ID Flashcards
Treatment of spontaneous peritonitis?
3rd gen ceph + aminoglycoside
Risk factors for spontaneous primary peritonitis? (2)
Specific type of bug in one.
Cirrhosis, nephrotic syndrome (encapsulated: pneumococcus - loss of IgG
common complication of chronic peritoneal dialysis
Staph epidermis peritonitis
common bug in VP shunt infx
staph epi
primary cause of occult bacteremia
strep pneumo
bug to worry about in asplenic pts
strep pneumo
Bugs causing septicemia in neonate
GBS, Ecoli, Strep pneumo, S aureus
Bug causing septicemia in infant
GBS, Ecoli, Strep pneumo, Saureus, salmonella
bugs causing septicemia in immunocompromised pts
GNR: pseudomonas, Ecoli, klebsiella
Staph
Abx for r/o sepsis in neonate
amp/cefotax or amp/gent
ecthyma gangenosum: large pustules on indurated inflamed base, think of what dz?
pseudomonas
rose spots, what dz?
salmonella typhosa
septicemia tx in >3 mo
vanc+CTX
prophylaxis for meningococcemia for who and with what?
all persons w/ contact w/ oral secretions, household contacts and close outside contacts
Tx w/ Rifampin q12 x2 days or CTX x1, or Cipro 500 x 1 in >18yo
Dx and Tx of DIC in sick kid
Expect low fibrinogen and high fibrin degredation products and high d-dimer.
Tx w/ ABX then clotting factors and platelets
what bugs does latex agglutination test for?
When to do this?
BINS: GBS, Influenza/H (HIB), Neisseria Mening, Strep pneumo
Helpful w/ partially treated infx when culture unreliable
latex agglutination caveats:
False positives in who?
cross reactivity w/ what?
False pos in children recently received HIB vaccine
Ecoli x-react w/ N. meningitidis.
transfusion related infx, esp pna?
CMV
pneumocystis jiroveci
PCP (pneumocystis carinii pneumonia)
tx for fever, neutropenia
- Zosyn (piperacillin-tazobactam) + aminoglycoside
- Ceftazidime or cefapime
water park bug, what does it cause
cryptosporidium (looks like viral gastro but lasts longer)
Tx of cryptosporidium or Giardia in child >1 yr w/ diarrhea
Tx if crypto and immunocompromised
Nitazoxanide
IF immunocompromised crypto: oral human IG or bovine colostrum
immigration + acute abdominal obstruction
ascaris lumbricoides, tx: albendazole x 1, mebendazole x 3d, ivermectin x1
staccato cough
chlamydia pna
intracytoplasmic inclusion bodies
chlamydia
definitive dx of chlamydial pna?
Ab-specific test or PCR
4Cs of chlamydia
Cough, conjunctivitis, chlamydia, cixteen wks
lab finding and possible tx for chlamydial pna in newborn
eosinophilia
emycin PO or azithro. Or if needed non-macrolide, sulfonamide
s/e of macrolides (azithro, clarithro)
diarrhea, abdominal stuff
dx of chlamydial pna in teen?
immunoflourescent Abs
most common fatal tick-borne dz in US?
Dx?
Tx?
RMSF
Dx w/ direct IF or skin bx
Tx w/ Doxy RIGHT away
rash in RMSF?
mac pap –> petechial,
extr –> trunk
season for RMFS?
Tx?
May/June
Doxycycline!
Bug in Q fever
what does it cause
what is tx
Coxiella burnetti - inhalation of spore like particles, can be tick bourne
causes PNA
tx w/ doxy or supportive care
Bug causing amebiasis
entamoeba histolytica
Bug causing severe GI bloody diarrhea, liver and brain abscesses, and lung dz?
Amebic dysetery, entamoeba histolytica
hematophagous trophozoites
E. histolytica
Tx of amebiasis (E. histolytica)
Flagyl or tinidazole –> luminal amebicide (iodoquinol, paromyin)
Can just do luminal if asx cyst excreter
iodoquinol or paromocyin are what?
