Anaerobic Infections (lecture)

Question 1

Patient with significant diarrhea after taking a round of carbapenems given prophylactically following a dental procedure. Abdominal X-ray shows thumb printing. What is the likely diagnosis and mechanism of the virulence?

Answer 1

This is likely C. difficile. Its virulence factors are toxin A and B, with B having the greatest impact.

Question 2

What is the first line IV Abx for C. difficile infection?

Answer 2

Metronidazole: Interferes with nucleic acid synth

CI in pregnant women - use Vanc

Question 3

What is the underlying cause behind recurrent brachial cleft cysts?

Answer 3

Failure of the 3rd and 4th brachial pouches to migrate.

Question 4

What is the main concern with regard to complications related to recurrent brachial cyst infection?

Answer 4

Lemierre’s syndrome: migration of oropharynx infection to carotid arteries and subsequent cerebral involvement.

Question 5

14 y.o. boy with severe RLQ ab pain. He has significant rebound tenderness and a positive jump test. What is the next step in care?

Answer 5

This is likely appendicitis - needs surgery