Diseases Exam 4 Flashcards
Causative Organism(s) for MARS Skin and Soft-Tissue Infection
Methicillin-resistant Staphylococcus aureus
Most Common Modes of Transmission for MRSA Skin and Soft-Tissue Infection
Direct contact, indirect contact
Virulence Factors for MRSA Skin and Soft-Tissue Infection
Coagulase, other enzymes, superantigens
Culture/Diagnosis for MRSA Skin and Soft-Tissue Infection
PCR, culture and Gram stain, coagulase and catalase tests, multitest systems, MSA
Prevention for MRSA Skin and Soft-Tissue Infection
Hygiene practices
Treatment for MRSA Skin and Soft-Tissue Infection
Clindamycin + TMP/SMZ; in Serious Threat category in CDC Antibiotic Resistance Report
EpidemiologyL for MRSA Skin and Soft-Tissue Infection
Community-associated MRSA infections most commonin children and young to middle-aged adultsIncidence increasing in communities (decreasing in hospitals)
Causative Organism(s) for Measles (Rubeola)
Measles virus
Most common modes of transmission for Measles (Rubeola)
Droplet contact
Virulence factors for Measles (Rubeola)
Syncytium formation, ability to suppress CMI
Culture/Diagnosis for Measles (Rubeola)
ELISA for IgM, acute/convalescent IgG
Prevention for Measles (Rubeola)
Live attenuated vaccine (MMR or MMRV)
Treatment Measles (Rubeola)
No antivirals; vitamin A, antibiotics for secondary bacterial infections
Distinguishing Features of the Rashes Measles (Rubeola)
Starts on head, spreads to whole body, lasts over a week
Epidemiological features for measles (Rubeola)
Incidence increasing in North America; in developing countries incidence is 30 million cases/yr and 1million deaths
Causative Organism(s) for Rubella
Rubella virus
Most common modes of transmission for Rubella
Droplet contact
Virulence factors for Rubella
In fetuses; inhibition of mitosis, induction of apoptosis, and damage to vascular endothelium
Culture/Diagnosis for Rubella
Acute IgM, acute/convalescent IgG
Prevention for Rubella
Live attenuated vaccine (MME or MMRV)
Treatment for Rubella
none
Distinguishing feature of the rashes for Rubella
Milder red rash, lasts approximately 3 days
Epidemiological features for Rubella
3 cases reported in United States in 2009; worldwide: 100,000 infants/yr born with congenital rubella syndrome
Causative organism(s) for Fifth Disease
Parvovirus B19
Most common modes of transmission for Fifths Disease
Droplet contact, direct contact
Virulence Factor for Fifth Disease
none
Culture/Diagnosis for Fifth Disease
Usually diagnosed clinically
Prevention for Fifth Disease
none
Treatment for Fifth Disease
none
Distinguishing features of the rashes for Fifth Disease
“Slapped-face” rash first, spreads to limbs and trunk, tends to be confluent rather than distinct bumps
Epidemiological feature for Fifth Disease
60% of population seropositive by age 20
Causative organism(s) for Roseola
Human herpesvirus 6
Most common modes of transmission for Roseola
Unknown
Virulence factors for Roseola
Ability to remain latent
Culture/Diagnosis for Roseola
Usually diagnosed clinically
Prevention for Roseola
none
Treatment for Roseola
none
Distinguishing features of the Rashes for Roseola
High fever precedes rash stage; rash not always present
Epidemiological feature for Roseola
> 90% seropositive, 90% of disease cases occur before age of 2
Causative Organism(s) for Impetigo- S. aureus
Staphylococcus aureus
Most Common Modes of Transmission for Impetigo- S. aureus
Direct contact, indirect contact
Virulence Factors for
Impetigo- S. aureus
Exfoliative toxin A, coagulase, other enzymes
Culture/Diagnosis for Impetigo- S. aureus
