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Infectious Disease > Bacterial Infections II > Flashcards

Bacterial Infections II Flashcards

1
Q

Actinomyces
Clostridia
Peptostreptococcus
Propionibacterium
Are all considered gram +/-

A

Gram +

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2
Q

Bacteroides
Fusobacterium
Prevotella
Porphyromonas
Are all considered gram +/-

A

Gram -

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3
Q

_____ are common in head and neck infections

A

Actinomyces (Actinomycosis)

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4
Q

____ and ____ are common in intra-abdominal infections

A

Actinomyces (Actinomycosis)
Peptostreptococcus

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5
Q

_____ are common in aspiration pneumonia

A

Actinomyces (Actinomycosis)

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6
Q

_____ are common in oral infections

A

Peptostreptococcus

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7
Q

_____ are common in foreign body infections

A

Propionibacterium

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8
Q

-Abscess formation with tissue necrosis

-Suppurative/purulent

-Foul odor of pus or infected tissue

Site of infection typically near where anaerobic flora reside
Mouth, jaw and neck (from dental roots)
Abdomen/pelvis (from GI tract)
Lungs (from aspiration)

Often polymicrobial

A

Gram + and - anaerobic infection

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9
Q

Gram + anaerobic infections that show air fluid levels within circumscribed infiltrate = _____

What is the dx?

A

lung abscess

aspiration pneumonia

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10
Q

How do you diagnosis a gram + anaerobic infection?

A

clinical suspicion

gram stain

culture

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11
Q

What is the treatment for Gram + Anaerobic Infections?

A

drainage and debridement

abx based on the site

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12
Q

What abx do you give for Gram + Anaerobic Infections around the oral/throat/neck?

A

clindamycin
Augmentin
Unasyn

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13
Q

What abx do you give for Gram + Anaerobic Infections around the GI/Pelvic/abscess? Give both oral and IV therapy

A

Oral therapy: moxifloxacin

IV therapy:
Mod/Severe Infection
ertapenem or ceftriaxone + metronidazole (cover for B. frag, Gram -)

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14
Q

What abx do you give for a severe Gram + Anaerobic Infections?

A

Imipenem

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15
Q

what abx do you give for a Gram + Anaerobic Infections for a lung abscess?

A

Beta-lactam plus a beta-lactam inhibitor
ampicillin-sulbactam (Unasyn)

Carbapenem (imipenem or meropenem)

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16
Q

what abx do you give for a Gram + Anaerobic Infections for a lung abscess that is allergic to beta-lactams?

A

Clindamycin

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17
Q

what abx do you give for a Gram + Anaerobic Infections for aspiration in the outpatient setting?

A

Augmentin or doxycycline

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18
Q

what abx do you give for a Gram + Anaerobic Infections for aspiration in the inpatient setting?

A

Beta-lactam plus a beta-lactam inhibitor
ampicillin-sulbactam (Unasyn)

metronidazole plus either Amoxil or pen G

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19
Q

What abx do you give prophylaxically for abscess prevention or patients with joint implants?

A

PCN or amoxicillin

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20
Q

What abx do you give for dental and minor procedures for Endocarditis prophylaxis?

A

Amoxicillin

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21
Q

What do you give prophylaxis for colorectal surgery?

A

Metronidazole (Flagyl) PLUS 2 or 3 gen cephalosporin or Cipro

Carbapenems

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22
Q

What bacteria is the most common species for clostridial soft tissue infections?

A

C. perfringens

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23
Q

_____ infections produce cellulitis, myositis, and clostridial myonecrosis (gas gangrene)?

A

C. perfringens

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24
Q

What bacterial infection causes Pain, edema, erythema, tissue crepitus (gas formation), foul smelling
Progress to shock, renal failure, possibly death

A

C. perfringens

Gastroenteritis

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25
Q

Where is C. perfringens typically found?

A

throughout the environment, usually in the soil

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26
Q

_____ are rapid producers and may be positive in 6 hrs

A

Clostridia

27
Q

Describe the Clostridial Soft Tissue Infection Treatment.

A

Drainage and debridement

Pip/taz plus clindamycin to cover strep and clostridium; then change to PCN plus clindamycin if only the later

hyperbaric therapy

28
Q

Where are C. perfringens typically found?

A

Found in feces, soil, air, water

29
Q

C. perfringens produces an _____ that can become ingested

A

enterotoxin

30
Q

Mild gastroenteritis
Watery diarrhea
Vomiting and fever unusual
Self limiting (24hrs)
Above s/s are associated with ______

A

C. perfringens

31
Q

Produces spores
Found in soil
Transmitted after injury via wound or burns
IVDU (intravenous drug use)
Above characteristics are associated with _____

A

C. tetani (Tetanus)

32
Q

Spore enters wound and travels to peripheral nerve endings
Causes muscle stimulation
Tonic spasticity
Generalized or local
Once bound, cannot be neutralized
^ is the pathophys associated with ______

A

Tetanus

33
Q

What is the incubation period of tetanus?

