.D. PSEUDO-CELLULITIS - ALL THAT S RED IS NOT INFECTION FIRST HOSPITALIZATION: 62 YEAR OLD MALE ADMITTED WITH DIAGNOSIS OF CELLULITIS Hx of AODM, Morbid Obesity,
More informationPediatric Dermatology. Wingfield Rehmus, MD MPH BC Children s Hospital
Pediatric Dermatology Wingfield Rehmus, MD MPH BC Children s Hospital Conflict of interest! No financial conflict of interest! Individual products shown are examples only not a product endorsement Pediatric
More informationBone and Joint Infections in Diabetics: Diagnosis and Management of Diabetic Foot and Other Common Lower Extremity Infections
Bone and Joint Infections in Diabetics: Diagnosis and Management of Diabetic Foot and Other Common Lower Extremity Infections Objectives How do you to diagnose, classify and manage DFI? How do you diagnose
More informationWounds and Infections: Wound Management From the ID Physician Standpoint. Alena Klochko, MD Orlando VA Medical Center Infectious Disease Department
Wounds and Infections: Wound Management From the ID Physician Standpoint Alena Klochko, MD Orlando VA Medical Center Infectious Disease Department Objectives Distinguish between colonization, critical
More informationControlling Communicable Diseases in the School Setting LCDR C. SCOTT LOVE, MD, MPH, FAAP DEPARTMENT HEAD, PEDIATRICS
Controlling Communicable Diseases in the School Setting LCDR C. SCOTT LOVE, MD, MPH, FAAP DEPARTMENT HEAD, PEDIATRICS Disclosure There is no conflict of interest pertaining to this presentation, materials,
More informationNecrotizing Fasciitis. Madhuri Rao, MD June 27 th, 2013 Case from Kings County Hospital Center
Necrotizing Fasciitis Madhuri Rao, MD June 27 th, 2013 Case from Kings County Hospital Center 31 yo F www.downstatesurgery.org Case Presentation PMH: DM (type 1), CRI, verrucous elephantiasis of LE PSH:
More informationAbscess cellulitis in the mouth
Cari untuk: Cari Cari Abscess cellulitis in the mouth Cellulitis is inflammation that has spread to the surrounding soft tissues of the mouth. It is a dental emergency because, if not treated, it can cau
More informationMRSA. and You. A Guide for You and Your Family. (Methicillin Resistant Staphylococcus aureus) CH-IPC 001
MRSA (Methicillin Resistant Staphylococcus aureus) and You A Guide for You and Your Family CH-IPC 001 12 What is MRSA? MRSA is a kind of staph germ (Staphylococcus aureus). Staph germs live on the skin
More informationDecember 3, 2015 Severe Sepsis and Septic Shock Antibiotic Guide
Severe Sepsis and Septic Shock Antibiotic Guide Surviving Sepsis: The choice of empirical antimicrobial therapy depends on complex issues related to the patient s history, including drug intolerances,
More informationPYOGENIC INFECTIONS. Dr. Kenéz Éva - Anna Division of Infectious Diseases
PYOGENIC INFECTIONS Dr. Kenéz Éva - Anna Division of Infectious Diseases 2015.11.10 KEY POINTS The virulence factors of streptococcus and staphylococcus Disease caused by streptococcus and staphylococcus
More informationDivision of Vascular and Endovascular Surgery University of South Florida School of Medicine Tampa, Florida
Division of Vascular and Endovascular Surgery University of South Florida School of Medicine Tampa, Florida Appearance: oearly < 3 mo. olate > 3 mo.. Extent: Szilagyi Classification: Grade I: infection
More informationMRSA: Implications in Sports Medicine
MRSA: Implications in Sports Medicine Staphylococcus aureus, often referred to as staph, are bacteria commonly carried on the skin or in the nose of healthy people Staphylococcus Aureus Occasionally, staph
More informationMichael S. Niederman, M.D. Clinical Director Pulmonary and Critical Care Medicine New York Presbyterian Hospital Weill Cornell Medical Center
CA-MRSA Pneumonia Michael S. Niederman, M.D. Clinical Director Pulmonary and Critical Care Medicine New York Presbyterian Hospital Weill Cornell Medical Center Professor of Clinical Medicine Weill Cornell