Routinely based on clinical signs, when necessary, culture and Gram stain, coagulase and catalase tests, multitest systems, PCR
Prevention for Impetigo- S. aureus
Hygiene practices
Treatment for Impetigo- S. aureus
Topical mupirocin or retapamulin, oral dicloxacillin, cephalexin, or TMP-SMZ; (MRSA is in Serious Threat category in CDC Antibiotic Resistance Report)
Distinguishing Features for
Impetigo- S. aureus
Seen more often in older children, adults
Epidemiological Features for
Impetigo- S. aureus
Prevalence approximately 1% of children in North America
Causative Organism(s) forImpetigo- S. pyogenes
Streptococcus pyogenes
Most Common Modes of Transmission for Impetigo- S. pyogenes
Direct contact, indirect contact
Virulence Factors for Impetigo-S. pyogenes
Streptokinase, plasminogen-binding ability, hyaluronidase, M protein
Culture/Diagnosis for
Impetigo- S. pyogenes
Routinely based on clinical signs, when necessary, culture and Gram stain, coagulase and catalase tests, multitest systems, PCR
Prevention for Impetigo- S. pyogenes
Hygiene practices
Treatment for Impetigo- S. pyogenes
Topical mupirocin or retapamulin
Distinguishing Features for Impetigo- S. pyogenes
Seen more often in newborns
Causative Organism(s) for Vesicular/Pustular Rash Diseases- Chickenpox
Human herpesvirus 3 (varicella-zoster virus)
Most Common Modes of Transmission for Vesicular/Pustular Rash Diseases- Chickenpox
Droplet contact, inhalation of aerosolized lesion fluid
Virulence Factors for Vesicular/Pustular Rash Diseases- Chickenpox
Ability to fuse cells, ability to remain latent in ganglia
Culture/Diagnosis for Vesicular/Pustular Rash Diseases- Chickenpox
Based largely on clinical appearance
Prevention for Vesicular/Pustular Rash Diseases- Chickenpox
Live attenuated vaccine; there is also vaccine to prevent reactivation of latent virus (shingles)
Treatment for Vesicular/Pustular Rash Diseases- Chickenpox
None in uncomplicated cases; acyclovir for high risk
Distinguishing Features for Vesicular/Pustular Rash Diseases- Chickenpox
No fever prodrome; lesions are superficial; in centripetal distribution (more in center of body)
Epidemiological Features for Vesicular/Pustular Rash Diseases- Chickenpox
Chickenpox: vaccine decreased hospital visits by 88%, ambulatory visits by 59%; shingles: 1 million cases annually
Causative Organism(s) for Vesicular/Pustular Rash Diseases- Smallpox
Variola virus
Most Common Modes of Transmission for Vesicular/Pustular Rash Diseases- Smallpox
Droplet contact, indirect contact
Virulence Factors for Vesicular/Pustular Rash Diseases- Smallpox
Ability to dampen, avoid immune response
Culture/Diagnosis for Vesicular/Pustular Rash Diseases- Smallpox
Based largely on clinical appearance
Prevention for Vesicular/Pustular Rash Diseases- Smallpox
Live virus vaccine (vaccinia virus)
Treatment for Vesicular/Pustular Rash Diseases- Smallpox
Cidofovir, immune globulin
Distinguishing Features for Vesicular/Pustular Rash Diseases- Smallpox
Fever precedes rash, lesions are deep and in centrifugal distribution (more on extremities)
Epidemiological Features for Vesicular/Pustular Rash Diseases- Smallpox
Last natural case worldwide was in 1977
Causative Organism(s) for Conjunctivitis- Neonatal Conjunctivitis
Chlamydia trachomatis or Neisseria gonorrhoeae
Most Common Modes of Transmission for Conjunctivitis- Neonatal Conjunctivitis
Vertical
Virulence Factors for Conjunctivitis- Neonatal Conjunctivitis, Bacterial Conjunctivitis, Viral Conjunctivitis
None
Culture/Diagnosis for Conjunctivitis- Neonatal Conjunctivitis
Gram stain and culture
Prevention for Conjunctivitis- Neonatal Conjunctivitis
