1887

Chapter 4 : Skin and Soft Tissue Infections

Authors: Peter H. Gilligan1, M. Lynn Smiley3, Daniel S. Shapiro5
VIEW AFFILIATIONS HIDE AFFILIATIONS
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
Content Type: Textbook
Publication Year: 2003

Category: Clinical Microbiology; Best-Selling Textbook

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Preview this chapter:
Preview Magnify
Zoom in
Zoomout

Skin and Soft Tissue Infections, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555816353/9781555812072_Chap04-1.gif /docserver/preview/fulltext/10.1128/9781555816353/9781555812072_Chap04-2.gif

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

Key Concept Ranking

Toxic Shock Syndrome Toxin 1
0.49179217
Central Nervous System Diseases
0.46375284
0.49179217
Highlighted Text: Show | Hide
Loading full text...

Full text loading...

Figures

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
/content/10.1128/9781555816353.chap4.fig4-1
Figure 1
10.1128/9781555816353/fig32-1_thmb.gif
10.1128/9781555816353/fig32-1.gif
Image of Figure 1
Figure 1

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
Permissions and Reprints Request Permissions
Download as Powerpoint
/content/10.1128/9781555816353.chap4.fig4-2
Figure 2
10.1128/9781555816353/fig32-2_thmb.gif
10.1128/9781555816353/fig32-2.gif
Image of Figure 2
Figure 2

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
Permissions and Reprints Request Permissions
Download as Powerpoint
/content/10.1128/9781555816353.chap4.fig4-3
Figure 3
10.1128/9781555816353/fig32-3_thmb.gif
10.1128/9781555816353/fig32-3.gif
Image of Figure 3
Figure 3

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
Permissions and Reprints Request Permissions
Download as Powerpoint
/content/10.1128/9781555816353.chap4.fig4-4
Figure 4

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

10.1128/9781555816353/fig32-4_thmb.gif
10.1128/9781555816353/fig32-4.gif
Image of Figure 4
Figure 4

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
Permissions and Reprints Request Permissions
Download as Powerpoint
/content/10.1128/9781555816353.chap4.fig4-5
Figure 1
10.1128/9781555816353/fig33-1_thmb.gif
10.1128/9781555816353/fig33-1.gif
Image of Figure 1
Figure 1

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
Permissions and Reprints Request Permissions
Download as Powerpoint
/content/10.1128/9781555816353.chap4.fig4-6
Figure 2
10.1128/9781555816353/fig33-2_thmb.gif
10.1128/9781555816353/fig33-2.gif
Image of Figure 2
Figure 2

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
Permissions and Reprints Request Permissions
Download as Powerpoint
/content/10.1128/9781555816353.chap4.fig4-7
Figure 1
10.1128/9781555816353/fig34-1_thmb.gif
10.1128/9781555816353/fig34-1.gif
Image of Figure 1
Figure 1

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
Permissions and Reprints Request Permissions
Download as Powerpoint
/content/10.1128/9781555816353.chap4.fig4-8
Figure 2
10.1128/9781555816353/fig34-2_thmb.gif
10.1128/9781555816353/fig34-2.gif
Image of Figure 2
Figure 2

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
Permissions and Reprints Request Permissions
Download as Powerpoint
/content/10.1128/9781555816353.chap4.fig4-9
Figure 1
10.1128/9781555816353/fig35-1_thmb.gif
10.1128/9781555816353/fig35-1.gif
Image of Figure 1
Figure 1

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
Permissions and Reprints Request Permissions
Download as Powerpoint
/content/10.1128/9781555816353.chap4.fig4-10
Figure 2
10.1128/9781555816353/fig35-2_thmb.gif
10.1128/9781555816353/fig35-2.gif
Image of Figure 2
Figure 2

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
Permissions and Reprints Request Permissions
Download as Powerpoint
/content/10.1128/9781555816353.chap4.fig4-11
Figure 1
10.1128/9781555816353/fig36-1_thmb.gif
10.1128/9781555816353/fig36-1.gif
Image of Figure 1
Figure 1

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
Permissions and Reprints Request Permissions
Download as Powerpoint
/content/10.1128/9781555816353.chap4.fig4-12
Figure 2
10.1128/9781555816353/fig36-2_thmb.gif
10.1128/9781555816353/fig36-2.gif
Image of Figure 2
Figure 2

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
Permissions and Reprints Request Permissions
Download as Powerpoint
/content/10.1128/9781555816353.chap4.fig4-13
Figure 1
10.1128/9781555816353/fig37-1_thmb.gif
10.1128/9781555816353/fig37-1.gif
Image of Figure 1
Figure 1

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
Permissions and Reprints Request Permissions
Download as Powerpoint
/content/10.1128/9781555816353.chap4.fig4-14
Figure 1
10.1128/9781555816353/fig38-1_thmb.gif
10.1128/9781555816353/fig38-1.gif
Image of Figure 1
Figure 1

