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Infection of The Skin, Soft Tissue
Infection of The Skin, Soft Tissue
Hair
Sweat pores
Nails
Skin
Epidermis
Hair shaft
Dermis
Hypodermis
Microbiota
in hair follicle Nerve
Treponema pallidum Syphilis Disseminated infectious rash seen in secondary stage of disease, 2-
Treponema pertenue Yaws 3 months other infection
Rickettsia prowazekii Typhus Macular or hemorrhagic rash
Rickettsia rickettsii Spotted fever Macular or hemorrhagic rash
Rickettsia coronii Spotted fevers Macular or hemorrhagic rash
Streptococcus pyogenes Scarlet fever Erythematous rash caused by erythrogenic toxin
Staphylococcus aureus Toxic shock syndrome Rash and descuamation due to toxin
Blastomyces dermatitidis blastomycosis Papule or pustule develops into granuloma lessions containing
organisms
Cryptococcus neoformans Crytococcosis Papule or pustule, ussually on face or neck
Bacterial Infections of Skin, Soft Tissue and
Muscle:
The classification depends upon the layer of skin and soft tissue
involved:
Abscess formation. Boils and carbuncles result of infection and
inflamation of the hair follicles in the skin (folliculitis)
Spreading infections (subcutan).
○ Impetigo (epidermis) bullous, crusted or pustular eruption of the
skin
○ Erysipelas (Erythematous inflamation) generally on face, legs or
feet and often accompanied by pain and fever
Necrotizing infections.
○ Fasciitis The inflamatory response to infection of the soft tissue
bellow the dermis causing disruption of the blood supply
gangrene or myonecrosis associated with ischemia of the muscle
layer (anaerobic organisms gas gangrene)
Direct Entry Into Skin of Bacteria and Fungi
Structure involved Infection Common Cause
C
INTRODUCTION
PENYEBABNYA :EXO-
TOXIN TSST1 (SUPER Ag )
DI U.S.A KASUSNYA
6000/th; .90% DEWASA DI
DALAM DARAH NYA (+)
Ab SST1.
PENANGGULANGAN :
DRAINAGE & ANTISTAPY-
LOCOCCAL CHEMO-
THERAPI
Scalded skin syndrome
Disease of young children
Mediated through minor
Staphylococcal infection by
‘epidermolytic toxin’ producing strains
Mild erythema and blistering of skin
followed by shedding of sheets of
epidermis
Children are otherwise healthy and
most eventually recover
STAPHYLOCOCCAL SCALDED SKIN SYNDROME
Rheumatic fever
kebanyakan terjadi
sbg kelanjutan infeksi
Streptococcus
pyogenus pada
tenggorokan
Erysipelas. What chemicals cause the reddening of
the skin in erysipelas?
DIAGNOSIS
Tx
- sterile cleaning, dressings
- refer to diabetic
specialist/surgeon for
debridement or amputation
Necrotizing Faciitis
Merupakan infeksi yg akut dan fatal, etiologinya campuran
dari kuman anaerob dan kuman fakultatif anaerob
infeksi yg sangat toksik, menyebabkan nekrosis berat yang
menyebar ke jaringan sekitar dan bawahnya.
Etiologi utamanya Streptococcus pyogenes (flesh eating
bacteria) kematian tinggi.
Eksisi radical diperlukan untuk mengangkat jaringan
nekrotik
pemberian antibiotik lokal dan sistemikFasciitis pada
dinding perut berakibat fatal
Necrotizing Faciitis
Dark blisters of necrotizing fasciitis. The disease,as shown here on a
thigh, is commonly produced by so-called flesheating Streptococcus
pyogenes
Traumatic Or Surgical Wounds Infected By
Clostridia
Etiologinya, senergitik antara kuman flora normal kulit dengan :
Clostridium tetani tetanus
C.tetani tidak bersifat invasif, Toksin (tetanospasmin) ke otak
timbul gejala tetanus
jalur yg dilalui toksin untuk sampai ke otak:
luka syaraf perifer sitem syaraf pusat (ascending tetanus) di
dalam tubuh penderita masih terdapat Ab terhadap toksi tetani; mudah
ditanggulangi (pemberian anti-toksin secara lokal )
luka darah/ getah bening sistem syaraf pusat (desending
tetanus)
Sukar ditanggulangi, Antitoksin yg diberikan tidak dapat mengikat
kembali toksin yg telah berikatan dengan jaringan (syaraf)
Sukar ditanggulangi, Antitoksin yg diberikan tidak dapat mengikat
kembali toksin yg telah berikatan dengan jaringan (syaraf)
Toksin yang telah
berikatan dengan
syaraf tidak dapat
dinetralkan oleh
antitoksin
Traumatic or Surgical Wounds Infected
A B A. = + anti-toksin
B. = tanpa anti-toksin
Blocked
pore
3. Blackhead. Dead and dying bacteria and sebum
form a blockage of the pore.
Unclassified
Runyon Group 1
Runyon Group 2
Runyon Group 3
Runyon Group 3
Positive lepromin skin test Negative lepromin (extract of lepromatous tissue) skin
Regions of the skin that have lost sensation as a result of nerve Slow symmetric nerve involvement
damage are characteristic of this form of leprosy
Severe asymetric nerve involvement of sudden onset with few Continous bacteremia, very infectious
bacilli present in the lasions
Cell mediated immunity is intact and and the skin is infiltrated Cell mediated immunity is deficient and the skin is infiltrated
with T cells with supressor T cells
strong antibody reaction, defect of cell immunity to M.leprae as strong hypersensitivity of delayed type, feeble humoral
antigen.Many bacteria in skin macrophages (Schwann cells), immunity, many lymphocytes and granulomas, few bacteria in
tissue (activated macrophages fagocyte and eliminated bacteriae
Amyloidosis Amyloidosis
Tuberculoid Leprosy
Lepromatous Leprosy
Pathogen and Virulence Factors
a high G +C
Non-endospore-forming,
Gram-positive bacillus with a cell wall containing a large
amount of mycolic acid, a waxy lipid composed of chains of
60–90 carbon atoms
Acid fast bacilli
Strict human pathogens
Cannot be cultivated in-vitro
Grows best at 30 C
Armadillo’s used for obtaining M leprae
Transmission - ? Air borne
Low infectivity- prolonged contact required
Pathogen and Virulence Factors
This unusual cell wall is responsible for several
important characteristics of the bacterium:
• Slow growth rate (due to the time required to
synthesize numerous molecules of mycolic acid). The
generation time varies from hours to several days.
• Protection from lysis once it is phagocytized.
• Growth within phagocytes.
• Resistance to Gram staining, detergents, many
common antimicrobial drugs, and drying out.
The acid-fast staining procedure was developed to
differentially stain mycobacteria
Pathogen and Virulence Factors
The bacterium has never been grown in
cell-free laboratory culture, a fact that
has hindered research and diagnostic
studies.
The nine-banded armadillo, which has a
normal body temperature of 30°C, is its
only other natural host and has proven
valuable in studies on leprosy and on
the efficacy of leprosy treatments
Typical acid-fast bacilli: singly, in parallel bundles or in globular masses
are regularly found in scraping from skin or mucous membranes
(particularly in the nasal septum) in lepromatous leprosy.
Mycobacterium leprae
Spectrum of clinical presentations
dependent on host –parasite interactions