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Chapter 4 : Skin and Soft Tissue Infections

Authors: Peter H. Gilligan1, M. Lynn Smiley3, Daniel S. Shapiro5
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Affiliations: 1: Director, Clinical Microbiology-Immunology Laboratories University of North Carolina Hospitals; 2: Professor, Microbiology-Immunology and Pathology University of North Carolina School of Medicine, Chapel Hill, North Carolina 27514; 3: Senior Vice President of Clinical Research, Trimeris, Inc. Durham, North Carolina; 4: Clinical Professor, Medicine (Infectious Diseases) University of North Carolina School of Medicine, Chapel Hill, North Carolina 27514; 5: Director, Clinical Microbiology and Molecular Diagnostics Laboratories Boston Medical Center; 6: Associate Professor, Medicine, Pathology and Laboratory Medicine Boston University School of Medicine, Boston, Massachusetts 02118
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Publication Year: 2003

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Abstract:

This section talks about skin and soft tissue infections and presents case studies relating to this subject. The resistance of skin to infection is due to the integrity of the keratinized skin, the presence of inhibitory fatty acids produced by sebaceous glands, the dryness of the skin, and the inhibitory effect of the resident normal skin flora. Skin and soft tissue infections can be caused by either direct penetration of a pathogen through the skin or hematogenous spread of the pathogen to the site. In the setting of severe damage to the skin, as occurs with burns, even normally innocuous organisms, including endogenous bacteria, can cause severe disease. Similarly, when the skin is no longer dry, as may occur in moist intertriginous spaces or when occlusive dressings are present, the patient is at increased risk of infection. The characteristic rash of Lyme disease, erythema migrans, is specific enough to establish the diagnosis. The nature of the lesion (macular, papular, vesicular, pustular, or bullous) may help to narrow the differential diagnosis. Skin and soft tissue infections can be classified on the basis of the anatomic level at which infection occurs. The more superficial infections, such as folliculitis caused by or cellulitis caused by , are important to treat at an early stage. Important agents of skin and soft tissue infection are finally listed in the chapter.

Citation: Gilligan P, Smiley M, Shapiro D. 2003. Skin and Soft Tissue Infections, p 201-240. In Cases in Medical Microbiology and Infectious Diseases, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816353.ch4
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Skin and Soft Tissue Infections
Citation: Gilligan P, Smiley M, Shapiro D. 2003. Skin and Soft Tissue Infections, p 201-240. In Cases in Medical Microbiology and Infectious Diseases, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816353.ch4
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Citation: Gilligan P, Smiley M, Shapiro D. 2003. Skin and Soft Tissue Infections, p 201-240. In Cases in Medical Microbiology and Infectious Diseases, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816353.ch4
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Citation: Gilligan P, Smiley M, Shapiro D. 2003. Skin and Soft Tissue Infections, p 201-240. In Cases in Medical Microbiology and Infectious Diseases, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816353.ch4
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Citation: Gilligan P, Smiley M, Shapiro D. 2003. Skin and Soft Tissue Infections, p 201-240. In Cases in Medical Microbiology and Infectious Diseases, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816353.ch4
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Disks (clockwise, starting at 4 o'clock): penicillin, oxacillin, gentamicin, vancomycin, erythromycin, clindamycin, trimethoprim/sulfamethoxazole.

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Disks (clockwise, starting at 4 o'clock): penicillin, oxacillin, gentamicin, vancomycin, erythromycin, clindamycin, trimethoprim/sulfamethoxazole.

Citation: Gilligan P, Smiley M, Shapiro D. 2003. Skin and Soft Tissue Infections, p 201-240. In Cases in Medical Microbiology and Infectious Diseases, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816353.ch4
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Citation: Gilligan P, Smiley M, Shapiro D. 2003. Skin and Soft Tissue Infections, p 201-240. In Cases in Medical Microbiology and Infectious Diseases, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816353.ch4
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Citation: Gilligan P, Smiley M, Shapiro D. 2003. Skin and Soft Tissue Infections, p 201-240. In Cases in Medical Microbiology and Infectious Diseases, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816353.ch4
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Citation: Gilligan P, Smiley M, Shapiro D. 2003. Skin and Soft Tissue Infections, p 201-240. In Cases in Medical Microbiology and Infectious Diseases, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816353.ch4
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Citation: Gilligan P, Smiley M, Shapiro D. 2003. Skin and Soft Tissue Infections, p 201-240. In Cases in Medical Microbiology and Infectious Diseases, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816353.ch4
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Citation: Gilligan P, Smiley M, Shapiro D. 2003. Skin and Soft Tissue Infections, p 201-240. In Cases in Medical Microbiology and Infectious Diseases, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816353.ch4
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Citation: Gilligan P, Smiley M, Shapiro D. 2003. Skin and Soft Tissue Infections, p 201-240. In Cases in Medical Microbiology and Infectious Diseases, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816353.ch4
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Citation: Gilligan P, Smiley M, Shapiro D. 2003. Skin and Soft Tissue Infections, p 201-240. In Cases in Medical Microbiology and Infectious Diseases, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816353.ch4
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Citation: Gilligan P, Smiley M, Shapiro D. 2003. Skin and Soft Tissue Infections, p 201-240. In Cases in Medical Microbiology and Infectious Diseases, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816353.ch4
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Citation: Gilligan P, Smiley M, Shapiro D. 2003. Skin and Soft Tissue Infections, p 201-240. In Cases in Medical Microbiology and Infectious Diseases, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816353.ch4
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Citation: Gilligan P, Smiley M, Shapiro D. 2003. Skin and Soft Tissue Infections, p 201-240. In Cases in Medical Microbiology and Infectious Diseases, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816353.ch4
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Citation: Gilligan P, Smiley M, Shapiro D. 2003. Skin and Soft Tissue Infections, p 201-240. In Cases in Medical Microbiology and Infectious Diseases, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816353.ch4
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Citation: Gilligan P, Smiley M, Shapiro D. 2003. Skin and Soft Tissue Infections, p 201-240. In Cases in Medical Microbiology and Infectious Diseases, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816353.ch4
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Tables

Skin and Soft Tissue Infections
Citation: Gilligan P, Smiley M, Shapiro D. 2003. Skin and Soft Tissue Infections, p 201-240. In Cases in Medical Microbiology and Infectious Diseases, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816353.ch4
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TABLE 4

SELECTED SKIN AND SOFT TISSUE PATHOGENS

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TABLE 4

SELECTED SKIN AND SOFT TISSUE PATHOGENS

Citation: Gilligan P, Smiley M, Shapiro D. 2003. Skin and Soft Tissue Infections, p 201-240. In Cases in Medical Microbiology and Infectious Diseases, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816353.ch4

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