More informationUpdated Guidelines for Managing Diabetic Foot Infections
Updated Guidelines for Managing Diabetic Foot Infections Benjamin A. Lipsky, MD, FACP, FIDSA, FRCP Emeritus Professor, University of Washington Visiting Professor, University of Geneva Visiting Professor,
More informationSSTIs. Dr Carlos Dobles R. San José, 29 de abril de 2017
SSTIs Dr Carlos Dobles R. San José, 29 de abril de 2017 NORMAL SKIN FLORA Propionibacterium acnes Corynebacterium sp. Staphylococci Staphylococcus epidermidis Staphylococcus aureus Streptococci sp. Candida
More informationGram Positive Coccus Staphylococci Dr. Hala Al Daghistani
Medical bacteriology Gram Positive Coccus Staphylococci Dr. Hala Al Daghistani The Staphylococci are gram-positive spherical cells, nonmotile, usually arranged in grapelike irregular clusters. Some are
More informationWorld Society of Emergency Surgery (WSES) guidelines for management of skin and soft tissue infections
Sartelli et al. World Journal of Emergency Surgery 2014, 9:57 WORLD JOURNAL OF EMERGENCY SURGERY REVIEW World Society of Emergency Surgery (WSES) guidelines for management of skin and soft tissue infections
More informationInfectious Diseases Potpourri. Disclosures 7/24/2014. No conflict of interest to disclose. Pot-pour-ri \,pō-pu - rē\ noun
Infectious Diseases Potpourri Nick Gilpin, DO Section Head, Infectious Diseases Beaumont Health Systems Grosse Pointe Assistant Clinical Professor, OUWBSOM Assistant Clinical Professor, MSUCOM Presented
More informationTypes of Skin Infections
Anatomy of Skin Types of Skin Infections Bacterial Impetigo Folliculitis Acne Fungal /Parasitic Tinea Pedis Tinea Cruris Tinea Versicolor Tinea Corporis Toenail fungus Allergic/Irritation conditions Dermatitis
More informationInfectious Disease Hot Topics: 2008
Infectious Disease Hot Topics: 2008 Joseph Domachowske MD Professor of Pediatrics, Microbiology and Immunology Golisano Children s Hospital at SUNY Upstate Medical University Topic 1: COMMUNITY-ASSOCIATED
More informationStaphylococci. What s to be Covered. Clinical Scenario #1
Staphylococci Micrococcus, which, when limited in its extent and activity, causes acute suppurative inflammation (phlegmon), produces, when more extensive and intense in its action on the human system,
More informationRECOMMENDATIONS FOR INVESTIGATION AND CHEMOPROPHYLAXIS RELATED TO INVASIVE GAS CASES, INCLUDING STREPTOCOCCAL TOXIC SHOCK AND NECROTIZING FASCIITIS
RECOMMENDATIONS FOR INVESTIGATION AND CHEMOPROPHYLAXIS RELATED TO INVASIVE GAS CASES, INCLUDING STREPTOCOCCAL TOXIC SHOCK AND NECROTIZING FASCIITIS These recommendations are the consensus of investigators
More informationInformational Awareness
Informational Awareness What is MRSA? MRSA is a kind of Staphylococcus aureus ( staph ) bacterium that is resistant to betalactam antibiotics, including methicillin, oxacillin, penicillin, and amoxicillin.
More informationWhat s to be Covered. Microbiology of staphylococci Epidemiology of S. aureus infections Pathogenesis of S. aureus infections
Staphylococci Micrococcus, which, when limited in its extent and activity, causes acute suppurative inflammation (phlegmon), produces, when more extensive and intense in its action on the human system,
More informationOSTEOMYELITIS. If it occurs in adults, then the axial skeleton is the usual site.
OSTEOMYELITIS Introduction Osteomyelitis is an acute or chronic inflammatory process of the bone and its structures secondary to infection with pyogenic organisms. Pathophysiology Osteomyelitis may be
More informationCommon Bedside Procedures in Pediatric Emergency Medicine
Common Bedside Procedures in Pediatric Emergency Medicine James Luckey M.D. Children Hospital of the King s Daughters/ EVMS April 12, 2018 Objectives 1. Identify the indications, contraindications, and
More informationLiving with MRSA. Things to remember about living with MRSA: This is really serious. I need to do something about this now!
