Skin and soft-tissue infections

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Skin and soft-tissue infections

SSTIs or Skin and Soft Tissue Infections are infections of the skin, muscles, fascial, and subcutaneous tissue including a wide spectrum of clinical presentations ranging from simple cellulitis to necrotizing fasciitis. Diagnosing the exact extent of the disease is undeniably significant for the successful management of a patient with a soft-tissue infection.

Common Types of SSTIs:

Impetigo

It is one of the most common bacterial infections in children. This acute and highly contagious infection of the superficial layers of the epidermis is primarily caused by Staphylococcus aureus or Streptococcus pyogenes. Furthermore, the infection of existing skin lesions (for instance, wounds, cuts, chickenpox lesions, abrasions, insect bites) can also occur.

Folliculitis

It is defined biologically as the presence of inflammatory cells in the wall of the hair follicle. In the case of superficial folliculitis, the inflammation is actually restricted to the infundibular area of the follicle. Whereas, in deep folliculitis, the inflammation involves not only the deeper areas but also extends into the surrounding dermis.

Erysipelas

It is another bacterial skin infection that mainly involves the upper dermis which characteristically extends into the superficial cutaneous lymphatics. In addition, it is intensely erythematous, tender, and presents n indurated plaque with a sharply demarcated border. The well-defined margin of it is something that can help differentiate it from other skin and soft tissue infection for example, cellulitis.

Cellulitis

This term commonly indicates a non necrotizing inflammation of the skin as well as subcutaneous tissues. It often follows a breach in the skin. Even though a portal of entry may not be obvious, yet the breach may involve invasive qualities of a few bacterias and microscopic skin changes.

Necrotizing Fasciitis

Also known as synergistic gangrene, Meleney ulcer,  hemolytic streptococcal gangrene, Fournier gangrene (when located to the perineal and scrotum area). This type of infection is a potentially life-threatening medical emergency that involves devastating and persistently spreading destruction of soft tissue along with associated systemic toxicity.

Major classification of SSTIs:

Uncomplicated SSTI

This type of skin and soft tissue infection include folliculitis, simple abscesses, Minor Wound Infections, and superficial cellulitis. They respond well to a simple course of Antibiotics or source control management i.e. Debridement or Drainage. They pose a little risk to limb and life.

Complicated SSTI

This type of infection involves deeper tissues and primarily needs pivotal surgical intervention. Indeed, the response to therapy is usually complicated by the underlying illness conditions. The complicated abscesses, infected ulcers & burn wounds, infections in diabetics, and deep-space wound infections come under this SSTI type. These types of infection are often life-threatening.

Causes and Symptoms of SSTIs:

SSTIs or Skin and Soft Tissue Infections can be caused by various bacterias as well as other microorganisms that enter the skin through burns, wounds, and irritated skin. People suffering from diseases of the lymph system, peripheral vascular illness, and neuropathy (numbness) are more susceptible to this infection.

However, the skin and soft tissue infections are mainly characterized by warmth, tenderness, redness, as well as oozing at the infection site. If the infection is severe, additional signs may include:

  • Chills
  • Fever
  • Nausea
  • Weakness
  • Dizziness
  • Dimpling of the skin
  • Itching and burning skin
  • Swelling of the tissue

Diagnoses of SSTIs:

Skin and soft tissue infections are diagnosed by examining the infected area. Also, there are a variety of tests utilized to diagnose the type of infection that include:

  • Blood test: In this type of test, a blood sample is taken in order to determine blood markers of inflammation, kidney function, liver function and so on.
  • Biopsy: A tissue sample will be taken from the infected site to view under a microscope. And, thus, the infectious agent can be identified.
  • Computed tomography (CT) scan: In computed tomography scan, computer technology and X-ray are combined to produce detailed cross-sectional images of blood vessels, bone, and images of tissues.
  • Lab test: When the lab test is performed, a sample of the liquid draining or pus from the infected area may be analyzed in order to identify what microorganism is actually causing the infection.

Treatment of SSTIs:

Most uncomplicated skin and soft tissue infections can be treated at home. However, if the infection does not heal, the treatment may include:

  • Antibiotic or antifungal cream
  • Surgery to remove dead tissue
  • Surgery to drain the infection
  • Hyperbaric oxygen therapy
  • Surgery to amputate a damaged limb
  • Oral antibiotic or antifungal medications
  • IV medications
  • Dermal substitutes to replace the loss of tissue
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