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
Permissions and Reprints Request Permissions
Download as Powerpoint
/content/10.1128/9781555816353.chap4.fig4-15
Figure 1
10.1128/9781555816353/fig39-1_thmb.gif
10.1128/9781555816353/fig39-1.gif
Image of Figure 1
Figure 1

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
Permissions and Reprints Request Permissions
Download as Powerpoint
/content/10.1128/9781555816353.chap4.fig4-16
Figure 2
10.1128/9781555816353/fig39-2_thmb.gif
10.1128/9781555816353/fig39-2.gif
Image of Figure 2
Figure 2

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
Permissions and Reprints Request Permissions
Download as Powerpoint

References

/content/book/10.1128/9781555816353.chap4
1. Centers for Disease Control and Prevention. 2002. Staphylococcus aureus resistant to vancomycin—United States, 2002. Morb. Mortal. Wkly. Rep. 51: 565– 567.
2. Diekema, D. J.,, M. A. Pfaller,, F. J. Schmitz,, J. Smayevsky,, R. N. Jones,, M. Beach, and the SENTRY Participants Group. 2001. Survey of infections due to Staphylococcus species: frequency of occurrence and antimicrobial susceptibility of isolates collected in the United States, Canada, Latin America, Europe, and Western Pacific region for the SENTRY antimicrobial surveillance program, 1997-1999. Clin. Infect. Dis. 32(Suppl.): S114– S132.
3. Dinges, M. M.,, P. M. Orwin,, and P. M. Schlievert. 2000. Exotoxins of Staphylococcus aureus. Clin. Microbiol. Rev. 13: 16– 34.
4. Llewelyn, M.,, and J. Cohen. 2002. Superantigens: microbial agents that corrupt immunity. Lancet Infect. Dis. 2: 156– 162.
5. Lowy, F. D. 1998. Staphylococcus aureus infections. N. Engl. J. Med. 339: 520– 532.
6. Moreno, F.,, C. Crisp,, J. H. Jorgenson,, and J. E. Patterson. 1995. Methicillinresistant Staphylococcus aureus as a community organism. J. Infect. Dis. 21: 1308– 1312.
7. Shapiro, M.,, K. J. Smith,, W. D. James,, W. J. Giblin,, D. J. Margolis,, A. N. Foglia,, K. McGinley,, and J. J. Leyden. 2000. Cutaneous microenvironment of Human Immunodeficiency Virus (HIV)-seropositive and HIV-seronegative individuals, with special reference to Staphylococcus aureus colonization. J. Clin. Microbiol. 38: 3174– 3178.
8. Smith, T. L.,, M. L. Pearson,, K. R. Wilcox,, C. Cruz,, M. V. Lancaster,, B. Robinson-Dunn,, F. C. Tenover,, M. J. Zervos,, J. D. Band,, E. White,, W. R. Jarvis, and the Glycopeptide-Intermediate Staphylococcus aureus Working Group. 1999. Emergence of vancomycin resistance in Staphylococcus aureus. N. Engl. J. Med. 340: 493– 501.
1. Talan, D. A.,, D. M. Citron,, F. M. Abrahamian,, G. J. Moran,, E. J. Goldstein, and the Emergency Medicine Animal Bite Infection Study Group. 1999. Bacteriologic analysis of infected dog and cat bites. N. Engl. J. Med. 340: 85– 92.
2. Weber, D. J.,, J. S. Wolfson,, M. N. Swartz,, and D. C. Hooper. 1984. Pasteurella multocida infections: report of 34 cases and review of the literature. Medicine 63: 133– 154.
1. Arvin, A. M. 1996. Varicella-zoster virus. Clin. Microbiol. Rev. 9: 361– 381.
2. Wise, R. P.,, M. E. Salive,, M. M. Braun,, G. Terracciano Mootrey,, J. F. Seward,, L. G. Rider,, and P. R. Krause. 2000. Postlicensure safety surveillance for varicella vaccine. JAMA 284: 1271– 1279.
1. Abramson, O.,, R. Dagan,, A. Tal,, and S. Sofer. 1995. Severe complications of measles requiring intensive care in infants and young children. Arch. Pediatr. Adolesc. Med. 149: 1237– 1240.
2. Centers for Disease Control and Prevention. 1999. Global measles control and regional elimination, 1998-1999. Morb. Mortal. Wkly. Rep. 48: 1124– 1130.
3. Centers for Disease Control and Prevention. 2000. Measles—United States, 1999. Morb. Mortal. Wkly. Rep. 49: 557– 560.