Things to remember about living with MRSA: 1. Wash your hands often. 2. Take care of yourself: Eat right, exercise, quit smoking, and avoid stress. 3. Take good care of your skin. 4. Keep skin infections
More informationForty-Eighth Annual Teaching Conference Pediatrics for the Practitioner -UT Health Science Center San Antonio School of Medicine June 10-12, 2011
The 48 th Annual Pediatrics for the Practitioner Symposium June 11, 2011 James H. Brien, DO James H. Brien, DO has no relevant financial relationships with commercial interests to disclose. Case #1 4½-month-old
More informationPodcast (Video Recorded Lecture Series): Soft Tissue Infections for the USMLE Step One Exam
Podcast (Video Recorded Lecture Series): Soft Tissue Infections for the USMLE Step One Exam Howard J. Sachs, MD www.12daysinmarch.com Email: Howard@12daysinmarch.com MSK Infections Bone and Joint Infections
More informationA WEATHER FORECAST. It is gonna be cold It is gonna be gray It is gonna last for the rest of your life Groundhog day Bill Murray
A WEATHER FORECAST It is gonna be cold It is gonna be gray It is gonna last for the rest of your life Groundhog day Bill Murray GOETHE Art is long, Life short, Judgment difficult, Opportunity transient
More informationPost-Operative Laparoscopic Appendectomy Guide. Dr. Buck Parker, MD FACS Board Certified Surgeon
Post-Operative Laparoscopic Appendectomy Guide Dr. Buck Parker, MD FACS Board Certified Surgeon www.drbuckparker.com Thanks! Thanks so much for downloading my laparoscopic appendectomy guide! This guide
More informationBloodborne Pathogen Safety Awareness Including information regarding MRSA
Bloodborne Pathogen Safety Awareness Including information regarding MRSA Presented by the Department of Environmental Health, Safety & Risk Management Bloodborne Pathogens Bloodborne Pathogens are microorganisms
More informationPneumonia Community-Acquired Healthcare-Associated
Pneumonia Community-Acquired Healthcare-Associated Edwin Yu Clin Infect Dis 2007;44(S2):27-72 Am J Respir Crit Care Med 2005; 171:388-416 IDSA / ATS Guidelines Microbiology Principles and Practice of Infectious
More informationnumber Done by Corrected by Doctor Hamed Al-Zoubi
number 9 Done by Mohammed Al askar & Muhammed Alajmi Corrected by مها أبو عجمية Doctor Hamed Al-Zoubi 1 Gram positive cocci There are 3 types of gram positive cocci :- 1- Staphylococcus ( what we are going
More informationFighting Infection in Diabetes
I have no disclosures Fighting Infection in Diabetes Emily Abdoler, MD Division of Infectious Diseases GomerBlog. http://gomerblog.com/2018/02/nystatin-statin/ Does DM Increase Risk of Infections? Diabetic
More informationBone and Joint Infections Oh, My
Bone and Joint Infections Oh, My Dale Jarka, MD,CM, FRCSC The Children s Mercy Hospitals & Clinics The Children's Mercy Hospital 2016 1 Disclosures A: I have no relevant financial relationships with the
More informationLiving with MRSA. This is really serious. I need to do something about this now!
Living with MRSA This is really serious. I need to do something about this now! Learning how to control the spread of Methicillin-Resistant Staphylococcus Aureus (MRSA) IMPORTANT MRSA is a serious infection
More informationReview on Skin and Soft Tissue Infection
Preface Review on Skin and Soft Tissue Infection Professor Tzong-Luen Wang MD, PhD, JM, FESC, FACC, FCAPSC Chief, ED, Shin-Kong Wu Ho-Su Memorial Hospital Professor, Medical School, Fu-Jen Catholic University
More informationChoosing an appropriate antimicrobial agent. 3) the spectrum of potential pathogens
Choosing an appropriate antimicrobial agent Consider: 1) the host 2) the site of infection 3) the spectrum of potential pathogens 4) the likelihood that these pathogens are resistant to antimicrobial agents
More informationGROUP A STREPTOCOCCUS (GAS) INVASIVE
GROUP A STREPTOCOCCUS (GAS) INVASIVE Case definition CONFIRMED CASE Laboratory confirmation of infection with or without clinical evidence of invasive disease: isolation of group A streptococcus (Streptococcus
More informationDraft data: subject to change 3/26/2013
Request for CDC Assistance Skin Infection Knowledge, Attitudes, and Practices Among Alaska Native People Three Rural Alaska Communities, 2012 Gregory Raczniak, MD, PhD Epidemic Intelligence Service Officer
More informationSKIN INFECTIONS. Caroline Charlier-Woerther February 2017
SKIN INFECTIONS Caroline Charlier-Woerther February 2017 LEARNING OBJECTIVES Recognize the main types of infection Know the pathogens associated with them Know how to manage dermo-hypodermitis Know how
More information