Diphtheria, Mumps, Pneumococcal infections, Meningococcal infection, H. Influenzae infection Flashcards
1
Q
Diphtheria
A
- Toxigenic and non-toxigenic
- Toxin is produced only when infected with a bacteriophage that integrates the toxin-encoding genetic elements into the bacteria
2
Q
Diphtheria
- incubation period
- characteristics
- treatment
- prevention
A
- 2-5 days (range, 1-10 days)
- may involve any mucous membrane, grey patch forms in the throat
- Diphtheria anti-toxin (effective in early stages of the disease), antibiotics – Metronidazole, Macrolides, Procaine, Penicillin G
- vaccination – Diphtheria toxoid
3
Q
Mumps
A
- Humans are the only natural hosts
* Systemic viral infection affecting different organs –> meningitis, parotitis, pancreatitis, orchitis
4
Q
Mumps
- diagnosis
- treatment
- prevention
A
- based on clinical symptoms, history of vaccination should be taken into account
- no specific treatment, only symptomatic
- vaccination
5
Q
Pneumococcal infections
- leading cause of…
- source of infection
- route of infection
- more common in which age
A
- Leading cause of acute otitis, community acquired pneumonia, bacteremia, meningitis –> S. pneumoniae
- sick person or carrier
- respiratory droplets
- More common in children under 2 years of age and older than 65 years of age
*** Common asymptomatic resident of the human nasopharynx –> part of normal bacterial flora
6
Q
Pneumococcal infections
-risk factors (9)
A
all children under 2 years, children attending day care centers, chronic lung/heart/liver/kidney diseases, diabetes, immunodeficiency, asplenia or splenic dysfunction, cochlear implants, CSF leaks, children of certain races or ethnic groups
7
Q
Pneumococcal infections - Acute otitis media
- most common cause
- symptoms
- treatment
A
often as a complication of upper respiratory tract infection.
- S. pneumoniae
- fever, irritable, trouble sleeping, poor feeding, ear pulling, otalgia, discharges from ear, hearing loss
- Amoxicillin
8
Q
Pneumococcal infections - Community acquired pneumonia
- most common cause
- symptoms
- treatment
A
- S. pneumonia
- acute onset, fever, cough, tachypnea, intoxication, general malaise, chest pain, abdominal pain, headache
- Amoxicillin (non-severe), Benzylpenicillin IV (severe)
9
Q
Pneumococcal infections - Pneumococcal meningitis
- most common cause
- symptoms
- treatment
A
- S. pneumonia
- fever, headache, photophobia, loss of appetite, vomiting, irritability, seizures, meningeal symptoms, bulging fontanelle
- III generation cephalosporins, glucocorticoids at the beginning
10
Q
Pneumococcal infections
- diagnosis
- prophylaxis
A
- Labs: blood count, CRP, CSF analysis, bacterial culture, PCR
- Other tests: otoscopy, chest X-ray, etc. - vaccine
11
Q
Meningococcal infection
- virulence factor
- route of infection
- source of infection
- incubation period
- pathogenesis
A
- capsule
- respiratory droplets/ secretions
- humans
- 1-10 days (most commonly 4d.)
- defect in the complement system
12
Q
Meningococcal infection
-clinical forms
A
-Most dangerous are asymptomatic carriers –> young people up to 24 years old
- Invasive: nasopharyngeal colonization (asymptomatic carriers), acute nasopharyngitis
- Noninvasive: meningococcemia, meningitis, meningococcemia and meningitis
13
Q
Meningococcal infection
- diagnosis
- prevention
- treatment
- chemoprophylaxis
A
- Blood count, CRP, bacterial culture, blood culture
- Optimal period for taking blood for blood culture –> before starting antibiotics, beginning of fever period - vaccination
- antibiotics – 7 days
- Ceftriaxone 80mg/kg x 1d. i/v
- Cefotaxime 50 mg/kg every 6h, if younger <3months
* **Person shall be isolated for up to 24h counting from the beginning of antibiotic therapy (later no longer contagious to others) - Should be started as soon as possible, no longer than 7 days after contact
- Ceftriaxone and Ciprofloxacin
14
Q
Meningococcal infection
-symptoms
A
- Waterhouse-Friedrichsen syndrome: massive adrenal hemorrhage. Clinical features are fever, septic shock, DIC, hemorrhage in the skin and mucous membranes
- Hemorrhagic rash:
- Glass test – when the skin is pressed with the glass, the hemorrhagic rash does not disappear and remains visible through the glass - Fulminant meningococcal septicemia: sudden/acute onset, progresses within hours, development of shock, hemorrhagic rash, coagulation disorders, adrenal, renal and cardiac failure, coma, death
- Meningitis: Stiff neck, Brudzinski’s sign, Kernig sign, Floppy baby
- Fever and/or vomiting, severe headache, rash (anywhere), sleepy, difficult to wake, confused, seizures
- Bulging fontanel, refusing to eat, irritable when lifted, high-pitched moaning and crying
15
Q
H. influenzae
- which serotype causes most of invasive clinical forms?
- route of infection
- source of infection
- most common age
- seasonality
A
1 Serotype B
- respiratory droplets
- sick or healthy person (carrier)
- 4-6 months, 5-7 years
- spring and autumn
***Make up the normal microbial flora of the human respiratory tract
16
Q
H. influenzae
- risk factors
- pathogenesis
- differential diagnosis
A
- younger than 5 y.o, immunodeficiency, chronic diseases, attending day care, artificial feeding of infants, acute viral respiratory infections
- polysaccharide capsule, outer membrane (proteins and lipooligosaccharides), IgA protease
- Meningitis – most common cause in children
- Epiglottis – 4D (dysphagia, dyspnea, dysphonia, drooling), neck pain, sore throat, sudden onset, febrile fever, upper respiratory tract obstruction
- Pneumonia
- Bacteremia
17
Q
H. influenzae
1, diagnosis
2. treatment
3. prevention
A
- blood count, CRP, serology, blood culture, PCR, imaging tests
- Amoxicillin (if beta lactamase is not produced), II or III generation cephalosporins
- Meningitis: III generation cephalosporins 10d. and glucocorticoids
- Epiglottis: III generation cephalosporins 10-14d.
- Acute otitis media, pneumonia: amoxicillin, aminopenicillin with a beta lactamase inhibitor or II generation cephalosporins for 5-10d. - vaccine
