ID Flashcards
-MC cause of peritonitis in a dialysis pt or pt with VP shunt
Staph epi
- infx that occurs with nephrotic syndrome & cirrhosis
- pneumococcus in nephrotic kids
- Tx: CTX & aminoglycoside
Primary Spontaneous Peritonitis
-MC cause of bacteremia
Strep pneumo
-MC cause of septicemia in neonates (<1mo)
- GBS
- E. coli
- Strep pneumo
- S. aureus
-MC cause of septicemia in infants (1-12 mos)
- GBS
- Strep pneumo
- S. aureus
- Salmonella
-MC cause of septicemia in immunocompromised pts
- Gram neg bacilli
2. Staph
-MC cause of septicemia in asplenic pts (i.e. sickle cell)
-Strep pneumo
- decr plts
- decr fibrinogen
- incr D-dimer (most specific)
- incr coags
Tx: clotting factors and plts
DIC
-PPx for household contacts & close contacts of pts w meningococcemia
- Rifampin q12 x2d
- CTX x1
- Cipro x1 (>18 yo)
BINS B (GBS) Influenza/Hib Neisseria meningiditis Strep pneumo
+ Latex agglutination
picture a bunch of latex gloves in a giant bin
- ground glass appearance on Xray
- pts on Bactrim PPx
- h/o HIV, transplant
Pneumocystis jirovecii (PCP)
- long lasting, non-bloody, watery, diarrhea
- common in immunocompromised pts
- Tx: huma immune globulin or bovine colostrum
- in healthy children: nitazoxanide
Cryptosporidium
-PPx for neutropenic fever
Zosyn & aminoglycoside OR Ceftaz
- a child with acute abd obstruction & appendicitis-like Sx who emigrated from a tropical region
- Tx: albendazle X1
Mebendazole x3
Ivermectin
Ascaris Lumbricoides
- newborn w/ afebrile “staccato” cough & tachypnea w/wo eye DC
- intracytoplasmic inclusion bodies
- Dx w/ PCR or Ab test
- Tx: oral or IV erythromycin (not eye gtts or sulfa)
Chlamydia pneumoniae
- MC fatal tick borne dz in the US
- fevers, myalgias, headache, and petichial rash starting on the extremities
- peaks in May or June
- Dx: direct immunofluorescence of skin Bx
- Tx: doxycycline (all ages)
Rocky Mtn Spotted Fever
- pna but no rash
- spread by inhalation of particles
- 5d flu-like Sx -> resp Sx
- Tx: doxycycline
- barnyard animals
Q fever (Coxiella burnetti)
- causes amebiasis
- dysentery 1-2 wks abd pain, diarrhea, & tenesmus
- liver or brain abscess or lung dz
- stool cx: hematophagous trophozoites & hemoccult
- Tx: Flagyl & iodoquinol
Entamoeba histolytica
- hepatomegaly & GI pain & wheezing
- exposure to dogs & cats
- eosinophilia
- “child eating dirt”
- Ex: ELISA
- Tx: mebendazole
Toxocariasis
- cat scratch fever
- LAD
- Tx: azithromycin>Cipro>Bactrim
- **Avoid I&D
Bartonella henslae
- unimmunized child
- sepsis, meningitis, epiglottitis
- gram neg pleomorphic organism
- Tx: CTX
- **encapsulated organism
- PPx: Rifampin unless >4 & immunized
H. influenzae
3 phases:
- incubation: asymptomatic (1 wk)
- cattharal stage: rhinorrhea, anorexia, cough, fever (1 wk)
- paroxysmal: cough, cyanosis, & apnea (1-3 mo)
- Dx: Cx & immunofluorescence
- Tx: azithro (decr communicability)
- incr WBC + incr L + cough
Pertussis
-summer picnic 1-2 d prior to watery diarrhea, vomiting, & fever
-chix & human carriers
-Dx: stool Cx
-Tx: uncomlicated- unnecessary
>3mo or immunocompromised- Amox, Bactrim, Cefotax, or Cipro
Salmonella
- causes osteomyelitis/chondritis as a result of puncture wounds, otitis externa, & VAP
- Tx: Ceftaz, or Gent, Tobra, Cefepime
Pseudomonas
- child on a dairy farm with fever & myalgia
- transmitted by milk and dairy
- Dx: Ab test
- Tx: tetracycline or Bactrim & Rifampin
Brucellosis
- severe diarrhea after Clinda or Abx
- Heme + stools, mucously diarrhea
- Tx; po Flagyl or po Vanco
C. diff colitis
-when to give GBS PPx
- prev infant with invasive GBS
- GBS bacteremia during pregnancy
- GBS screen
- unknown GBS + <37 wks, ROM >18h, fever >38
- diplopia, dysphagia, dysarthria, dying to pee (urinary retention)
- poor feeding, ptosis, constipation
