Ch 74

Bakteriyel Hastalıklar

Vol 2 · sayfa 1273 · §12

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Fig. 74.3 Furuncles secondary to methicillin-resistant Staphylococcus aureus. Fluctuant erythematous nodules with a central pustule on the ankle (A) and finger (B). A, Courtesy Julie V. Schaffer, MD; B, Courtesy Frank Samarin, MD.

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Fig. 74.3 Furuncles secondary to methicillin-resistant Staphylococcus aureus. Fluctuant erythematous nodules with a central pustule on the ankle (A) and finger (B). A, Courtesy Julie V. Schaffer, MD; B, Courtesy Frank Samarin, MD.

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Fig. 74.5 Blistering distal dactylitis. Large vesiculopustule due to infection with group A Streptococcus. Courtesy Julie V. Schaffer, MD.

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Fig. 74.6 Ecthyma. Ulceration with hemorrhagic crust on the wrist (A) and leg (B) due to infection with group A streptococci. A, Courtesy Kalman Watsky, MD; B, Courtesy Michal Kidacki, MD, PhD.

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Fig. 74.6 Ecthyma. Ulceration with hemorrhagic crust on the wrist (A) and leg (B) due to infection with group A streptococci. A, Courtesy Kalman Watsky, MD; B, Courtesy Michal Kidacki, MD, PhD.

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Fig. 74.7 Staphylococcal scalded skin syndrome. A Diffuse erythema with an early superficial erosion in the antecubital fossa. B More extensive involvement on the neck with a wrinkled appearance of the erythematous skin in addition to peeling and multiple erosions. Courtesy Julie V. Schaffer, MD.

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Fig. 74.7 Staphylococcal scalded skin syndrome. A Diffuse erythema with an early superficial erosion in the antecubital fossa. B More extensive involvement on the neck with a wrinkled appearance of the erythematous skin in addition to peeling and multiple erosions. Courtesy Julie V. Schaffer, MD.

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Fig. 74.8 Toxic shock syndrome due to Staphylococcus aureus infection. A Blotchy erythema is evident on the thigh. B Hyperemia of the conjunctiva is seen.

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Fig. 74.8 Toxic shock syndrome due to Staphylococcus aureus infection. A Blotchy erythema is evident on the thigh. B Hyperemia of the conjunctiva is seen.

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Fig. 74.9 Desquamation of the foot following scarlet fever. Courtesy Eugene Mirrer, MD.

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Fig. 74.11 Cutaneous strepto- coccal infections. A, B Sharply demarcated erythema on the upper arm and chest (A) and buttocks (B) in two patients with erysipelas. C Streptococcal intertrigo presenting as a sharply demarcated, bright pink, moist plaque in the axilla of an infant. D Bright red erythema extending from the anal verge in a young boy with streptococcal perianal disease. A, Courtesy Lorenzo Cerroni, MD; B, Courtesy Mary Stone, MD; C, D, Courtesy Julie V. Schaffer, MD.

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Fig. 74.11 Cutaneous strepto- coccal infections. A, B Sharply demarcated erythema on the upper arm and chest (A) and buttocks (B) in two patients with erysipelas. C Streptococcal intertrigo presenting as a sharply demarcated, bright pink, moist plaque in the axilla of an infant. D Bright red erythema extending from the anal verge in a young boy with streptococcal perianal disease. A, Courtesy Lorenzo Cerroni, MD; B, Courtesy Mary Stone, MD; C, D, Courtesy Julie V. Schaffer, MD.

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Fig. 74.12 Bullous and necrotizing cellulitis. A Extensive soft tissue infection of the lower extremity due to group A streptococcal infection. B Edema and confluent bullae. C Multiple areas of necrotic crusting and focal purulence due to streptococcal cellulitis.

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Fig. 74.12 Bullous and necrotizing cellulitis. A Extensive soft tissue infection of the lower extremity due to group A streptococcal infection. B Edema and confluent bullae. C Multiple areas of necrotic crusting and focal purulence due to streptococcal cellulitis.

