bacterial infections dd3

8/14/2019 Bacterial Infections DD3

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Bacterial skin Infection

University of Hargeisa Medical Faculty(UoH-MF)

Dermatology Department

Dr. Ismail Adam Abdilahi

2008


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Predisposing factors

Trauma or abrasion of the skin

Viral disease .

Primary dermatoses e.g. Eczema .

Poor hygiene and overcrowding


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Staph. infectionsImpetigo contagiosum .

Boils .


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Impetigo contagiosumDefinition :Acute contagious superficial

pyogenic infection of the skin.Types :

Non-bullousbullous


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Non-bullous impetigo

Caused by staph. inassociation with strep.or by strep alone.


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Clinical features:

Age : mainly preschoolSites : face,limbs andscalp are common.

Palms and soles are notaffected.


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There is thin-walled vesicleson erythematous base that

soon rupture yellowishbrown crusts that dry and

separate erythema whichfades without scarring.

Complication : post-strep.acute glomerulonephritis .


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Bullous impetigoCaused by staph throughstaph toxin (exfoliatin)


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Clinical features:

Age : all agesSite : face is oftenaffected but mayoccur any whereincluding palms and

soles


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The bullae are less rapidlyruptured( persistent for 2-3days) and become much

larger. When rupture thinbrownish crust.


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Treatment of impetigoUse antiseptic e.g. potassiumpermanganates.

Topical antibiotic .Systemic antibiotics .

Treatment of predisposingfactors: e.g. Scabies.


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BoilsPainful erythematous tenderpapular lesions which are

related to infection of hairfollicles .

Sites: neck, axillae, buttocks,and thighs.


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If infection spreads to

involve several folliclescarbuncle.

Screen for diabetesmellitus in case of

recurrent boils.


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Treatment of boils:

Is similar to that ofimpetigo but systemic

antibiotics are oftennecessary.

Surgical incision may beneeded.

t t


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treptococca

infections

Erysipelas.

Ecthyma.


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ErysipelasWidespread erythema andcellulitis due to infection of thedermis and upper cutaneoustissue by group A strep reaching

the dermis through a wound or asmall abrasion red, swollen andtender skin


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Lymphangitis andlymphadenitis are frequent.

Common sites are legs andface.

Complications:lymphedema, subcutaneous

abscess, septicemia, nephritisand meningitis.


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Treatment :Penicillin 1 g/day orErythromycin .

Treatment of anyunderlying skin disease e.g.chronic fissuring.


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EcthymaChronic ulceration due to

infection of the dermis by staph

and strep.Often prolonged so needs

intensive local antiseptic

treatment combined withsystemic antibiotics.


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infections

-Cutaneous tuberculosis.

-Leprosy .


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tuberculosis


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Lupus vulgarisMost common form ofskin tuberculosis.

I f i


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Infection throughhematogenous spread orprimary inoculation of the skinwith mycobacterium

tuberculosis.Histopathology : granulomas

with central caseation and theorganism can bedemonstrated.


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Clinical features:Erythema, scaling andscarring plaques.


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T t t


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Treatment :multi-drugtherapy for 6-9 months :

Rifampicin 600mg daily (450mgfor body wt less than 55kg)

INH 300mg dailyBoth half an hour before breakfastfor 6 month

Pyrazinamide 1.5-2gm daily for 2months only

TREATMENT OF


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TREATMENT OF

LEPROSY

PAUCIBACILLARY : for6 month .

Rifampicin 600 mg monthlyDapsone 100 mg daily .

MULTIBACILLARY


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MULTIBACILLARY :

for 2 years .Rifampicin 600 mg +

clofazimin 300 mgmonthly .

Dapsone 100 mg +clofazimin 50 mg daily .


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bacterial infections dd3

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