Screen mothers, apply antibiotic or silver nitrate to newborn eyes
Treatment for Conjunctivitis- Neonatal Conjunctivitis
Topical and oral antibiotics; (antibiotic-resistant N. gonorrhoeae is in Urgent Threat category in CDC Antibiotic Resistance Report)
Gatifloxacin or levofloxacin ophthalmic solution
Distinguishing Features for Conjunctivitis- Neonatal Conjunctivitis
In babies <28 days old
Epidemiological Features for Conjunctivitis- Neonatal Conjunctivitis
Less than 0.5% in developed world; higher incidence in developing world
Causative Organism(s) for Conjunctivitis- Bacterial Conjunctivitis
Streptococcus pneumoniae, Staphylococcus epidermidis, Staphylococcus aureus, Haemophilus influenzae, Moraxella, and also Neisseria gonorrhoeae, Chlamydia trachomatis
Most Common Modes of Transmission for Conjunctivitis-
Bacterial Conjunctivitis
Direct, indirect contact
Culture/Diagnosis for Conjunctivitis-
Bacterial Conjunctivitis
Clinical diagnosis
Prevention for Conjunctivitis-
Bacterial Conjunctivitis
Hygiene
Treatment for Conjunctivitis-
Bacterial Conjunctivitis
Gatifloxacin or levofloxacin ophthalmic solution
Distinguishing Features for Conjunctivitis-
Bacterial Conjunctivitis
Mucopurulent discharge
Epidemiological Features for Conjunctivitis-
Bacterial Conjunctivitis
More common in children
Causative Organism(s) for Conjunctivitis- Viral Conjunctivitis
Adenoviruses and others
Most Common Modes of Transmission for Conjunctivitis-
Viral Conjunctivitis
Direct, indirect contact
Culture/Diagnosis for Conjunctivitis-
Viral Conjunctivitis
Clinical diagnosis
Prevention for Conjunctivitis-
Viral Conjunctivitis
Hygiene
Treatment for Conjunctivitis-
Viral Conjunctivitis
None, although antibiotics often given because type of infection not distinguished
Distinguishing Features for Conjunctivitis-
Viral Conjunctivitis
Serous (clear) discharge
Epidemiological Features for Conjunctivitis-
Viral Conjunctivitis
More common in adults
Causative Organism(s) for Meningitis
Neisseria meningitidis
Streptococcus pneumoniae
Haemophilus influenzae
Most Common Modes of Transmission for Meningitis-Neisseria meningitidis
Droplet contact
Virulence Factors for Meningitis-Neisseria meningitidis
Capsule, endotoxin, IgA protease
Culture/Diagnosis for Meningitis-Neisseria meningitidis
Gram stain/culture of CSF, blood, rapid antigenic tests, oxidase test
Prevention for Meningitis-Neisseria meningitidis
Conjugated vaccine; ciprofloxacin, rifampin, or ceftriaxone used to protect contacts
Treatment for Meningitis-Neisseria meningitidis
Ceftriaxone, aztreonam, chloramphenicol
Distinctive Features for Meningitis-Neisseria meningitidis
Petechiae, meningococcemia rapid decline
Epidemiological Features for Meningitis-Neisseria meningitidis
United States: 0.9–1.5 cases per 100,000 annually; meningitis belt: 1,000 cases per 100,000 annually
Most Common Modes of Transmission for Meningitis-Streptococcus pneumoniae
Droplet contact
Virulence Factors for Meningitis- Streptococcus pneumoniae
Capsule, induction of apoptosis, hemolysin and hydrogen peroxide production
Culture/Diagnosis for Meningitis- Streptococcus pneumoniae
Gram stain/culture of CSF
Prevention for Meningitis- Streptococcus pneumoniae
Two vaccines: PCV13 (children and adults), and PPSV23 (adults)
Distinctive Features for Meningitis- Streptococcus pneumoniae
Serious, acute, most common meningitis in adults
Treatment for Meningitis- Streptococcus pneumoniae
Vancomycin + ceftriaxone; in “Serious Threat” category in CDC Antibiotic Resistance Report
Epidemiological Features for Meningitis- Streptococcus pneumoniae
