BACTERIAL DISEASES OF THE SKIN AND WOUNDS

Pathogen Signs & Symptoms Virulence Factors Pathogenesis & Diagnosis, Treatment, Prevention
Epidemiology
Folliculitis S. epidermidis Pimple, sty furuncle, Enzymes S. epidermidis Diagnosis
carbuncle - Coagulase Opportunists Coagulase-positive
S. aureus - Hyaluronidase S. aureus o S. aureus
- Staphylokinase More virulent Coagulase-negative
- Lipase Grows on skin o S. epidermidis
- B-Lactamase or mucous Treatment
Slime layer membranes Dicloxacillin
Toxins Colonizes moist o Cannot be
- Cytolytic toxin skin folds inactivated by B-
- Leucocidin Lactamase
- Epidermal cell Penicillin, methicillin,
differentiation macrolides, aminoglycosides,
inhibitor cephalosporin
- Exfoliative toxin Vancomycin
Toxic shock syndrome toxin Prevention
Proper aseptic techniques
Immunization
SSSS S. aureus Reddening and Exfoliative toxins Toxemia Diagnosis
wrinkling of skin, *usually leads to death Sloughing of skin
large blisters due to secondary Fluid in blisters of SSSS
containing fluid infections o No S. aureus
lacking bacteria or Candida Treatment
WBCs albicans Antimicrobial drugs
P. aeruginosa (cloxacillin)
Impetigo S. aureus Small, flattened, red S. pyogenes Colonizes skin then Diagnosis
patches (face & limbs) M protein invades through open Vesicles
Hyaluronic acid wounds Pus is found in blisters filled
capsule with bacteria and WBCs
Pyrogenic toxins Usually infects children Staphylococcal impetigo
below the nose o Clusters of Gm+
Erysipelas S. pyogenes Spread of infection Streptococcal impetigo &
(impetigo) into Acute erysipelas
surrounding lymph glomerulonephritis o Chains of Gm+
nodes and triggers Treatment
pain and inflammation Impetigo: topical mupirocin,
oral clindamycin/amoxicillin
Erysipelas: penicillin

L. MORALES | 1NUR6
 BACTERIAL DISEASES OF THE SKIN AND WOUNDS
Prevention
Good hygiene and
cleanliness
Clean abrasions with soap
and water
Necrotizing Fasciitis S. pyogenes Hot, painful, sunburn- Enzymes Person-to person Diagnosis
like rash at the site of Streptokinase contact through breaks Difficult because early
S. aureus infection Hyaluronidase in skin symptoms are general and
Deoxyribonuclease flulike
Clostridium Fever, tiredness, M protein Spreads rapidly along Treatment
perfringens muscle aches Toxins muscle fascia Removal of dead tissue
Streptolysin S IV broad-spectrum
Bacteroides fragilis Exotoxin A Other virulence factors antimicrobial drugs
(clindamycin and penicillin)
Secretion of toxins Prevention
Wash any openings on the
skin thoroughly

Acne Propionibacterium Propionic acid Normal skin Diagnosis

Easily observed
S. aureus Whitehead Treatment
Doxycycline
Blackhead Benzoyl peroxide
Retinoic acid
Pustule formation UV light

Cat Scratch Disease Bartonella henselae Localized swelling at Endotoxin (Lipid A) Cat scratches or bites Diagnosis
the site of cat introduce bacterium into Positive indirect fluorescent
scratches or bites the skin antibody test
(immunofluorescence assay)
Blood-sucking against Bartonella antigens
arthropods may also Treatment
transfer bacterium Rifampin
Ciprofloxacin
Bacterium grows Gentamicin
intracellularly Prevention
Avoiding cat-inflicted
Release of endotoxin wounds
Adequate cleansing of bites
or scratches

L. MORALES | 1NUR6
 BACTERIAL DISEASES OF THE SKIN AND WOUNDS
Pseudomonas Infection Pseudomonas Fever, chills, shock Structural components Surface of burned Diagnosis
aeruginosa Fimbriae and areas Pyocyanin discoloration
With lung infection: adhesins
*Rarely causes breathlessness, Capsule Thick, scab-like crust Treatment
disease (opportunist) coughing, wheezing, Enzymes forms over surface of Debridement
rapid breathing, Neuraminidase severe burn Combination of
weight loss Elastase aminoglycoside and B-
Endotoxin Pseudomonas grow Lactam antimicrobials
Toxins beneath crust and can Polymyxin
Exotoxin A and move into blood
exoenzyme S
Kills cells, destroys
Pyocyanin
tissues, releases
endotoxin
Cutaneous Anthrax Bacillus anthracis Localized itching Endospore, capsule, three Direct contact of Treatment
followed by a raised anthrax toxins endospores with Oral antimicrobial drugs
lesion then forms wounded skin, infected (ciprofloxacin, penicillin,
eschar animals, or erythromycin) for 60 days
contaminated animal Prevention
products Vaccinate livestock
Bury or burn carcasses of
dead animals
Ciprofloxacin and post-
infection immunization
Gas Gangrene Clostridium Increased pain and Endospores, 11 toxins, rapid Affects individuals with Diagnosis
swelling around injury, growth and reproduction deep, lacerating Appearance of gas
fever, gangrene, foul- wounds gangrene
smelling drainage, Large Gm+ bacilli detection
crepitation, Endospores are Treatment
tachycardia introduced into dead Removal of dead tissue
tissue (germination and Antitoxin
Within one week: growth) IV penicillin and clindamycin
Shock, kidney failure, Application of oxygen under
death Clostridial toxins kill high pressure
neighboring cells, then Prevention
bacterium spreads into
Difficult to prevent
dead tissue
Proper cleaning of wounds

L. MORALES | 1NUR6