ID Flashcards
A healthy 7 yo boy is admitted with progressive cellulitis of his arm after scraping his wrist several days ago. Despite good dose bactrim x2 days, redness has continued to spread. He has a temp of 38.5 C, healing abrasion on right arm with 6cm surrounding erythema, no drainage or fluctuate, very tender. No allergies. Which is the most appropriate antibiotic?
A) ceftriaxone
B) linezolid
C) nafcillin
D) vanc
C. Nafcillin
Most non suppurative cellulitis are due to GAS or MSSA. GAS thought to be resistant to bactrim. A and B do treat these but are unnecessarily broad spectrum.
A 37day old with fever, poor feeding with a red, swollen area under infants right mandible that has rapidly worsened over the last 4 hours. The infant is ill appearing and irritable. Full sepsis eval done. CSF with WBC 400 and glucose of <5. Of the following, the CSF gram stain will most likely show:
A) gram negative coccobacilli
B) gram negative rods
C) gram positive diplococci
D) gram positive rods
C. This is cellulitis/Adenitis syndrome caused by late onset GBS.
Early onset GBS is spread:
A) due to exposure to vaginal
Flora
B) due to exposure to visitors
C) due to skin to skin transmission
D) due to transplacental transmission
A. Colonizes lower GI tract and vaginal canal in 15-35% of women. After membrane rupture, can ascend to the uterus or by mucosal surface contact during passage through the birth canal. Transplacental transmission is not known to occur.
Risk factors for early onset GBS include:
PROM (>18hrs)
Intrapartum fever
Intra-amniotic fluid infection
GBS bacteruria during pregnancy
Prior infant with GBS
A previously healthy 15yo M is seen for new onset seizures. His VSS, he is sleepy but avoidable and answering questions. Exam is unremarkable. A noncontrast CY shows several calcified lesions in the brain parenchyma. The most likely exposure is:
A) cat litter
B) sand boxes with dog feces
C) soil contaminated with human feces
D) undercooked pork
C. Neurocystercercosis is not caused by eating undercooked pork but by soil, food, water, or fingers contaminated with human feces that contain T solium eggs. Taeniasis (tapeworm intestinal infection) can be caused by ingested undercooked pork by consuming the tapeworm (has already completed its life cycle).
