5 Infectious Patalim Pearls Flashcards
risk factors for developing cellulitis and erysipelas
lymphedema
skin breakdown/site of entry
venous insufficiency
leg edema
obesty
neutropenia
immunocompromise
hypogammaglobulinemia
chronic renal disease
cirrhosis
signs specific for erysipelas
butterfly pattern
millian ear sign
peau d’ orange - both ceelulitis and erysipelas
this classically associated with necrotizing soft tissue infection
severe pain, anxiety, and diaphoresis
gold standard in diagnosis and treatment of necrotizing soft tissue infection
surgery
mortality skyrockets if debridment is delayed >24 hours
single most important feature to make diagnosis early in necrotizing fasciitis
pain out of proportion
hard signs of necrotizing fasciitis
crepitus, skin necrosis, bullae, hypotension, gas on xray
most reliable sign of necrosis on CT
non-enhancing deep tissues
aka Durand-Nicolas-Favre disease
LGV
more serious influenza
Influenza A
Risk factors for severe influenza
children younger than 2y
adults ≥65
comorbid
immunosuppresion
pregnancy
<19y receiving long-term aspirin
morbid obesity
HSV1 resides in
trigeminal ganglila
HSV 2 resides in sacral ganglia
hallmark of HSV encephalitis
acute onset of fever and neurologic symptoms
independent predictors of a poort outcome for patients with HSV encephalitis
GCS ≤6
FOCAL cns LESIONS
INCREASED PATIENT AGE
start of antiviral thearpy >4 days after onset of symptoms
varicella zoster IG is limited to
postexposure prophylaxis of nonimmune pregnant women and the severely immunosuppresed
often a clue to an immmuodefficient condition
herpes zoster involveing more than three dermatomes
varicella, acyclovir and antivirals decrase the number of lesions and shorten the course if started within
24 hours of rash onset
herpes zoster, start antiviral wihtin
72 hours of rsh onset
start >72 hours if vesicles are still present or patient is immunocompromised
HIV: seroconversion and detectable antiresponse at
3-8 weeks
treatment of cyrptococoosis
amphotericin B
+ flucytocine
most common complaint in tetanus
pain and stiffness in the masster muscles (lockjaw)
preferred agent for muscle relaxation in tetanus
midazolam (water-solubble agent)
lorazepam and diazepam may result in metabolic acidosis secondary to propylene glycol vehicle
DOC in uncomplicated malaria
artemisinin-containing combination therapies
artemether-lumefrantine
artesunate-amodiaqune
antimalarial for sevre (complicated) malaria
artesunate
or quinidine gluconate
PLUS
doxycyline
or clindamycin (in children <8y)
reversal of hot and colod sensation
ciguera toxin (most common in barracuda)
tx in ciguera toxin
supportive care
high-dose atropine for bradycardia
IV manitol for severe neurologic sympotoms
toxin in pufferfish
tetrodotoxin
tx in pufferfish intoxication
emergent supportive care
anticholinesterase such as neostigmein and edrophoneium
toxin in tuna
scombroid (histamine
most characteristic component of secondary stage of lyme disease
multiple annular/target shaped sin findigns
most common neurologic symptom of secndary stage of lyme disease
development of cranial neuritis, most oftenunilateral or bilateral facial nerve palsy
classic presentaiton of yellow fever
triad of
jaundice
black emesis
albuminuria
death in 7-10 days after onset
most common cause of acute themorrhagic fever in temperate climates
neissereia minengitidis
preferred HIV postexposure prohylaxis
tenofovir 300 mg + emtriciabine 200 mg OD
PLUS
raltegravir 400,g IBID or dolutegravir 50 mg OD
FOR 28 DAYS
