Bacterial Infections Flashcards
Treatment of chlamydia
Doxycycline or macrolides e.g. azithromycin
Partner notification
Complications of chlamydia
Infertility
PID
Ectopic pregnancy
What % of women have GBS?
20%
Who does not get treated for GBS?
Non pregnant women
Early pregnancy
Effects of GBS on baby
Neonatal sepsis
Neonatal meningitis
Treatment of GBS
IV Benpen
If allergic - vancomycin or clindamycin
Causes of vaginal discharge
Thrush
Gonorrhoea
Bacterial vaginosis
Where is Staph A normally found?
As a normal commensal on the skin, nose and groin
What can staph A normally cause infections of?
Skin and soft tissue infections
Infective endocarditis
Prosthetic limb infections
What is MRSA?
When staph A is resistant to flucloxacillin
What does Staph A produce
Penicillinase
What is used to assess the severity of pneumonia?
CURB65
Treatment of community acquired pneumonia
Amoxicillin
Test for legionella
Antigen in the urine
What are the most common contaminants of blood cultures?
Staphylococcus epidermidis and other coag -ve staphs
What condition/infection can strep oralis cause?
IE
What does IE stand for?
Infective endocarditis
What can EColi 0157 result in?
HUS
Causes of gastroenteritis
Campylobacter
Shigella
Ecoli 0157
Salmonella
Causative organism of pneumonia following influenzas
Staph Areus
Causative organism of community acquired pneumonia
Strep pneumonia EE
Treatment of lower urinary tract infection
Trimethoprim
Nitrofurantoin
Treatment of acute pyelonephritis
Broad spec cephalosporin or quinolone
Treatment of dental abscess
Amoxicillin
Treatment of cellulitis near the nose / eyes
Co amoxiclav
Feature of legionella pneumophilia
Deranged LFTs
1st line Tx for severe otitis external
Flucloxacillin
Treatment of cellulitis
Flucloxacillin
Causative organism of exacerbation of bronchiectasis
Haemophilus influenzae
Treatment of infective exacerbations of chronic bronchitis
Amoxicillin OR
Tetracycline OR
Clarity romp in
What kind of bacteria is neiserria meningitis?
Gram -ve cocci
Treatment of throat infections requiring Ax
Phenoxymethylpenicillin
Treatment of hospital acquired pneumonia which presents within 5 days of admission
Co amoxiclav or cefuroxamine
Treatment of hospital acquired pneumonia after 5 days
Piperacillin and tazobactam OR
Broad spec cephalosporin (e.g. ceftazime) OR
Quinolone (e.g. ciprofloxacin)
Treatment of acute prostatitis
Quinolone or trimethoprim
Treatment of animal or human bite
Co amoxiclav
Treatment of mastitis due to breastfeeding
Flucloxacillin
Treatment of sinusitis
Amoxicillin or doxycycline or erythromycin
Treatment of otitis media
Amoxicillin
What kind of bacteria are staph, strep and enterococcus?
Gram +ve cocci
Association of mycoplasma pneumoniae
Haemolytic anaemia
Treatment of pneumoniae caused by atypical pathogens
Clarithromycin
Who is Kleibsiella pneumonia typically seen in?
Alcoholics
Presentation of pneumococcal pneumoniae
Rapid onset
High fever
Pleuritic chest pain
Herpes labialise
What lymphadenopathy can be seen in rubella?
Suboccipital and post auricular lymphadenopathy
What may occur before campylobacter infection?
Flu like prodrome
What may a campylobacter infection mimic?
Appendicitis
Treatment of bacterial vagi no’s is
Oral or topical metronidazole or topical clindamycin
What type of syphillis would a painless ulcer indicate?
Primary
Treatment of non gonococcal urethritis
Doxycycline or azithromycin
What type of syphillis does an ascending aortic aneurysm indicate?
Tertiary
Treatment of syphillis
Benpen
Complication of Lyme disease of the heart
Heart block
What causes diptheria?
Corynebacterium diptheriae
Presentation of diptheria
Diptheric membrane on tonsils Necrosis of myocardial, neural and renal tissue Sore throat Bulky cervical lymphadenopathy Neuritis e.g. CNS Heart block
What may be present in the history to point towards diptheria?
