Head/Neck bugs Flashcards
What are the common causes of the common cold?
rhinovirus, coronavirus, parainfluenza virus, rsv, influenza virus, adenovirus, and human metapneumovirus
What is the most common bacterial cause of pharyngitis?
Group A strep (strep pyogenes)
What symptoms, if present with pharyngitis, suggest a viral etiology?
Cough and rhinorrhea
What are the risks associated with untreated bacterial pharyngitis caused by GAS?
Peritonsillar abscesses, retropharyngeal abscesses, post-strep glomerulonephritis, acute rheumatic fever
What are the symptoms of acute EBV infection?
Infectious mononucleosis: fever, lymphadenopathy, tonsillar pharyngitis
What is the likely etiology of a generalized maculopapular rash after ampicillin or amoxicillin treatment?
EBV incorrectly treated with antibiotics leading to a reaction to the antibiotics
What is the only fungal cause of pharyngitis?
Candidia
What is the presentation of primary HSV-1 infection?
Gingivostomatitis, fever, malaise, headache, vesicles (that progress to ulcers), submandibular lymphadenopathy
What disease presents with ulcers isolated to the soft palate and anterior pillars?
Hand, foot, and mouth disease (coxsackie A virus)
What are the typical causes of epiglottitis?
Formerly haemophilus influenzae type B, now more often strep pneumo, strep pyogenes, and staph aureus
What is lemierre syndrome?
A complication of bacterial pharyngitis/tonsillitis that involves extension of infection to the lateral pharyngeal spaces and internal jugular vein. Can lead to sepsis and death.
What bacteria is most often the cause of lemierre syndrome?
Fusobacterium necrophorum
What is the treatment of lemierre disease?
Beta-lactamase resistant beta-lactam antibiotic
What is ludwig angina?
Life-threatening cellulitis of the soft tissue involving the floor of the mouth and neck.
What is the likely etiology of ludwig angina?
Usually polymicrobial involving oral flora
What are the common symptoms of ludwig angina?
Neck pain, swelling, dysphagia, “bull neck”
What is cervicofacial actinomycosis?
A chronic odontogenic infection caused by actinomyces spp. that complicates tooth infection or gingivitis
What is the most common viral cause of otitis media?
RSV, coronaviruses, influenza, adenovirus, human metapneumovirus, picornaviruses
What are the most common bacterial causes of otitis media?
Strep pneumo, haemophilus influenzae, moraxella catarrhalis
What is the mechanism of acute otitis media?
Edema obstructs the eustacian tube and leads to an increase in negative pressure of the middle ear and build up of mucosal secretions that feed bacterial growth
What are common causes of otitis externa?
Pseudomonas aeruginosa, staph aureus
What are common causes of acute sinusitis?
Viruses, strep pneumo, haemophilus influenzae
What are common causes of chronic sinusitis?
Staph aureus, strep pneumo
What are the most common causes of periorbital cellulitis?
Staph aureus, strep pneumo, strep pyogenes
What is the presentation of periorbital cellulitis?
Erythema, edema, eyelid swelling, usually unilateral. Normally has motility and regular vision.
What is the difference between periorbital and orbital cellulitis?
Orbital cellulitis is more serious and involves the muscle or fat within the orbit, not just the skin/soft tissue around the orbit
What are the most common causes of orbital cellulitis?
Staph aureus, strep spp.
What condition is rhino-orbital-cerebral mucormycosis associated with?
Diabetic ketoacidosis
What are the JONES criteria?
Criteria for rheumatic fever. Joints (migratory polyarthritis), (<3) carditis, Nodules, Erythema marginatum, Syndenham’s chorea
What species is group B streptococcus?
a) streptococcus gallolyticus
b) streptococcus dysgalactiae
c) streptococcus agalactiae
d) streptococcus milleri
e) streptococcus mutans
c) streptococcus agalactiae
What cell is latently infected by EBV?
a) B-lymphocyte
b) T-lymphocyte
c) NK cell
d) endothelial cell
a) B-lymphocyte
A 23 year-old woman presents with one week of fever, chills, and sore throat progressing to right-sided neck pain and then pleuritic chest pain and SOB. On exam she has right neck swelling and tenderness. Chest x-ray shows multiple nodular opacities. What bacteria is the likely cause of infection?
a) streptococcus pneumoniae
b) streptococcus pyogenes
c) haemophilus influenzae
d) fusobacterium necrophorum
d) fusobacterium necrophorum
A 67 year-old male presents with jaw swelling for 2 days. He has been taking oral penicillin for a few days for an infected tooth. Now he can’t fully open his mouth and notices wheezing when he exhales. On exam he has audible stridor and sublingual and submandibular swelling. What is the likely cause of this infection?
a) clostridium tetani
b) mixed oropharyngeal flora
c) haemophilus influenzae
d) streptococcus pyogenes
b) mixed oropharyngeal flora
