Bacteria

Question 1

AT Y P I C A L O R G A N I S M

Answer 1

• Mycoplasma • Legionella

Question 2

Antibiotics 😈

Question 3

EXAMPLES OF ANTIBIOTIC CHOICES FOR SELECTIVE ORGANISMS

Answer 3

• Methicillin-resistant Staphylococcus aureus (MRSA) infection: Rifampicin or
Gentamicin (adjunctive therapy), Clindamycin (community acquired), Vancomycin
(hospital acquired).
• Streptococcal infection: Penicillin and Amoxicillin.
• E.coli and klebsiella infection: Ceftriaxone, Gentamicin, Sulfamethoxazole-
Tr i m e t h o p r i m and Ciprofloxacin.
• Psuedomonas infection: Cefepime, Gentamicin and Piperacillin-Ta z o b a c t a m .
• Anaerobic infection: Clindamycin and Metronidazole.

Question 4

SCARLET FEVER

Answer 4

Scarlet fever is a diffuse erythematous eruption that generally
occurs in association with pharyngitis.
• Caused by beta- hemolytic group A Streptococcus (S. pyogenes).
• Incubation period 1-7 days.
• Mode of transmission is droplet.
Fever • Sorethroat • Headache • Rash • Vomiting and diarrhea • Abdominal pain.

Question 5

SCARLET FEVER

Answer 5

To n s i l : m i g h t c o v e r w i t h w h i t e g r a y e x u d a t e . • To n g u e : w h i t e s t r a w b e r r y t o n g u e then it
become Red tongue with persistent
prominent papillae.
First day: rash distribution in (axilla, groin &
back). • Second day: generalized but not in the face,
with a character of sandpaper on touch
(sandpaper rash). • 3rd-4th day: the rash start to disappear then
a desquamation progress downward.

Question 6

DIAGNOSIS SCARLET FEVER

Answer 6

DIAGNOSIS
• Clinically • CBC • Inflammatory markers • Blood culture • Antistreptolysin O titer • Throat swab for culture

Penicillin V, Amoxicillin and Ampicillin for 10 days. • Alternatives to penicillin:
Cephalosporins, clindamycin, and macrolides.

Question 7

COMPLICATIONS of scarlet

Answer 7

COMPLICATIONS
• Acute rheumatic fever, post-streptococcal
glomerulonephritis, and reactive arthritis. • Streptococcal toxic shock syndrome. • Pediatric autoimmune neuropsychiatric disorder
associated with group A streptococci (PANDAS).

Question 8

Ty p h o i d f e v e r

Answer 8

Ty p h o i d f e v e r ( a l s o k n o w n E n t e r i c f e v e r ) i s r a r e i n i n d u s t r i a l i z e d
countries. However, it remains a serious health threat in the
developing world, especially for children.
• Incubation period 5 to 21 days. • Mode of transmission is Fecal-oral.

Question 9

Ty p h o i d f e v e r ( a l s o k n o w n E n t e r i c f e v e r

Answer 9

Relative bradycardia or pulse-temperature
dissociation may be observed.
• Rising (“stepwise”) fever and bacteremia
develop. • While chills are typical, frank rigors are rare. • Relative bradycardia or pulse-temperature
dissociation may be observed.
Abdominal pain develops and
“rose spots” الاسبوع ٢
(faint salmon-colored macules on the trunk
and abdomen) may be seen.

THIRD WEEK
• Hepatosplenomegaly,

Question 10

TREATMENT DURATION 7- 10 DAYS

Typhoid

Answer 10

TREATMENT DURATION 7- 10 DAYS
• Used to be first line:
Ampicillin, Tr i m e t h o p r i m -Sulfamethoxazole, a n d
Chloramphenicol.
• Empiric therapy in sever disease:
Carbapenem or 3rd generation Cephalosporin.
• Empiric therapy in uncomplicated disease:
Fluoroquinolones (Ciprofloxacin or Ofloxacin).
Azithromycin

Question 11

The most serious complications of typhoid fever are intestinal
bleeding or perforation.
• Other possible complications include:
• Myocarditis, endocarditis
• Pneumonia
• pancreatitis
• Kidney or bladder infections
• meningitis
• Psychiatric problems, such as delirium, hallucinations and paranoid
psychosis