Bacterial infections II - anaerobes Flashcards
g+ anaerobic infections
- actinomyces
- peptostreptococcus
- propionibacterium
- clostridia
what g+ anaerobe is most common with H&N infections, intra-abd infections, and aspiration pneumonia
actinomyces
what g+ anaerobe is most common in oral infections
peptostreptococcus
what g+ anaerobe is most common in foreign body infections
propionibacterium
presentation of anaerobic infections
- abscess with tissue necrosis
- suppurative/purulent
- foul odor
usually invades deep organ/tissues
general tx for anaerobic infections
based on mixed anaerobic infection!
1. drainage and debridement!!
-fistula tract excision
abx for oral/throat/neck G+ anaerobic infection? G-?
- G+
- clinda
- Amoxicillin / Clavulanic acid (augmentin)
- Ampicillin / Sulbactam (unasyn) - G-
- clinda
- metronidazole
3 abx for GI/pelvic anaerobic g+ infection
- moxifloxacin
- ertapenem or ceftriaxone PLUS etronidazole (mod/severe)
- imipenem (severe)
3 abx for lung anaerobic abscess
- ampicillin-sulbactam (unasyn)
- carbapenem
- clinda
abx for lung anaerobic aspiration
+ outpatient
- augmentin or doxy
+ inpatient
1. amp-sulbactam (unaysn)
2. metronidazole + amoxil/Pen G
what abx is given for dental procedure prophylaxis
PCN or amoxicillin
what abx is given for dental and minor procedures for endocarditis prophylaxis
amoxicillin
what abx are given for colorectal surgery prophylaxis
- metronidazole + 2/3gen cephalo or Cipro
- carbapenems
what is the most common species that causes clostridial soft tissue infections
C. perfringens
- cellulitis
- myositis
- gas gangrene
tissue creptius is commonly seen in?
clostridial soft tissue infection
what makes clostridia cultures different from other anaerobes?
rapid producers - cultures can be positive in 6hrs
tx for clostridial soft tissue infection
- drainage and debridement
- pip/taz + clinda to cover strep and clostridium; then change to PCN + clinda if only clostridia
- hyperbaric treatment
s/s of c. perfringens gastroenteritis
MILD gastroenteritis - fever and vomiting is unusual
self-limiting (24h)
what disease is caused by spores entering a wound and travels to peripheral nerve endings, causing muscle stimulation
tetanus
7 clinical presentations of tetanus
- jaw stiffness
- difficulty swallowing
- stiff neck, arms, and/or legs
- HA
- tonic muscle spasms
- difficulty opening jaw (trismus)
- rsp failure due to spasm of diaphragm/laryngeal spasm
tx for tetanus
tetanus immune globulin (HTIG) IM within 24 HRS OF PRESENTATION
full series of tetanus vaccine
PCN or metronidazole
Supportive care - rsp, msk
wound debridement
what are the effects/complications of botulism
NS - dry mouth, slurred speech, dysphagia
blurred vision, drooping eyelids
progressively worsening neurologic symptoms
Rsp failure (major complication)
tx for botulism
antitoxin - from CDC
supportive care
- rsp care - endotracheal tube
- GI/nutrition care - NG tube
PCN G or metronidazole (wound)
common presentation of C. difficle
diarrhea - frequent, watery, sometimes bloody
N/V RARE
How do you diagnose C. diff
stool sample
- leukocytes present
tx for C. diff
fidaxomicin, vancomycin
(mild to severe)
4 g- anaerobic infections
- bacteroides
- fusobacterium
- porphyromonas
- prevotella
abx for g- GI/pelvic abscess
extended spectrum PCNs
- pip/taz
- carbapenems
- metronidazole + cephalo
what is the most common cause of vaginal discharge
bacterial vaginosis
what anaerobe is most prevalent for bacterial vaginosis
gardnerella
presentation and diagnosis of BV
- thin, off-white/grayish vaginal discharge
- fishy smell
…. - elevated pH
- clue cells present
- positive KOH (whiff test)
3 tx for BV
- metronidazole
- clinda
- tinidazole (not common)
oral preferred!!!