Luminal amebicide
round worm
Toxocariasis
eosinophilia, exposure to dog/cats, preschooler eating dirt: Gi and Resp sx
Toxocariasis
3 clinical manifestations of toxocariasis?
- viscera larva migrans: fever, hepatomegaly, wheezing
- ocular larva migrans: visual disturbance
- covert toxocariasis: GI sx, pruritis, rash
Viscera Larva Migrans in suspected toxocariasis
Dx and Tx?
Dx w/ ELISA and get stool cx to r/o other parasites
Tx w/ mebendazole or thiabendazole
(Longhaired cats, Licking dogs/dirt, ____Dz in Lungs and Liver)
What is the dz?
Big clue?
Larval!! (Ls: Toxocariasis)
*hepatomegaly
Tx of giardia?
flagyl, furazolidone, albendazole
Tx of schisosomal, liver fluke, tapeworm?
Praziquantel
tx of strongyloidiasis
thiabendazole
strong guy doing bends
Bug in cat scratch disease
When to tx
What to tx w/?
bartonella henselae
tx: supportive unless hepatomegaly, large painful LAD, immunocompromise –> azithro, emycin, cipro, Bactrim, Rifampin are all choices
bug to cover for in cat bite and tx
staph and Pasteurella multocida
Tx w/ Clinda and Bactrim (for pasteurella)
gram negative pleomorphic org in non-immunized child
Tx
HIB, H flu
Tx: CTX
3 encapsulated bugs to think about w/ asplenia
- H flu
- strep pneumo
- N. meningitidis
when to give HIB prophylaxis?
with what?
if a child <4 incompletely immunized is in house or immunocompromised child in house.
Rifampin!
Trick: no px if non-typeable Hflu
dx of pertussis
Tx of pertussis
Dx: culture and IF nasal swabs
Tx: erythromycin estolate, or clarithro/azithro
how does pertussis tx help?
- catarrhal stage: shortens the URI phase
2. during paroxysmal stage: decr period of communicability but doesn’t shorten coughing ever
how do you handle pertussis prophylaxis
anyone exposed gets erythromycin to prevent spread
classic salmonella poisoning: timing and dx
1-2 d after exposure. stool culture
who should be treated for salmonella infx? and with what?
< 3 mo infant, risk for invasive dz (malignancy, colitis, immune compromise). Tx w/ amox, bactrim, cefotax, cipro in adult.
type of bug causing pna / death in CF?
pseudomonas cepacia
ABx for pseudomonas
ceftaz**
gent, tobra, cefepime
dairy farm, fevers, myalgias
Dx and Tx
brucellosis, dx w/ Ab testing, tx Doxy, Bactrim + Rifampin
Prolonged tx
tx of cdiff
flagyl
GBS risk fx?
- low SES
- multiple sex partners
- hx stds, young maternal age
- ROM >18h
- fetal scalp monitor/instrument breaking skin
indications for GBS prophylaxis in pregnant lady
- previous infant w/ invasive GBS dz
- GBS bacteriuria
- pos GBS screen
- unknown GBS w/ gestation < 37wk, ROM>18, fever 38
descending paralysis in infant
infantile botulism
mechanism of botulism
block release of Ach (presynaptic)
when to treat newborn w/syphilis?
- if mom tx in last mo of pregnancy
- if tx w/ emycin which doesn’t cause placenta
- if baby titers are higher than mothers
Whats the deal with newborn syphilis lab results
FTA-ABS are forever high
VDRL should go down
macular papular rash, HSM, and peeling skin in newborn
Dx?
Syphilis
sniffles, bullous lesions, osteochonditis, HSM in newborn
Dx and Tx
syphilis, PCN
white nodules on placenta in sick newborn
listeria (microabscesses)
Listeria vs GBS regarding mom in pregancy
ASX during pregnancy: GBS
Flu like: listeria
the buzz words for campylobacter fetus
family w/ animal exposure
premature delivery