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Fig. 74.12 Bullous and necrotizing cellulitis. A Extensive soft tissue infection of the lower extremity due to group A streptococcal infection. B Edema and confluent bullae. C Multiple areas of necrotic crusting and focal purulence due to streptococcal cellulitis.

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Fig. 74.15 Pseudocellulitis – clinical examples. A Erythema migrans with erosion following rupture of a central bulla. Inking of the skin reflects initial diagnosis of cellu- litis. B Extravasation reaction following infusion of docetaxel. C Excessive limb swelling (ELS) following injection of multiple vaccines. This reaction does not preclude future immunizations. D Acute gout with abrupt onset of severe pain, warmth and erythema of the left great toe with difficulty in weight bearing. E Acute inflammatory edema with erythematous, edematous plaque sparing the inguinal fold. A, Courtesy Kalman Watsky, MD; B, Courtesy Edward Cowen, MD; C, D, Courtesy Karynne O. Duncan, MD.

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Fig. 74.15 Pseudocellulitis – clinical examples. A Erythema migrans with erosion following rupture of a central bulla. Inking of the skin reflects initial diagnosis of cellu- litis. B Extravasation reaction following infusion of docetaxel. C Excessive limb swelling (ELS) following injection of multiple vaccines. This reaction does not preclude future immunizations. D Acute gout with abrupt onset of severe pain, warmth and erythema of the left great toe with difficulty in weight bearing. E Acute inflammatory edema with erythematous, edematous plaque sparing the inguinal fold. A, Courtesy Kalman Watsky, MD; B, Courtesy Edward Cowen, MD; C, D, Courtesy Karynne O. Duncan, MD.

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Fig. 74.15 Pseudocellulitis – clinical examples. A Erythema migrans with erosion following rupture of a central bulla. Inking of the skin reflects initial diagnosis of cellu- litis. B Extravasation reaction following infusion of docetaxel. C Excessive limb swelling (ELS) following injection of multiple vaccines. This reaction does not preclude future immunizations. D Acute gout with abrupt onset of severe pain, warmth and erythema of the left great toe with difficulty in weight bearing. E Acute inflammatory edema with erythematous, edematous plaque sparing the inguinal fold. A, Courtesy Kalman Watsky, MD; B, Courtesy Edward Cowen, MD; C, D, Courtesy Karynne O. Duncan, MD.

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Fig. 74.15 Pseudocellulitis – clinical examples. A Erythema migrans with erosion following rupture of a central bulla. Inking of the skin reflects initial diagnosis of cellu- litis. B Extravasation reaction following infusion of docetaxel. C Excessive limb swelling (ELS) following injection of multiple vaccines. This reaction does not preclude future immunizations. D Acute gout with abrupt onset of severe pain, warmth and erythema of the left great toe with difficulty in weight bearing. E Acute inflammatory edema with erythematous, edematous plaque sparing the inguinal fold. A, Courtesy Kalman Watsky, MD; B, Courtesy Edward Cowen, MD; C, D, Courtesy Karynne O. Duncan, MD.

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Fig. 74.15 Pseudocellulitis – clinical examples. A Erythema migrans with erosion following rupture of a central bulla. Inking of the skin reflects initial diagnosis of cellu- litis. B Extravasation reaction following infusion of docetaxel. C Excessive limb swelling (ELS) following injection of multiple vaccines. This reaction does not preclude future immunizations. D Acute gout with abrupt onset of severe pain, warmth and erythema of the left great toe with difficulty in weight bearing. E Acute inflammatory edema with erythematous, edematous plaque sparing the inguinal fold. A, Courtesy Kalman Watsky, MD; B, Courtesy Edward Cowen, MD; C, D, Courtesy Karynne O. Duncan, MD.

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Fig. 74.17 Necrotizing fasciitis. Tense, woody edema of the forearm with purple–gray areas of necrosis and bullae with watery discharge. Intravenous drug use was a predisposing factor. Courtesy Luis Requena, MD.

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Fig. 74.19 Palmar lesions due to staphylococcal endocarditis.

