Visit DermWeb  Skin Infections and Infestations

 

  

Viral Infections (continued)Bacterial Diseases (continued)

 

 

 

 

 

 

Staphylococcus aureus
Staphylococcus aureus

Staphylococcus aureus
Staphylococcus aureus

Staphylococcus aureus
Staphylococcus aureus

Staphylococcus aureus
Staphylococcus aureus

Staphylococcus aureus
Staphylococcus aureus

Staphylococcus aureus
Staphylococcus aureus

Staphylococcus aureus
Staphylococcus aureus

Staphylococcus aureus
Staphylococcus aureus

Streptococcus pyogenes
Streptococcus pyogenes

Streptococcus pyogenes
Streptococcus pyogenes

Streptococcus pyogenes
Streptococcus pyogenes

 

 


Bacterial Diseases

Streptococcal and Staphylococcal Infections

Impetigo

Non-bullous: Face (nose/mouth)

Spontaneous course 2-3 weeks; can have prolonged course

Bullous: Face; anywhere
Post-strep. Acute glomerulonephritis decreasing in incidence 

Occurs 18-21 days post-skin infection; 10 days post-throat infection (scarlet fever) 

 

Ecthyma
(Strep/Staph/both)

Crusts beneath which ulceration occurs

Heals with scarring

Buttocks/thighs/legs

 

Cellulitis

Warm, intense erythema with poorly demarcated borders.  Leg and face often involved.

Mainly Streptococcus, can be Staphylococcus

Cellulitis in children: H. influenza

Especially face

Complications: A possibility, especially when it occurs on the face (e.g. cavernous sinus thrombosis)
Diagnosis: Culture.  Skin biopsy not recommended. 

 

Folliculitis

Follicular-based pustules (compare with miliaria)

Furuncle

Hair follicle-based Staph. aureus abscess

Diabetes associated (?)

HIV (may coalesce into violaceous plaques)

Sites: face/neck/buttocks

 

Scarlet Fever

Strep. pyogenes pyrogenic exotoxin

Upper respiratory tract usual portal of entry

Ages 1-10 years most common

Incubation: 2-5 days; fever, anorexia, vomiting, tonsillitis, lymphadenopathy
Rash: 2nd day:
Trunk - "sunburn with goose pimples"
Arms - Pastia's lines
Mouth - circumoral pallor

7th-10th day:
Desquamation: lamellar on palms/soles, branny elsewhere

"White strawberry tongue" -> "red strawberry" tongue

 

Staphylococcal Scalded- Skin Syndrome

Epidermolytic toxin

Abrupt onset - fever & skin tenderness

Scarlatiniform rash present early

 

Toxic Shock Syndrome (toxins)

Fever, rash, and desquamation: required for diagnosis

Staph. aureus, severe infection with Strep. pyogenes

After 1985 most cases not menstrual.  Recent report from England: toxic shock after minor skin procedure

Clinical: Acute onset fever, rash.  Vomiting & diarrhea.
Rash: Widespread macular erythema - clears 3 days

Edema of hand/feet; purpura; desquamation - 10-21 days after onset (fingertips, palmar/plantar skin)

Mortality from shock 7%

 

 

  
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