4. Hersh, B. S.,, G. Tambini,, A. C. Nogueira,, P. Carrasco,, and C. A. de Quadros. 2000. Review of regional measles surveillance data in the Americas, 1996-99. Lancet 355: 1943– 1948.
5. Sommer, A. 1997. Vitamin A prophylaxis. Arch. Dis. Child. 77: 191– 194.
1. Aly, R. 1999. Ecology, epidemiology and diagnosis of tinea capitis. Ped. Infect. Dis. J. 18: 180– 185.
2. Gupta, A. K.,, and R. K. Scher. 1998. Oral antifungal agents for onychomycosis. Lancet 351: 541– 542.
3. Weitzman, I.,, and R. C. Summerbell. 1995. The dermatophytes. Clin. Microbiol. Rev. 8: 240– 259.
1. Centers for Disease Control and Prevention. 1996. Recommendations for the use of Lyme disease vaccine. Recommendations of the Advisory Committee on Immunization Practices (ACIP). Morb. Mortal. Wkly. Rep. 48(RR-7): 1– 17. (Erratum, 48:833.)
2. Centers for Disease Control and Prevention. 1995. Recommendations for test performance and interpretation from the Second National Conference on Serologic Diagnosis of Lyme Disease. Morb. Mortal. Wkly. Rep. 44: 590– 591.
3. Liang, F. T.,, A. C. Steere,, A. R. Marques,, B. J. Johnson,, J. N. Miller,, and M. T. Philipp. 1999. Sensitive and specific serodiagnosis of Lyme disease by enzymelinked immunosorbent assay with a peptide based on an immunodominant conserved region of Borrelia burgdorferi vlsE. J. Clin. Microbiol. 37: 3990– 3996.
4. Nadelman, R. B.,, and G. P. Wormser. 1998. Lyme borreliosis. Lancet 352: 557– 565.
5. Spach, D. H.,, W. C. Liles,, G. L. Campbell,, R. E. Quick,, D. E. Anderson, Jr.,, and T. R. Fritsche. 1993. Tick-borne diseases in the United States . N. Engl. J. Med. 329: 936– 947.
6. Thanassi, W. T.,, and R. T. Schoen. 2000. The Lyme disease vaccine: conception, development, and implementation. Ann. Intern. Med. 132: 661– 668.
1. Carpenter, C. F.,, T. K. Gandhi,, L. K. Kuo,, G. R. Corey,, S.-M. Chen,, D. H. Walker,, J. S. Dumler,, E. Breitschwerdt,, B. Hegarty,, and D. J. Sexton. 1999. The incidence of ehrlichial and rickettsial infections in patients with unexplained fever and recent history of tick bite in central North Carolina. J. Infect. Dis. 180: 900– 903.
2. Jones, T. F.,, A. S. Craig,, C. D. Paddock,, D. B. McKechnie,, J. E. Childs,, S. R. Zaki,, and W. Schaffner. 1999. Family cluster of Rocky Mountain spotted fever. Clin. Infect Dis. 28: 853– 859.
3. Paddock, C. D.,, P. W. Greer,, T. L. Ferebee,, J. Singleton, Jr.,, D. B. McKechnie,, T. A. Treadwell,, J. W. Krebs,, M. J. Clarke,, R. C. Holman,, J. G. Olson,, J. E. Childs,, and S. R. Zaki. 1999. Hidden mortality attributable to Rocky Mountain spotted fever: immunohistochemical detection of fatal, serologically unconfirmed disease. J. Infect. Dis. 179: 1469– 1476.
4. Thorner, A. R.,, D. H. Walker,, and W. A. Petri, Jr. 1998. Rocky Mountain spotted fever. Clin. Infect. Dis. 27: 1353– 1360.
1. Alvar, J.,, C. Cañavate,, B. Gutiérrez-Solar,, M. Jiménez,, F. Laguna,, R. López- Vélez,, R. Molina,, and J. Moreno. 1997. Leishmania and human immunodeficiency virus: the first ten years. Clin. Microbiol. Rev. 10: 298– 319.
2. Klaus, S.,, and S. Frankenburg. 1999. Cutaneous leishmaniasis in the Middle East. Clin. Dermatol. 17: 137– 141.
3. Magill, A. J.,, M. Grogl,, R. A. Gasser, Jr.,, W. Sun,, and C. N. Oster. 1993. Visceral infection caused by Leishmania tropica in veterans of Operation Desert Storm. N. Engl. J. Med. 328: 1383– 1387.
4. Salman, S. M.,, N. G. Rubeiz,, and A.-G. Kibbi. 1999. Cutaneous leishmaniasis: clinical features and diagnosis. Clin. Dermatol. 17: 291– 296.

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
/content/10.1128/9781555816353.chap4.tab4
TABLE 4

SELECTED SKIN AND SOFT TISSUE PATHOGENS

10.1128/9781555816353/tab4_thmb.gif
10.1128/9781555816353/tab4.gif
Generic image for table
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

Back to top
This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error