A

5-30 days

34
Q

What is the clinicial presentation of tetanus?

A

Jaw stiffness
difficulty swallowing
stiff neck, arms and legs
HA
Tonic muscle spasms
Trismus
Respiratory failure due to spasm of diaphragm/
laryngeal spasm

35
Q

What is trismus?

A

Difficulty of opening jaw

36
Q

How do you diagnosis tetanus?

A

clinical suspension

Cultures are NOT sensitive

37
Q

What is the treatment for tetanus?

A

Hospitalization
Supportive care
Respiratory care
Drugs for muscle spasms
Wound debridement
Tetanus immune globulin (HTIG) IM within 24 hrs of presentation
Full series of tetanus vaccine
PCN or metronidazole

38
Q

What are some common sources of Botulism?

A

Contaminated Food
Home-canned foods - most common
All types of commercial foods
Direct injection (needles) or through wound

39
Q

there are ____ different subtypes of botulism

What is the CDC classification?

A

8

CDC A

40
Q

Respiratory failure
Due to diaphragmatic paralysis
Dry mouth, slurred speech, dysphagia
Blurred vision, drooping eyelids

^ s/s of _____

A

botulism

41
Q

What is the timeframe associated with botulism? Which s/s show up first?

A

18-36 hrs after toxin ingestion

N/V/abdominal cramps precede neurologic symptoms

42
Q

Where do you culture botulism if the source was ingested? Injected?

A

stool- if ingested

wound- if injected

43
Q

What is the treatment for botulism?

A

hospitalization
supportive care: respiratory, NG tube
Antitoxin
if wound: PCN G or metronidazole

44
Q

Clostridioides and referred to as ______

A

Pseudomembranous Colitis

45
Q

C. Difficile diseases occur due to ????

A

overgrowth of organism in the colon

Most common - after antibiotic use that alters normal GI flora
Immunocompromised person who encounters organism

46
Q

Diarrhea, frequent, watery and sometimes bloody (very smelly)

Abdominal cramping, tenderness and bloating
N/V is rare

Typically begins 5-10 days after abx use, can take up to 2 months

what type of infection?

A

C. difficile - Antibiotic Associated Colitis

47
Q

What steps do you take to correctly dx C. difficile?

A

Stool sample for C. diff toxin
Fecal leukocytes present
Sigmoidoscopy
imaging: may show ileus or distended colon

48
Q

When would you order a sigmoidoscopy when dx C. diff? What would it reveal?

A

If culture is negative or nondiagnostic and high suspicion of disease

Reveals the presence of pseudomembranes

49
Q

What do you treat mild-moderate C diff with?

A

Fidaxomicin 200 mg PO BID
Vancomycin 125 mg PO QID

50
Q

What do you treat severe C diff with?

A

Vancomycin 125-500 mg PO QID
Can also do by enema (rare)
Fidaxomicin 200 mg PO BID
May add metronidazole to the above Ab

51
Q

What do you treat recurrent C diff with?

A

Fidaxomicin or vancomycin 500 mg PO q6hrs

52
Q

What do you treat resistant C diff with?

A

fecal transplant

53
Q

Of the gram - anaerobes what two are normal in oral and large bowel flora?

A

Prevotella and Fusobacterium

54
Q

______ are prevalent in intra-abdominal infections

A

Bacteroides fragilis

55
Q

Gram + and - can lead to _____ however shock is usually absent

A

bacteremia

56
Q

Gram - anaerobic infection on the oral/throat/neck region, what abx?

A

clindamycin or metronidazole

57
Q

Gram - anaerobic infection on the GI/pelvic abscess, what abx?

A

Extended spectrum PCNs
pip/taz (Zosyn) or
carbapenems or
metronidazole (Flagyl) plus cephalosporin (ex. cefepime)

58
Q

____ is the most common cause of vaginal discharge

A

bacterial vaginosis

59
Q

Gardnerella - most prevalent
Prevotella, Peptostreptococcus, Bacteroides
Mycoplasma hominis and Ureaplasma urealyticum (not anaerobes)
are all considered _______

A

polymicrobial anaerobes

60
Q

What is a risk factor of bacterial vaginosis?

A

sexual activity

61
Q

Presence of clue cells and positive whiff test indicate ____

A

bacterial vaginosis

62
Q

Thin, off-white to grayish vaginal discharge
Vaginal odor: “fishy smell”
Characteristic vaginal discharge
Elevated pH of vaginal discharge
Presence of clue cells on microscopy
Positive “whiff test”

^ all indicate _____

A

bacterial vaginosis

63
Q

What is a positive whiff test?

A
64
Q

What is the treatment for bacterial vaginosis?

A

metronidazole (Flagyl)
oral or vaginal

clindamycin (Cleocin)
oral or vaginal

tinidazole
oral

Infectious Disease (16 decks)

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