Download - 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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