Med-Surg - Integumentary System, part 4: Bacterial & Fungal Skin Infections
by Cathy Parkes February 21, 2023 Updated: August 10, 2023 4 min read
Full transcript and video captions coming soon!
Hi, I'm Cathy with Level Up RN. In this video, I'll be covering a variety of bacterial and fungal skin infections. And at the end of the video, I'm going to give you guys a little quiz to test your knowledge of some of the key points I'll be covering, so definitely stay tuned for that. And if you have our Level Up RN Medical-Surgical Nursing flashcards, definitely pull those out so you can follow along with me. Let's first talk about some common bacterial skin infections. So folliculitis is inflammation of a hair follicle, and it will present as a small, erythematous pustule. Treatment of folliculitis is typically not necessary but can include topical antibiotics. A furuncle is infection of multiple hair follicles as well as the adjacent tissue, and a furuncle will present as a larger, erythematous, pus-filled nodule. Treatment of a furuncle can include warm compresses, incision and drainage, as well as antibiotics. Cellulitis is the infection of the deeper tissue, and left untreated, it can be life-threatening. So if you end up working on a medical-surgical floor, this is something you will see pretty frequently. Symptoms of cellulitis include erythema, warmth, pain, and swelling in the affected area, as well as fever and malaise. Treatment includes the administration of systemic antibiotics, and in many cases, IV antibiotics are required.
Moving on to fungal skin infections now. The two main types of infections that we're going to talk about here include dermatophytosis, which is a tinea infection, and candidiasis. So tinea infections can include ringworm as well as tinea capitis, which is a tinea infection on the head where you would wear a cap; tinea corporis, which is a tinea infection on the body; tinea cruris, which is jock itch; and tinea pedis, which is athlete's foot. Tinea infections are spread through contact with infected people, infected animals, or contaminated objects. Signs and symptoms of a tinea infection include pruritus, so itching, as well as red, scaly, and/or cracked skin. A ring-shaped rash may also be present as shown here. And with tinea capitis, we may have hair loss as well. Tinea infections are commonly diagnosed through clinical examination. A KOH test can be used as well. In terms of treatment, oral or topical antifungal agents are used. With tinea capitis, a selenium sulfide shampoo may also be used in conjunction with an oral antifungal agent. In terms of patient teaching, because this fungus thrives in warm, moist environments, we should advise our patient to keep their skin clean and dry. They should avoid sharing personal items, and they should avoid walking barefoot through locker rooms or public showers as well.
Next, we have candidiasis, which is another type of fungal infection. Examples of candidiasis include thrush, which is a candida infection in the mouth, as well as a yeast infection, which is a candida infection in the vagina. So in terms of the pathophysiology, candidiasis occurs when there is an imbalance in the local flora that allows for the overgrowth of candida. So for example, when we administer antibiotics, that kills off a bunch of bacteria. And then the candida is like, "Woohoo, there's lots more room for me to grow now," and that's how we end up with candidiasis. Other risk factors include immunosuppression as well as oral corticosteroids, pregnancy, and diabetes. Signs and symptoms of candidiasis include red irritated skin with burning and itching. With oral candidiasis, we will have white patches in the mouth and throat. Diagnosis of candidiasis can be done through clinical examination as well as using a KOH test, and treatment includes the administration of antifungal agents. Just like other fungi, candida thrives in warm, moist environments, so we want to advise our patient to keep their skin clean and dry. In order to prevent vaginal candidiasis, we should advise our patient to wear cotton underwear and to avoid tight clothing. Antibiotics should only be taken as necessary because they disrupt the local flora, which can lead to candidiasis. And then for patients who use inhaled corticosteroids, it's imperative that they rinse their mouth out after administration.
All right. It's quiz time. I've got three questions for you. First question, what potentially life-threatening bacterial infection of the deeper tissue must be treated with systemic antibiotics? The answer is cellulitis. Question number two, what type of fungal infection is spread through contact with people, pets, or contaminated objects? The answer is dermatophytosis or a tinea infection. Question number three, what teaching should be provided to a patient who uses an inhaled corticosteroid medication in order to prevent a candidiasis infection? The answer is you need to teach them to rinse their mouth out after administration. Okay, that is it. I hope you enjoyed this video and learned a lot. Take care and good luck with study.
The two main types of infections we're going to talk about include-- so tinea infections can include ringworm, tidia. Tidia. In addition, for tinea capitis, selenium sulfide.
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