Gram + organisms Flashcards by Kelby Pierce

Where are s. epidermis infections found?

Skin
Hospital acquired infections

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Where are s. saprophyticus infections found?

UTI

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Where are s. lugdunensis infections found?

Foreign body/prosthetic device infections

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What are the coagulase positive staphs?

S aureus

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What are the coagulase negative staphs?

S epidermis, s saprophyticus, s lugdunensis

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How do you treat staph skin infections?

Low risk MSSA:
Keflex
Dicloxacillin
High risk MRSA:
Clindamycin
Doxycycline/minocycline
Bactrim
Inpatient:
Vancomycin

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How do you treat staph osteomyelitis?

Broad: Vancomycin and 3/4 cephalosporin
MSSA: nafcillin, oxacillin, cefazolin
MRSA: vanc

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What are the causes of TSS?

Staph or GABHS
Vagina/tampon use, nasopharynx/packing, wound/abscess packing

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What is the clinical presentation of TSS?

Fs, hypotension, myalgias, N/V/D
Shedding rash on palms and soles
Hepatic damage, thrombocytopenia, confusion
Renal impairment, syncope, shock

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What is the treatment for TSS?

Admission
Vanc + clindamycin + pip/taz or cefepime or carbapenem

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What are the symptoms of scalded skin syndrome?

Widespread bullae with sloughing
fs, malaise
sepsis, electrolyte abnormalities

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What is the treatment for scalded skin syndrome?

MSSA: nafcillin or oxaxillin
MRSA: vancomycin

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What are the symptoms of staph food poisoning?

N/V/D cramping that start 2-8 hours after ingestion and resolve in 12 hours

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What are the treatment for coagulase negative staphylococcal infections?

Vancomycin

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What types of infections is Strep pyogenes associated with?

Pharyngitis
Skin infections

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What types of infections is strep agalactiae associated with?

Septic abortion, illness in neonates
Normal flora in intestine and vagina

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What type of infections is s. bovis associated with?

endocarditis

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What condition does scarlet fever accompany?

Sore throat due to strep pharyngitis 2/2 strep pyogenes

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What is the treatment for strep pharyngitis?

PCN G
PCN K
Amoxicillin
(if allergic Keflex or Omnicef, then last choice z-pack)

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What is the classic presentation of scarlet fever?

A sunburn like sandpaper rash, strawberry tongue

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What is impetigo caused by?

GABHS (or staph aureus)

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What is the presentation of impetigo?

Focal vesicular pustular lesions with honey-colored crust

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What is the treatment for impetigo without concern for MRSA?

Topical Bactroban
Keflex
Dicloxacillin

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What is the treatment for impetigo with concern for MRSA?

Bactrim
Doxycycline
Clindamycin

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What is erysipelas?

A painful superficial cellulitis with dermal lymphatic involvement that typically involves the face

What is erysipelas caused by?

GABHS (or staph aureus)

What is the outpatient treatment for erysipelas?

Penicillin Amoxicillin (also dicloxacillin, cephalexin, clinda/erythromycin)

What is the inpatient treatment for erysipelas?

Vancomycin (covers s aureus) cefazolin (Ancef) ceftriaxone (Rocephin) Clindamycin

What is cellulitis caused by?

GABHS or staph

What does group B/ strep agalactiae cause?

neonatal sepsis

What is the treatment for a strep B+ mother?

PCN G Ampicillin Cefazolin (or Clinda/Vanc)

What does streptococcus pneumoniae cause?

Otitis Media Sinusitis Pneumonia Meninges Endocarditis

What is the most common cause of CAP?

Strep pneumoniae (pneumococcal pneumonia)

What are the most common causes of otitis media?

S. pneumo M cat H influenza

What are risk factors for otitis media?

Smoking in the house Family history Bottle feeding

What is the treatment for otitis media?

Amoxicillin Augmentin/Omnicef Rocephin (daily shot for 3 days)

What causes acute sinusitis?

S aureus S pneumoniae M cat H influenza

What is the treatment for sinusitis?

Augmentin Doxycycline/clinamycin

What colored sputum is pneumococcal pneumonia?

Rust colored

What x-ray findings would you suspect for someone with pneumococcal pneumonia?

lobar consolidation, sometimes with effusion

When should you obtain a sputum culture for pneumonia?

For admission or if the patient has comorbidities

What is the treatment for uncomplicated outpatient pneumonia?

Amoxicillin Doxycycline Azithromycin

What is the treatment for complicated outpatient pneumonia?

Levofloxacin Augmentin/cephalosporin + zmax/doxycycline

What is the inpatient treatment for pneumonia?

Levofloxacin Zmax + amoxicillin/ceftriaxone

What are the most common causes of meningitis for children and young adults?

Baby - group B strep kiddo - s. pneumoniae Teen - neisseria meningitidis S aureus with head trauma H flu is rare but possible outside US bc HIB vax

What is the most common cause of meningitis for adults?

S. pneumoniae S aureus N meningitidis (less common here)

What is the most common causes of meningitis for elderly?

S. pneumoniae S aureus Listeria monocytogenes

What are the most common infections associated with enterococcus?

UTI Bacterimia Endocarditis Intra-abdominal infections Wound infections

What is the treatment for endocarditis?

ampicillin + gentacmicin

What is the treatment for skin/wounds and UTIs?

Ampicillin or vanc (regardless of complexity)

What if the patient has VRE? What is the treatment?

Linezolid Daptomycin

What are the three ways to get bacillus anthracis

Cutaneous Ingestion Inhalation

What are all the CDC category A agents we discussed?

Bacillus anthracis

What are the symptoms of cutaneus anthrax?

Painless black eschar LAD Fever, malaise, HA

What are the symptoms of ingested anthrax?

Fevers, N/V, bloody diarrhea GI bleed Mouth/GI ulcers Obstruction Perferation

What are the symptoms of inhaled anthrax?

Flu-like leading to severe hypoxemia and shock

What is the treatment for anthrax?

Cipro (doxycycline if you cant)

What are the two types of infections that b cereus can cause?

Diarrheal and emetic

What is commonly associated with b cereus?

Rice and leftovers

What is the treatment for b cereus?

Nothing, usually self limiting and harmless

What foods are associated with Listeria Monocytogenes?

Dairy Raw Veggies Meat

What is the presentation of Listeria?

Bacteremia Meningitis Dermatitis Oculoglandular symptoms

What is the treatment for Listeria?

Ampicillin and gentamicin (inpatient) amoxicillin (outpatient)

What does corynebacterium diphtheriae cause?

Pharyngeal diphtheria Nasal infection

What is unique about pharyngeal diphtheria infections?

Cause a grey tonsillar/pharyngeal membrane

What is the treatment for diphtheria?

Diphtheria equin antitoxin PCN or erythromycin