U.S. incidence before vaccine for children: 7.7 hospitalizations per 100,000. After vaccine for children: 2.6 per 100,000
Most Common Modes of Transmission for Meningitis-Haemophilus influenzae
Droplet contact
Virulence Factors for Meningitis-Haemophilus influenzae
Capsule
Culture/Diagnosis for Meningitis-Haemophilus influenzae
Culture on chocolate agar
Prevention for Meningitis-Haemophilus influenzae
Hib vaccine, ciprofloxacin, rifampin, or ceftriaxone
Treatment for Meningitis-Haemophilus influenzae
Ceftriaxone
Distinctive Features for Meningitis-Haemophilus influenzae
Serious, acute, less common since vaccine became available
Epidemiological Features for Meningitis-Haemophilus influenzae
Before vaccine, 300,000– 400,000 deaths worldwide per year
Causative Organism(s) for Meningitis #2
- Listeria monocytogenes
- Cryptococcus neoformans
- Coccidioides immitis
- Virus
Most Common Modes of Transmission for Meningitis-Listeria monocytogenes
Vehicle (food)
Virulence Factors for Meningitis-Listeria monocytogenes
Intracellular growth
Culture/Diagnosis for Meningitis-Listeria monocytogenes
Cold enrichment, rapid methods
Prevention for Meningitis-Listeria monocytogenes
Cooking food, avoiding unpasteurized dairy products
Treatment for Meningitis-Listeria monocytogenes
Ampicillin, trimethoprim- sulfamethoxazole
Distinctive Features for Meningitis-Listeria monocytogenes
Asymptomatic in healthy adults; meningitis in neonates, elderly, and immunocompromised
Epidemiological Features for Meningitis- Listeria monocytogenes
Mortality can be as much as 33%
Most Common Modes of Transmission for Meningitis–Cryptococcus neoformans
Vehicle (air, dust)
Virulence Factors for Meningitis–Cryptococcus neoformans
Capsule, melanin production
Culture/Diagnosis for Meningitis–Cryptococcus neoformans
Negative staining, biochemical tests, DNA probes, cryptococcal antigen test
Prevention for Meningitis–Cryptococcus neoformans
none
Treatment for Meningitis–Cryptococcus neoformans
Amphotericin B and fluconazole
Distinctive Features for Meningitis–Cryptococcus neoformans
Acute or chronic, most common in AIDS patients
Epidemiological Features for Meningitis–Cryptococcus neoformans
Incidence before AIDS: >1 case per million per year; 66 cases per year in pre-HAART era; worldwide: 1 million new cases per year
Most Common Modes of Transmission for Meningitis-Coccidioides immitis
Vehicle (air, dust, soil)
Virulence Factors for Meningitis- Coccidioides immitis
Granuloma (spherule) formation
Culture/Diagnosis for Meningitis- Coccidioides immitis
Identification of spherules, cultivation on Sabouraud’s agar
Prevention for Meningitis- Coccidioides immitis
Avoiding airborne endospores
Treatment for Meningitis- Coccidioides immitis
Amphotericin B or oral or IV itraconazole
Distinctive Features for Meningitis- Coccidioides immitis
Almost exclusively in endemic regions
Epidemiological Features for Meningitis- Coccidioides immitis
Incidence in endemic areas: 200–300 annually
Most Common Modes of Transmission for Meningitis-Viruses
Droplet contact
Virulence Factors for Meningitis-Viruses
Lytic infection of host cells
Culture/Diagnosis for Meningitis-Viruses
Initially, absence of bacteria/fungi/ protozoa, followed by viral culture or antigen tests
Prevention for Meningitis-Viruses
none
Treatment for Meningitis-Viruses
Usually none (unless specific virus identified and specific antiviral exists)
Distinctive Features for Meningitis-Viruses
Generally milder than bacterial or fungal
Epidemiological Features for Meningitis-Viruses
In United States, 4 of 5 meningitis cases caused by viruses: 26,000– 42,000 hospitalizations/year