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PEDIA 2 > GRAM POS BACTERIA > Flashcards

GRAM POS BACTERIA Flashcards

1
Q
  • Gram-positive cocci in pairs and clusters
  • Most common cause of pyogenic skin & soft tissue infection
  • Transmission: primarily by direct contact, auto-
    inoculation
  • most common cause of Osteomyelitis and suppurative arthritis in children
  • common cause of acute endocarditis
  • principal cause of TSS.
A

Staph aureus

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2
Q
  • acute multisystem disease
  • Caused by TSST-1 producing S. aureus
  • Menstruating women ‘
  • Nonmenstrual TSS
  • TSST-1 causes massive fluid loss from the intravascular space
A

Toxic Shock Syndrome

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3
Q

most common species of CONS

A

S. epidermidis

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4
Q

Manifestation of CONS

A
  • Bacteremnia
  • endocarditis
  • CSF shunta
  • UTI
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5
Q

DOC OF CONS

A

Vancomycin

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6
Q
  • Gram positive, lancet-shaped, polysaccharide
    encapsulated diplococcus
  • Common inhabitants of the respiratory tract of humans
  • Transmission: respiratory droplets
  • Polysaccharide capsule important pathogenicity factor
  • 2nd most common cause of meningitis
A

Streptococcus pneumonia Pneumococcus

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7
Q

DIAGNOSIS of Streptococcus pneumonia

A

lancet-shaped diplococci on Gram staining

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8
Q

Tx of Meningitis for Strep pneumonia

A
  • If penicillin susceptible: Penicillin or Cefotaxime or
    Ceftriaxone
  • If nonsusceptible: Vancomycin + high dose Cefotaxime or Ceftriaxone
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9
Q

Tx of Invasive infections outside CNS for Strep pneumonia

A
  • High dose Cefotaxime or Ceftriaxone
  • Penicillin allergy: Clindamycin, Erythromycin, TMP-SMX
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10
Q
  • Vaccine can’t be given in patients <2 yrs old
  • Can be given in infants
A
  • PPSV 23
  • PCV 13
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11
Q

Prophylaxis (for high risk children) for Streptococcus pneumonia

A
  • Penicillin V potassium
  • Benzathine Penicillin G IM every month
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12
Q
  • Gram-positive cocci in chains
  • Natural reservoir: human
  • Virulence due to:
    > M protein
    > Erythrogenic toxins
  • Manifestations
    > RTI
    + Acute pharyngitis
    + Pneumonia
    > Impetigo
    > Erysipelas
    > Scarlet fever
A

GAS

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13
Q

Group A Streptococcus: Severe invasive disease

A
  1. GAS Toxic Shock Syndrome
  2. GAS necrotizing fasciitis
  3. Focal and systemic infections not meeting criteria for 1&2
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14
Q

DOC for GAS

A

penicillin for 10 days

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15
Q

JONES CRITERIA: MAJOR MANIFESTATION

A
  • Carditis
  • Polyarthritis
  • Erythema marginatum
  • Subcutaneous nodules
  • Chorea
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16
Q

JONES CRITERIA: MINOR MANIFESTATION

A
  • Arthralgia
  • fever
  • Elevated acute phase reactants:
    > Erythrocyte sedimentation rate
    > C-reactive protein
    > Prolonged PR interval
17
Q

Dx of ARF can be made without fulfilling the Jones criteria:

A
  1. Chorea
  2. Indolent carditis
  3. Recurrence of ARF
18
Q

Duration of Secondary: prevention of pharyngitis in Pxs at risk of recurrent ARF

A
  • Rheumatic fever without carditis: 5 yr or until 21 yr of age, whichever is longer
  • Rheumatic fever with carditis but without residual heart disease (no valvular disease”): 10 yr or until 21 yr of age, whichever is longer
  • Rheumatic fever with carditis and residual heart disease (persistent valvular disease”): 10 yr or until 40 yr of age, whichever is longer, sometimes lifelong prophylaxis
19
Q
  • Anaerobic gram positive cocci in chains or pairs
A

GBS

20
Q

CXR LAB FINDINGS

A

reticulogranular patterns, patchy infiltrates, opacification, increased interstitial markings

21
Q

GBS
- DOC
- Initial empiric treatment

A
  • Penicillin G
  • Ampicillin + Aminoglycoside
22
Q
  • acute toxin-mediated disease; occurs worldwide
    especially in tropical countries
  • Aerobic, non-encapsulated,non-spore-forming, gram-positive bacillus
  • Exclusive inhabitant of human mucous membranes and skin
  • Toxigenicity occurs only when the bacillus is lysogenized by a bacteriophage carrying the genetic info for the tox gene
  • Only the toxigenic strains can cause severe disease
  • 4 biotypes: mitis, intermedius, belfanti, gravis
A

Corynebacterium diphtheriae

23
Q

Transmission: Corynebacterium diphtheriae

A
  • Airborne respiratory droplets
  • Direct contact with respiratory secretions
  • Exudate from infected skin lesions
24
Q
  • Mainstay of therapy
  • Neutralizes circulating (unbound) toxin (efficacy diminishes with elapsed time after onset of mucocutaneous Sx)
  • Dose: 20,000-120,000 U based on toxicity, size & site of membrane and duration of illness
  • Available only from CDC
A

Equine Diphtheria antitoxin

25
Q

Staining Dx of Corynebacterium diphtheriae

A

club-shapes forms

26
Q

Classified based on site of disease: Corynebacterium diphtheriae

  • Scaly rash/nonhealing ulcers with clearly demarcated edges & gray-brown membrane
  • Extremities more often affected
  • More prolonged bacterial shedding
  • Greater contamination of environment
  • Increased transmission to the pharynx and skin of close contacts
A

Cutaneous Diphtheria

27
Q

Classified based on site of disease: Corynebacterium diphtheriae

  • fever
  • Hoarseness
  • Barking cough
  • Complications: airway obstruction, coma, death
A

Laryngeal Diptheria

28
Q

Classified based on site of disease: Corynebacterium diphtheriae

  • Most common site (94%)
  • Manifestations:
    > Sore throat*
    > Fever, dysphagia, hoarseness
  • Substantial systemic absorption of toxin
  • Early sx -> bluish-white memb —> grayish-green or black
    Pseudomembrane adheres to tissue —> bleeding on forceful removal
  • Underlying soft tissue edema +enlarged lymph nodes —> Bull-neck appearance
  • Danger of airway compromise
A

Pharyngeal & Tonsillar Diphtheria

29
Q

Classified based on site of disease: Corynebacterium diphtheriae

  • Serosanguineous, mucopurulent discharge
  • White membrane on nasal septum
  • Shallow ulceration of external nares, upper lip
  • Fairly mild — poor systemic absorption of toxin in this location
A

Anterior nasal Diphtheria

30
Q
  • Halts toxin production
  • Treats localized infection
  • Prevents transmission to contacts
A

Antibiotics: Erythromycin

31
Q

helps protect your child against: diphtheria. tetanus. pertussis (whooping cough)

A

The 6-in-1 vaccine for free, also commonly known as the DTaP/IPV/Hib/HepB vaccine

PEDIA 2 (7 decks)

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