- toxin blocks the release of Ach into the synapse
- Tx: supportive & antitoxin
Botulism
-maculopapular rash, HSM, & peeling skin in a newborn
-sniffles, bullous lesions, & osteochondritis
Tx: PCN if mom Tx’d < 1mo ago
if not Tx’d w/ PCN, or if baby’s titers higher than mom’s
Congenital Syphilis
- decr Hb, decr plts, hematuria
- incr UN/Cr, decr UOP, bloody diarrhea
- associated with E. coli
HUS
- septic newborn
- mom w/ fever & flu Sx
- placenta w/ white nodules
- Tx: Amp & Gent
Listeria monocytogenes
- septic newborn +/- preterm delivery
- exposure to animals
Camphylobacter
- fever, HSM, rash, & LAD
- exposure to rabbits
- Tx: gent (streptomycin, tetracyclines, Cipro)
Tularemia
- Bubonic plague
- swollen painful LAD
- exposure to dead animals
- septicemia, pulmonary ore meningeal
- Tx: streptomycin & gent (doxy, tetra, chloramphenicol)
Yersinia pestis
Y (widespread immunosuppresion) Extensive burns Antibiotics Suppressed immunity TPN use
Systemic candidiasis
- causes pulmonary dz & meningitis
- AIDS associated
- exposure to bird droppings
- encapsulated yeast
- Tx: AmphoB & Fluconazole OR Flucytosine (for resistant)
Cryptococcus
- flu-like Sx: fever, night sweats, HA, chest pain, aches
- travel to CA, AZ, TX
- Tx: AmphoB or fluconazole
Coccidiomycoses
- “asthmatic” with worsening Sx despite Tx
- eosinophils & infiltrates on CXR
- Tx: voriconazole or Ampho B
Aspergillosis
- flu Sx, HSM
- Ohio, Missisippi river valley
- bird or bat droppings
- Tx: supportive OR Ampho B
Histioplasmosis
- lymphocutaneous manifestations(ulcer on finger with a chain of nodules parallel to lymph channel) w/wo knee pain
- walk in a nursery or tree farm
Sporotrichosis
Sporothrix schenckii
Chorio retinitis Cerebral calcification a Center (peri ventricular) Culture (urine) Censorineural hearing loss Also, thrombocytopenia (blueberry) Tx: ganciclovir(causes bone marrow suppression)
Congenital cmv
- Sx: fever, mental status changes, HA
- Dx: CSF pleocytosis, incr protein, nl glucose
- late spring and early summer
- transmitted by ticks and mosquitos
- Dx: virus specific IgM
Arboviruses
- St. Louis
- LaCross
- W&E equine
- California
- west Nile
- Colorado tick fever
- meningitis
- underwear
- muscle aches
- pancreatitis
- swelling of parotid
Low grade fever, non-toxic
Mumps
-fever, toxic-appearing with parotid tenderness and swelling
Bacterial parotitis
- HHV-6
- 3-5 days high fever, then mac-pap rash will appear
- may have febrile seizures
Roseola infantum
- congenital cataracts and PDA
- low grade fever, mac-pap rash, LAD, non toxic appearing
Rubella (German measles)
- fever, cough, coryza, confluent rash, koplick spots, conjunctivitis
- most contagious 5d before and after rash occurs
- PPx IgG within 3d of exposure for IC pts or by 6d in children <1yr
Measles (rubeola)
- parvovirus b19
- hydrops fetalis, aplastic crisis
- spread by droplets
- fever, sore throat, rhinorrhea, malaise followed by slapped cheek rash
- may be accompanied by polyarthropathy
Fifths disease (erythema infectiosum)
- sz in the newborn period
- temporal bone involvement
- sepsis and meningitis
- Dx: PCR
HSV
- chronic non specific Sx of weight loss, fever, night sweats, thrush
- Dx DNA by PCR
- most common mode of transmission is vertical
- Tx with AZT
- Sx: recurrent bacterial infx, HSM, ftt, dd, cognitive impairment
- screen at birth, 2, 4, & 6 mo with PCR
HIV
- Sx: conjunctivitis, pharyngitis, LAD, intusucception
- summer months
Adenovirus
Serum galactomannan tests for this
Aspergillus
Patient treated with Amox for 1 week
- swollen lymph nodes
- periarticular swelling
- dusky urticaria like lesions
Serum sickness like reaction
- skin lesion caused by prolonged exposure to cold objects
- bluish red nodules
- resolve within weeks
Cold panniculitis
