Ch 30: Common Problems in Infectious Diseases & Antimicrobial Therapy

Question 1

What is the usual microorganism involved and what is the standard antibiotic coverage for a patient with purulent meningitis of unknown cause between age 18 and 50?

Answer 1

Streptococcus pneumoniae, Neisseria meningitidis

Vancomycin, ceftriaxone

Question 2

What is the usual microorganism involved and what is the standard antibiotic coverage for a patient with purulent meningitis of unknown cause over age 50?

Answer 2

S pneumoniae, N meningitidis, Listeria monocytogenes, gram-negative bacilli, group B streptococcus

Vancomycin, ampicillin, ceftriaxone

Question 3

What is the usual microorganism involved and what is the standard antibiotic coverage for a patient with purulent meningitis of unknown cause who has impaired cellular immunity?

Answer 3

L monocytogenes, gram-negative bacilli, S pneumoniae

Vancomycin, ampicillin, cefepime

Question 4

What is the usual microorganism involved and what is the standard antibiotic coverage for a patient with purulent meningitis of unknown cause who is post surgical or post traumatic?

Answer 4

Staphylococcus aureus, S pneumoniae, aerobic gram-negative bacilli, coagulase-negative staphylococci, diphtheroids (eg, Propionibacterium acnes; uncommon)

Vancomycin, cefepime

Question 5

The most common form of localized infection causing a fever of unknown origin (FUO) is an _____ _____.

Answer 5

occult abscess

p. 1288

Question 6

Which two cancers classically present as a fever of unknown origin?

Answer 6

leukemia and lymphoma

Question 7

A contaminating organism in an immunocompetent individual may be a _____ in an immunocompromised one.

Answer 7

pathogen

p. 1289

Question 8

In immunocompromised patients, cultures must be interpreted with caution, and isolates shouldn’t be disregarded as ______.

Answer 8

contaminants

Question 9

Hypogammaglobulinemia can occur in _____ _____, chronic lymphocytic leukemia, small lymphocyte lymphoma, and in patients who have undergone _____.

Answer 9

multiple myeloma

splenectomy

(p. 1290)

Question 10

Patients with ineffective humoral immunity lack opsonizing antibodies and are at particular risk for infection with encapsulated organisms.
Name three of those encapsulated organisms.

Answer 10

Haemophilus influenzae
Neisseria meningitides
Streptococcus pneumoniae

Question 11

Name 4 bacterial organisms that replicate intracellularly.

Answer 11

Listeria
Legionella
Salmonella
Mycobacterium

(p. 1290)