superficial bacterial infection. helpful for all undergratuate and post gratuate student.

1. Dr Pramod Adhikari

3. BACTERIA CAUSES CELLULITIS
 STAPHYLOCOCCUS AUREUS.
 STREPTOCOCCUS PYOGENS

6. Investigation
 CBC
 RBS
 PUS C/S

7. Treatment
 Analgesic : flexon 1 tab PO TID/SOS or
T. ketorol 1 tab TID/SOS or
 PPI: T. pantop 40 mg/ T. Aciloc 150mg PO BD
 Antibiotics:
Oral: T.Flucloxacillin 500mg PO QID
for 7 days / or
T. clavum 625mg (Amixycillin and potassium clavulanate)
IV: Inj ceftriaxone 1gm iv BD in sever case/ or
inj cefazolin 1gm iv BD

8. PRIMARY LESIONS

12. SECONDARY SKIN LESIONS:
 PUSTULES:It is a bulging patch of skin that’s full of
yellowish fluid called pus.eg:acne

13. 1)pustules

14. CRUSTING

15. SCALES

16. EXCORIATION

20. BACTERIAL INFECTION OF SKIN
 IMPETIGO
 FURUNCULOSIS
 BOILS

21. IMPETIGO

31. Carbuncle is an infective gangrene of the
subcutaneous tissue, which often occurs in the nape of
the neck.
The subcutaneous tissue become painful and
indurated and the overlying skin is red.
If not properly treated areas of softening
appear, the skin sloughs and discharges pus. Usually
there is one central large slough, surrounded by a
‘rosette’ of smaller area of necrosis.
Carbuncle

33. Site:
Nape of the neck
Upper part of the back
Susceptible group:
Diabetic pt
Male person
Age > 40 yrs
Chronic illness
Immuno- compromised person
Complication:
Septicaemia
Epidural abscess
Meningitis

34. Clinical feature:
- Uncommon before 40 yrs
- M > F
- Common in diabetic pt
- Skin- red, indurated
- Subcutaneous tissue – painful, indurated
- Slough out of skin
- Multiple discharging sinus
Investigations:
- CBC
- Blood sugar
- Urine sugar

35. Treatment:
- I&D of pus and excision of all dead tissue
- Control of DM
- Antibiotics to control infection
- Regular local wound care- Dressing at regular
interval
- Improvement of general condition
- If required, skin graft after formation of
granulation tissue
 Why nape of the neck is common site
- Less vascular area
- Lax and extensive tissue planes

36. Boil
 Boil is defined as an acute staphylococcal infection of
the hair follicles which usually proceeds to suppuration
an central necrosis. It is most common surgical
infection.
Pathogenesis:
 Orifices of hair become blocked by keratin
or sebum plug contents become infected by
staphylococcus leading to inflammation
suppuration and subsequent necrosis Boil is formed


37. Risk factor
 Susceptible group:
Debilitated pt
with chr: illness
 Anxious & worried people
 DM
The most common places for
boils to appear are on the
face, neck, armpits,
shoulders, and buttocks.

38. Sign and symptoms
 A boil starts as a hard, red, painful lump usually about half
an inch in size. Over the next few days, the lump becomes
softer, larger, and more painful.
These are the signs of a severe infection:
 The skin around the boil becomes infected. It turns red,
painful, warm, and swollen.
 More boils may appear around the original one.
 A fever may develop.
 Lymph nodes may become swollen.

39. Complication
 1. Cellulitis
 2. Secondary boil
 3. Abscess
 4. Secondary infection of draining L.N
 5. Carbuncle.(infective gangrene of the
subcutaneous tissue)

40. Treatment
 Improving of the general condition of the pt
 Proper antibiotics according to C/S
 Washing of the surrounding skin with antiseptic
solution.
 Keep the skin clean and dry
 Topical antibiotic: neomycin, mupirocin etc.
 - IV broad spectrum antibiotics such as Cefuroxime,
Ceftriaxone combined with metronidazole

41. Preventing Measures
 Help prevent by following these guidelines:
 Carefully wash clothes, bedding, and towels of a
family member who is infected with boils/ furunculs.
 Clean and treat minor skin wounds.
 Practice good personal hygiene.
 Stay as healthy as possible.

42. Contamination of pathogen
 Due to inappropriate hand washing measure such as
not using anti septic hand wash.
 Improper sterilization of hospital equipments, such as
dressing set, towels.
 Untidy environment surrounding health post.
 Improper waste management.
 Improper sanitation disposabale management.

43. Health education
 HYGEINE:
-keep the wound clean and dry.
-change the clothes daily.
-need to take daily shower.
NUTRITION:
-Eat high protein diet(meat,fish) and fruits.
-Avoid alcohal ,smoking, and sugar contained foods.
-

44. Furunculosis
Furunculosis is a deep
infection of the hair
follicle leading to
abscess formation
with accumulation of
pus and necrotic
tissue.
Cause
It appear on the hair-bearing parts of
the skin and the infectious agent
is Staphylococcus aureus.

45. Have a Good Day

46. FUNGAL INFECTION OF SKIN

49. Risk factor for fungal infection
 Sweating heavily.
 Living in warm or wet environment.
 Not keeping your skin clean and dry.
 Sharing items like clothes,shoes,towels or bedding items.
 Wearing tight clothing or footwear that doesn’t breathe
well.
 Taing part in activities that involve frequesnt skin to skin
contact.
 Coming into contact with animals that may be infected.
 Having a weakened immune system due to immune
suppressant drugs,cancer treatment or condition such as
HIV.

66. Clinical features
 Affected site looks typically yellow, brown.
 Affected nail easily brittle or break.
 Nail become thick then normal nail

72. Prevention of fungal infection
 Be sure to practice good hygiene.
 Never share clothes,towels,or any other personal items.
 Wear clean clothes every day particularly socks and
underwear.
 Choose the clothes that fit properly in your body.
 Avoid clothes or shoes that are too tight or have restrictive
fit.
 Make sure every clothes dry off properly in the sunlight.
 Wipe down shared surfaces such as gym equipments or
mats.
 Stay away from animals that have signs of fungal infection
such as missing fur or frequent scratching.

73. Indication of referal
 Recurrent symptoms after primary treatments.
 Fungal infection on immunocompromised patient
such as HIV.
 Secondary skin infection.

74. Pityriasis versicolor

75. Causes
 Pityriasis versicoclor is caused by type of yeast called
Malassezia. This yeast is found on the skin of more than
90%.

77. Investigation
 Wood lamp (black light) examination.
 Microscopy using potassium hydroxide (KOH)
 Skin biopsy.

78. Treatment