ID Flashcards
AIDS bugs
Cryptosporidium parvum
<180 CD4
Chronic diarrhea
Oocysts on acid-fast stool
Viral arthritis path
Parvo B19
Viral arthritis hx/pe
Daycare worker / kids
Polyarticular, symmetric arthritis @ MCP, PIP, wrists (like RA)
Slapped cheek (kids only)
Viral arthritis dx/tx
Normal ESR
Self-resolving in 2months
Disseminated gonococcemia hx/pe*
Often during period High risk sex practices Fever, chills Migratory polyarthralgias Tenosynovitis
Skin lesions (pustular, hemorrhagic) Non-swollen joints (unless progressed to septic arthritis)
Disseminated gonococcemia dx/tx*
Blood & skin cultures usually negative due to growth requirements
?
Dog/cat/human bite tx
Amoxicillin/clavulante
Necrotizing surgical infection hx/pe, dx, tx*
Intense pain Septic Reduced sensation Bullae Discharge Crepitus
Don’t culture ==> SURGICAL DEBRIDEMENT
Tetanus ppx*
Ig + toxoid: deep (>6cm) or dirty; 3+ vaccines > 5 years ago or less/unknown vaccination
Toxoid only: deep or dirty w/ 3+ vaccines < 5 years ago OR clean/minor w/ 3+ vaccines > 10 years ago
None: clean/minor and 3+ vaccines < 10 years ago
TB path, presentation, dx, precautions*, tx
Poor, mexican, incarcerated
Purulent sputum
Hemoptysis
Fever
Weight loss
Reactivation: apical cavitations (look for smaller lung volumes on CT to show apical)
==> IMMEDIATE isolation if suspected…CT afterward
Diabetic foot ulcer management*
Any ulcer: requires debridement
Ulcer with cellulitis, abscess or osteo ==> debridement plus IV abc
Ulcer with gangrene ==> amputation
Pneumocystis jirovecii path, presentation, dx, tx
Gram ?
Tropism for lung ==> spleen, liver, bone marrow
Immunocompromised host
Dyspnea
NON-productive cough
Fever
Bilateral, perihilar infiltrates
Legionella path, presentation*, dx, tx
Non-encapsulated gram negative
Pneumonia + TRIAD:
Fever
GI symptoms
Hyponatremia
Urinary antigen
Macrolide or quinolone
Pneumonia tx* MORE
Outpatient: azithromycin, doxycycline
Inpatient:
levofloxacin (not cipro)
clindamycin if aspiration suspicious (alcoholic, stroke, etc.)
Aspergillus path, presentation, dx, tx
Fungal infection, often 2/2 underlying disease
Asymptomatic
Hemoptysis
Fever / malaise
CXR: cavitary lesions, mobile* with position change 2/2 debris, air crescent*
Histoplasmosis path w/ geography, presentation*, dx, tx
Dimorphic fungus
Ohio and Missippi river valleys
Central America
Usually asymptomatic
Or fever, chills, NON-PRODUCTIVE cough
XR: multiple calcified nodules (lung > spleen)
Local: flucanazole or ketoconazole
Systemic: amphotericin B
Ameba path, presentation, dx, tx
Solitary abscess, usually liver > lung > brain
Travel history
Metronidazole
DON’T drain
Blastomycosis path, geography, presentation, dx, tx
Dimorphic fungus
Mississippi and east… not just NE!
Constitutional fever, night sweat, weight loss
Productive cough
Upper lobe lesions
SKIN AND BONE LESIONS!* ==> differentiates from histo and TB
?
Local: fluconazole or ketoconazole
Systemic: amphotericin B
Coccidioidomycosis path, geography, presentation, dx, tx
Dimorphic fungus
Southwest
Pneumonia
Meningitis
Skin / bone infection
?
Local: fluconazole or ketoconazole
Systemic: amphotericin B
Paracoccidioidomycosis path, geography, presentation, dx, tx
Spherule
Latin America
Severe pneumonia
?
?
Gram negative pneumonia ddx: bugs, presentations, dx
- E. coli
Non-encapsulated gram negative bacillus
Nosocomial pneumonia
2. Klebsiella Encapsulated gram negative bacillus Alcoholics, nosocomial Currant jelly sputum XR: upper lobe Culture: mucoid colonies
- Legionella
Non-encapsulated gram negative bacillus
Pneumonia + fever, GI upset, hyponatremia - Pseudomonas
Encapsulated gram negative bacillus
Nosocomial, CF patients, AIDS, bronchiectasis, neutropenia
X: Enterobacter, Proteus, Serratia
Rotavirus path, presentation, dx, tx, tx contraindication*
Fecal-oral GI infection
Watery osmotic diarrhea
Clinical?
Live attenuated vaccine
==> don’t administer if hx of intussusception or other GI malformation
