Necrotizing fasciitis / myositis / cellultis

Necrotizing fasciitis  Site- Muscle fascia and  subcutaneous fat, muscle tissue is spared Lab- CK↑ CT- Blurring fascia 1.Polymicrobial (type I) -Older adult, DM, comorbidities -Anaerobic species (most commonly Bacteroides, Clostridium, or Peptostreptococcus) +  Enterobacteriaceae (eg, Escherichia coli, Enterobacter, Klebsiella, Proteus) + facultative anaerobic streptococci (other than group A Streptococcus [GAS]) -Fournier gangrene(Perineum)-  facultative organisms (E. […]

Skin infection

Pathway- Epidermis→ upper dermis→ deep dermis→ subcutaneous fat→ fascia→ muscle Risk factor- Trauma, skin inflammation, edema due to impaired venous/lymphatic return, obesity, immunocompromised, skin infection Type 1.Impetigo Site- Epidermis 2.Erysipelas Site- Upper dermis  Pathogen- Beta-hemolytic streptococci Characteristics- Clear demarcation between involved and uninvolved tissue, butterfly” involvement of the face. Involvement of the ear (Milian’s ear […]

Meningitis

Pathogen 1.Newborn- Group B streptococcus, E.coli, Listeria 2.1~3 m/o- Group B streptococcus, E.coli, Listeria, salmonella, H.Influenza, Neisseria, S.pneumonia 3.3 m/o~12 y/o- H.Influenza, Neisseria, S.pneumonia 4.>12 y/o- Neisseria, S.pneumonia Presentation- Bulging Fontanelle, neck stiffness, Kernig sign, Brudzinski sign, Tripod sign Treatment- 3rd cephalosporin + vancomycin, add ampicillin if want to cover Listeria Duration- Neisseria(7 days), H.influenza, […]