Recent visitations to Eastern Europe / Russia / Asia
Features of congenital syphillis
Blunted upper incisor teeth (Hutchison’s teeth), mulberry molars
Rhagades (linear scars at angels of mouth)
Keratitis
Sabers shins
Saddle nose
Deafness
Treatment of early Lyme disease
Doxycycline
Treatment of trichomonas vaginalis
Metronidazole
Another name for slap cheek
Erythema infectious
Causative organism for Lyme disease
Borrelia burgdorferi
Test for Lyme disease
ELISA Abs to borrelia burgdorferi
What does LGV stand for?
Lymphogranuloma venereum
What causes LGV?
Chlamydia trochamitis
Stags of LGV
- Small painless pustule which later forms an ulcer
- Painful inguinal lymphadenopathy
- Proctocolitis
Treatment of LGV
Doxycycline
What does PJP stain with?
Silver stain
S/Es of amphotericin b
Nephrotoxicity
What is bacterial vaginosis?
An overgrowth of predominately anaerobic organisms such as Gardnerella vaginallis
Results in decreased lactic acid production producing aerobic lactobacilli resulting in increased vaginal pH
Who is bacterial vaginosis seen in?
Sexually active women
Presentation of bacterial vaginosis
Discharge - fishy, offensive
Asymptomatic in 50%
Amsels criteria for bacterial vaginosis
- Thin white homogenous discharge
- Clue cells on microscopy (stippled vaginal epithelial cells)
- Vaginal pH > 4.5
- +ve whiff test
Treatment for bacterial vaginsosis
Oral metronidazole 5 - 7 days
Relapse rate for BV
> 50% within 3 months
Risks of BV in pregnancy
Increased risk of preterm labour, low birth weight, chorioamniotis, late miscarriage
Treatment of PID
Oral ofloxacin + oral metronidazole + IM ceftrixazone
OR
Oral doxycycline and oral metronidazole
What kind of infection is trichomonas vaginalis?
STI caused by a parasite
Presentation of TV
Vaginal discharge - offensive, yellow, green, frothy
Vulvovaginitis
Strawberry cervix
Ph > 4.5
Asymptomatic in men but can cause urethritis
Investigation for tv
Microscopy of wet mount - motile trophozoites
Treatment of TV
Metronidazole 5-7 days or one off dose metronidazole 2g
What causes cat scratch disease?
Bartonella henselae
Causative organism of Chagas’ disease
Trypanosome cruzi
Presentation of Chagas’ disease
Dilated cardiomyopathy
Megaoesophagus
Mega colon
Pathology of gas gangrene
Life threatening bacterial infection causing gangrene that can cause muscle necrosis, sepsis, gas production and death
Causative organism of gas gangrene
Clostridium perfringes
Causes of gas gangrene
Traumatic / surgical inoculation of a wound with bacteria
Sponataneous often seen in immunosuppressive
Presentation of gas gangrene
Pain
Then systemic features (fever, dehydration)
Progressing to skin changes - often blisters which can burst producing foul smelling discharge
Often creptitus can be heard on movement
What is mycoplasma pneumoniae?
Atypical pneumoniae that typically occurs in younger patients
Presentation of mycoplasma pneumoniae
Prolonged and gradual onset
Flu like symptom preceding a dry cough
Bilateral consolidation on X-RAY
Investigations of mycoplasma pnunemoniae
Mycoplasma serology
+ve cold agglutination test
Complications of mycoplasma pneumoniae
Erythema multiforme Cold autoimmune haemolytic anaemia Meningoencephalitis Guillian barre syndrome Bulbous myringitis Pericarditis/myocarditis Hepatitis Pancreatitis Acute GN
Treatment of mycoplasma pneumoniae
Doxycycline or macrolide e.g. (erythromycin / clarithromycin)
Treatment of legionella
Clarithromycin
Treatment for MRSA
Nasal mupirocin and chlorhexidine for the skin
What is leprosy?
Granulomatous disease primarily affecting the peripheral nerves and skin
Causative organism of leprosy
Mycobacterium leprae
Presentation of leprosy
Patches of hypopigmented skin typically affecting buttocks, face and extensor surfaces of limbs
What determines what type of leprosy a patient will develop?
The degree of cell mediated immunity
Treatment of leprosy
3x therapy; Rifampicin, dapsone and clofazimine
Investigation for both chlamydia and gonorrhoea
NAATs
Treatment for atypical pneumonia
Clarithromycin
Very common organism causing LRTI in CF patients
Pseudomonas aeurginosa
What can mycoplasma cause?
Immune mediated neurological diseases
