Deck 57: Skin, Soft Tissue, and Wound Infections

Question 1

Match the condition with its definition. Choices follow:
a.Extensive necrosis of muscle caused by infectious agents
b.Infection of the fascia overlying muscle groups, often with involvement of the overlying soft tissue
c.A slowly progressive infection of the subcutaneous tissue with associated ulceration of portions of the overlying skin
d.A chronic gangrenous condition of the skin most often encountered as a postoperative complication, particularly after abdominal or thoracic surgery
Myositis

Answer 1

A
Myositis (involvement of muscle) is caused by various infectious agents. The nature of the pathologic process is variable, sometimes involving extensive necrosis of muscle, as in gas gangrene or clostridial myonecrosis, necrotizing cutaneous myositis or synergistic nonclostridial anaerobic myonecrosis, anaerobic streptococcal myonecrosis, myonecrosis caused by Bacillus spp., or myonecrosis caused by Aeromonas. Abscess in the psoas muscle may involve Mycobacterium tuberculosis, S. aureus, or various facultative or anaerobic gram-negative bacilli. Serious vascular problems resulting from loss of blood supply may lead to death of muscle; such muscle may become secondarily infected (vascular gangrene).

Question 2

The most reliable specimen for determining the etiology of ulcers and nodules are

A)from the base of the ulcer or nodule.
B)those collected following removal of overlying debris.
C)those collected by surgical biopsy of deep tissues.
D)those collected without contact with the superficial layers of the lesion.
E)All of the above are correct.

Answer 2

E
The most reliable specimens for determining the etiology of ulcers and nodules are those obtained from the base of the ulcer or nodule following removal of overlying debris or by surgical biopsy of deep tissues without contact with the superficial layers of the lesion.

Question 3

Match the condition with its definition. Choices follow:
a.Extensive necrosis of muscle caused by infectious agents
b.Infection of the fascia overlying muscle groups, often with involvement of the overlying soft tissue
c.A slowly progressive infection of the subcutaneous tissue with associated ulceration of portions of the overlying skin
d.A chronic gangrenous condition of the skin most often encountered as a postoperative complication, particularly after abdominal or thoracic surgery
Necrotizing fasciitis

Answer 3

B
Necrotizing fasciitis is a serious infection that occurs relatively infrequently. The basic pathology is infection of the fascia overlying muscle groups, often with involvement of the overlying soft tissue. At the fascial level, no barrier exists to spread of infection, so fasciitis may extend widely and rapidly to involve huge areas of the body in short periods. This process, once known as hospital gangrene, typically involves group A streptococci or S. aureus. Necrotizing fasciitis also frequently involves anaerobic bacteria, especially Bacteroides and Clostridium spp.

Question 4

Match the condition with its definition. Choices follow:
a.Extensive necrosis of muscle caused by infectious agents
b.Infection of the fascia overlying muscle groups, often with involvement of the overlying soft tissue
c.A slowly progressive infection of the subcutaneous tissue with associated ulceration of portions of the overlying skin
d.A chronic gangrenous condition of the skin most often encountered as a postoperative complication, particularly after abdominal or thoracic surgery
Meleney's ulcer

Question 5

An abnormal passage between two organs or leading from an internal organ to the body surface is known as a

A)fistula.
B)sinus tract.
C)necrotizing fascia.
D)decubitus.

Question 6

Match the condition with its definition. Choices follow:
a.Extensive necrosis of muscle caused by infectious agents
b.Infection of the fascia overlying muscle groups, often with involvement of the overlying soft tissue
c.A slowly progressive infection of the subcutaneous tissue with associated ulceration of portions of the overlying skin
d.A chronic gangrenous condition of the skin most often encountered as a postoperative complication, particularly after abdominal or thoracic surgery
Chronic undermining ulcer

Question 7

Match the condition with its definition. Choices follow:
a.Extensive necrosis of muscle caused by infectious agents
b.Infection of the fascia overlying muscle groups, often with involvement of the overlying soft tissue
c.A slowly progressive infection of the subcutaneous tissue with associated ulceration of portions of the overlying skin
d.A chronic gangrenous condition of the skin most often encountered as a postoperative complication, particularly after abdominal or thoracic surgery
Progressive bacterial synergistic gangrene