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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
Where is C. perfringens typically found?
throughout the environment, usually in the soil
26
_____ are rapid producers and may be positive in 6 hrs
Clostridia
27
Describe the Clostridial Soft Tissue Infection Treatment.
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
Where are C. perfringens typically found?
Found in feces, soil, air, water
29
C. perfringens produces an _____ that can become ingested
enterotoxin
30
Mild gastroenteritis Watery diarrhea Vomiting and fever unusual Self limiting (24hrs) Above s/s are associated with ______
C. perfringens
31
Produces spores Found in soil Transmitted after injury via wound or burns IVDU (intravenous drug use) Above characteristics are associated with _____
C. tetani (Tetanus)
32
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 ______
Tetanus
33
What is the incubation period of tetanus?
5-30 days
34
What is the clinicial presentation of tetanus?
Jaw stiffness difficulty swallowing stiff neck, arms and legs HA Tonic muscle spasms Trismus Respiratory failure due to spasm of diaphragm/ laryngeal spasm
35
What is trismus?
Difficulty of opening jaw
36
How do you diagnosis tetanus?
clinical suspension Cultures are NOT sensitive
37
What is the treatment for tetanus?
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
What are some common sources of Botulism?
Contaminated Food Home-canned foods - most common All types of commercial foods Direct injection (needles) or through wound
39
there are ____ different subtypes of botulism What is the CDC classification?
8 CDC A
40
Respiratory failure Due to diaphragmatic paralysis Dry mouth, slurred speech, dysphagia Blurred vision, drooping eyelids ^ s/s of _____
botulism
41
What is the timeframe associated with botulism? Which s/s show up first?
18-36 hrs after toxin ingestion N/V/abdominal cramps precede neurologic symptoms
42
Where do you culture botulism if the source was ingested? Injected?
stool- if ingested wound- if injected
43
What is the treatment for botulism?
hospitalization supportive care: respiratory, NG tube Antitoxin if wound: PCN G or metronidazole
44
Clostridioides and referred to as ______
Pseudomembranous Colitis
45
C. Difficile diseases occur due to ????
overgrowth of organism in the colon Most common - after antibiotic use that alters normal GI flora Immunocompromised person who encounters organism
46
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?
C. difficile - Antibiotic Associated Colitis
47
What steps do you take to correctly dx C. difficile?
Stool sample for C. diff toxin Fecal leukocytes present Sigmoidoscopy imaging: may show ileus or distended colon
48
When would you order a sigmoidoscopy when dx C. diff? What would it reveal?
If culture is negative or nondiagnostic and high suspicion of disease Reveals the presence of pseudomembranes
49
What do you treat mild-moderate C diff with?
Fidaxomicin 200 mg PO BID Vancomycin 125 mg PO QID
50
What do you treat severe C diff with?
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
What do you treat recurrent C diff with?
Fidaxomicin or vancomycin 500 mg PO q6hrs
52
What do you treat resistant C diff with?
fecal transplant
53
Of the gram - anaerobes what two are normal in oral and large bowel flora?
Prevotella and Fusobacterium
54
______ are prevalent in intra-abdominal infections
Bacteroides fragilis
55
Gram + and - can lead to _____ however shock is usually absent
bacteremia
56
Gram - anaerobic infection on the oral/throat/neck region, what abx?
clindamycin or metronidazole
57
Gram - anaerobic infection on the GI/pelvic abscess, what abx?
Extended spectrum PCNs pip/taz (Zosyn) or carbapenems or metronidazole (Flagyl) plus cephalosporin (ex. cefepime)
58
____ is the most common cause of vaginal discharge
bacterial vaginosis
59
Gardnerella - most prevalent Prevotella, Peptostreptococcus, Bacteroides Mycoplasma hominis and Ureaplasma urealyticum (not anaerobes) are all considered _______
polymicrobial anaerobes
60
What is a risk factor of bacterial vaginosis?
sexual activity
61
Presence of clue cells and positive whiff test indicate ____
bacterial vaginosis
62
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 _____
bacterial vaginosis
63
What is a positive whiff test?
64
What is the treatment for bacterial vaginosis?
metronidazole (Flagyl) oral or vaginal clindamycin (Cleocin) oral or vaginal tinidazole oral

Infectious Disease (16 decks)

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