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Fig. 74.20 Erythrasma. A Pink to brown scaly patches on the upper inner thighs. B Coral-red fluorescence upon illumi- nation with a Wood’s lamp. C Hyperpigmented plaques in the inguinal and periumbilical areas. D Well-demarcated, scaly, hyper- pigmented plaque of disciform erythrasma. A, B, Courtesy Louis A. Fragola, Jr, MD.

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Fig. 74.20 Erythrasma. A Pink to brown scaly patches on the upper inner thighs. B Coral-red fluorescence upon illumi- nation with a Wood’s lamp. C Hyperpigmented plaques in the inguinal and periumbilical areas. D Well-demarcated, scaly, hyper- pigmented plaque of disciform erythrasma. A, B, Courtesy Louis A. Fragola, Jr, MD.

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Fig. 74.21 Pitted keratolysis of the plantar surface of the foot. Multiple small (A) and larger coalescing (B) craters with decreased stratum corneum that favor pressure points on the plantar surface. Courtesy Kalman Watsky, MD.

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Fig. 74.21 Pitted keratolysis of the plantar surface of the foot. Multiple small (A) and larger coalescing (B) craters with decreased stratum corneum that favor pressure points on the plantar surface. Courtesy Kalman Watsky, MD.

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Fig. 74.22 Trichomycosis axillaris. Cylindrical sheaths and beading of the axillary hairs. A yellow color is seen most commonly.

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Fig. 74.23 Ecthyma diphthericum. Punched-out ulcer with a black eschar on the upper lip. Courtesy Joyce Rico, MD.

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Fig. 74.24 Erysipeloid. Erythema and edema with vesicle formation on the hand and fifth digit.

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Fig. 74.25 Acute meningococcemia. Purpura with irregular outline and central gunmetal gray color. Courtesy Kalman Watsky, MD.

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Fig. 74.26 Green nail syndrome. Blue–green discoloration of the nail due to pyocyanin produced by Pseudomonas aeruginosa. Note the associated onycholysis. Courtesy Julie V. Schaffer, MD.

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Fig. 74.27 Superficial infection of the skin with Pseudomonas. Note the macer- ation, erosions, and moth-eaten appearance of the skin. Courtesy Kalman Watsky, MD.

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Fig. 74.28 Pseudomonas hot-foot syndrome. Tender erythematous nodules on the heel. Courtesy Justin J. Green, MD.

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Fig. 74.29 Ecthyma gangrenosum. Embolic lesion of Pseudomonas aeruginosa on the chest. Note the necrotic center and inflammatory border.

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Fig. 74.30 Bacillary angiomatosis. A Bright red nodule and papule on the forehead. B Histologically, a dermal proliferation of vessels with plump endothelial cells is evident and scattered neutrophils are present in the accom- panying infiltrate. Bacilli (in this case Bartonella henselae) are identified with the Warthin–Starry stain (inset). B, Courtesy James Patterson, MD.

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Fig. 74.30 Bacillary angiomatosis. A Bright red nodule and papule on the forehead. B Histologically, a dermal proliferation of vessels with plump endothelial cells is evident and scattered neutrophils are present in the accom- panying infiltrate. Bacilli (in this case Bartonella henselae) are identified with the Warthin–Starry stain (inset). B, Courtesy James Patterson, MD.

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Fig. 74.31 Clinical manifestations of brucellosis. With permission from Slack MPE. Gram-negative coccobacilli. In: Armstrong D, Powderly WG (eds). Infectious Diseases. Edinburgh: Mosby, 2004.

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Fig. 74.34 Hemorrhagic bullae of the leg secondary to Vibrio vulnificus infection.

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Fig. 74.35 Acrodermatitis chronica atrophicans. The acral skin is atrophic, shiny, and wrinkled, with prominent superficial veins.

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Fig. 74.36 Cutaneous yaws on the knee of an adolescent from Indonesia. Courtesy Peter Ehrnstrom, MD.

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Fig. 74.37 Cervicofacial actinomycosis or “lumpy jaw”. Soft tissue swelling and draining erythematous nodules are seen. The discharge contained sulfur granules. Courtesy Joyce Rico, MD.

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