II. Pathophysiology: Predisposing factors

  1. Decreased tissue perfusion oxygenation
  2. Peripheral fluid stasis and edema
  3. Increased Skin Trauma risk
  4. Suppressed immune function

VI. Types: Parasitic Skin Infection

VII. Types: Viral Skin Infections

VIII. Risk Factors

  1. Immunodeficiency
    1. Asplenia
    2. Diabetes Mellitus (5 fold increased SSTI risk)
    3. HIV Infection
    4. Chemotherapy
    5. DMARDs (Rheumatoid Arthritis)
  2. Chronic Disease
    1. Comorbidity (e.g. cardiopulmonary, hepatorenal, debility)
    2. Dialysis (ESRD)
    3. Longterm intravascular access (MRSA risk)
    4. Lymphedema
    5. Obesity
    6. Peripheral Neuropathy
    7. Peripheral artery disease
    8. Trauma or surgery
    9. Eczema and other Pruritic Conditions
  3. Demographics
    1. Children and older adults (MRSA risk)
    2. Healthcare Worker
    3. Prolonged hospitalization (MRSA risk)
    4. Longterm Care (MRSA risk)
    5. Military (close quarters)
    6. Athlete
  4. Lifestyle
    1. Alcohol Abuse
    2. Nutritional deficiency
    3. IV Drug Abuse
    4. Water exposure (swimming in lakes, hot tubs)

IX. Classification

  1. Class 1
    1. Simple infection without systemic symptoms or signs of spread
    2. No uncontrolled comorbidities impacting treatment
    3. Outpatient Antibiotic management planned
  2. Class 2
    1. Infection with systemic symptoms or signs of spread (e.g. fever, sweats, Tachycardia) or
    2. Uncontrolled comorbidities impacting treatment or
    3. ParenteralAntibiotics required
  3. Class 3
    1. Infection with systemic symptoms or signs of spread (e.g. fever, sweats, Tachycardia) or
    2. Uncontrolled comorbidities impacting treatment
    3. Inpatient ParenteralAntibiotics required
  4. Class 4
    1. Infection with life-threatening systemic symptoms or signs of spread (e.g. severe Sepsis)
    2. Inpatient management with ParenteralAntibiotics (may require ICU care)
    3. Surgical Consultation may be warranted

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