ID Flashcards
CURB -65: Inpatient vs outpatient for PNA
Confusion
Uremia (BUN > 19)
Resp > 30
BP
ABx for meningitis infants
Cefotaxime + amp + vanc (+aminoglycoside if
ABx for meningitis 3 mo to 50 yrs
Ceftriaxone + vanc
ABx for 50 yrs + or impaired cellular immunity
Ceftriaxone + amp + vanc
Hepatitis B is associated with which vasculitis?
PAN
Uncomplicated UTI tx in non-pregnant person
Bactrim x 3 days or nitrofurantoin x 5 days or fosfomycin single dose
Complicated extend tx to 7 days
UTI in pregnant woman tx
Ampicillin, amox, or a cephalosporin for 7-10 days
Pyelonephritis uncomplicated tx
Bactrim or fluoroquinolone for 10-14 days; adjust after Ucx is back
Pyelonephritis complicated tx (pregnant, elderly, ill, cannot tolerate PO, concern for urosepsis)
IV amp + gent for 14-21 days (neg blood ctx) or 3 weeks (pos blood ctx)
HAART regimen must include
2 NRTs + either NNRT OR protease inhibitor
PPx in HIV
Bactrim for PCP
Chancroid
Haemophilus ducreyi; ragged edged ulcers, painful; tx with azithro or ceftriaxone
Lymphogranuloma venerum
C. trachomatis, painless ulcer with tender inguinal LAD; tx with doxy
RMSF
rash starts peripherally and then spreads centrally; may have elevated LFTs and thrombocytopenia; treat with doxycycline
Malaria treatment
If chloroquine resistance, give mefloquiine
Leptospirosis (spirochete)
Reservoir is rodents/farm animals, spread via water. Anicteric: rash, LAD, elev LFTs. Icteric: renal/liver failure, vasculitis, vascular collapse. Tx: doxy or tetracycline; IV penicillin if severe
Ehrlichiosis (intracellular, gram neg bacteria)
Spread via tick bite; fevere, chills, malaise, can progress to renal failure/GI bleed. Tx: doxycycline
Tularemia (Francisella tularensis, small gram-neg bacteria)
Spread by ticks, animal bites. Reservoir is rabbits. Fever, HA, nausea, ulcer at side of bite, painful LAN. Tx: Im streptomycin or gentamicin
Q fever causative organism
Coxiella burnetti
Q fever features
Reservoir is farm animals. Spread via blood, milk, inhalation. Acute: B sx, N/V. Chronic: endocarditis. Tx: acute- doxy or fluorquinolone. Chronic: rifampin
Cat scratch disease
Bartonella. Causes LAD. Tx: self-limited but give doxy to sx
Cryptococcus (yeast)
Assoc with pigeon droppings. Can cause pulm infection and/or CNS disease. Meningitis: elevated opening pressure. Tissue bx shows lack of inflammatory response. India ink shows halos. Tx: amphotericin + flucytosine x 2 weeks, followed by oral fluconazole.
Blastomycosis (dimorphic fungus)
Causes pulmonary and/or disseminated disease. Can cause verrucous skin findings. Tx: itraconazole (ampho if meningitis)
Histoplasmosis (dimorphic fungus w/ septate hyphae)
Bird/bat droppings in Ohio/Mississippi River valley. Flu-like sx, HSM, erythema nodosum. Tx: itraconazole (ampho if severe or immunocompromised)
Coccidiomycosis (dimorphic fungus)
Asx or nonspecific resp sx. Disseminated causes focal CNS findings. Tx fluconazole or itraconazole (ampho if severe or immunocompromised)
Sporotrichosis
Tx: itraconazole or K iodide for lymphocutaneous
ampho if disseminated
Cryptosporidium (protozoa)
Fecal oral spread. Causes watery diarrhea. Supportive care only
Amebiasis (E. histolytica, protozoa)
Bloody diarrhea, abd pain, +/- liver abscess. Metronidazole for abscess.
Ascariasis (roundworm)
May be asx, can have abd pain, vomiting. If heavy worm burden can have bowel or bile duct obstruction. Tx: albendazole, mebendazole, or pyrantel pamoate.
Hookworm
Larve enter skin –> lung –> cough and swallow –> GI tract. Cough, anemia, malabsorption, anemia, eosinophilia. Tx: mebendazole or pyrantel pamoate
Enterobiasis (enterobius vermicularis or pinworm)
Perianal pruritis at night. Tx: mebendazole or pyrantel pamoate
Tapeworm (cestodes e.g. Taenia solium)
Cysticercosis. From pork etc. Most common cause of epilepsy worldwide. Tx: praziquantel, vitamin b12 if deficient (fish tapeworm).
Schistosomiasis (trematode)
Penetration of skin in contaminated fresh water –> lungs –> portal vein –> venules of mesentery, bladder, uterus. Can cause fever/diarrhea, and later cause liver fibrosis, pHTN. Tx: praziquantel
Giardiasis (protozoa)
Lauren’s diarrhea lol
Tx: metronidazole
Trichinellosis (roundworm)
Infection from undercooked meat. Triad: periorbital edema, myositis, eosinophilia. Also see subungual splinter hemorrhages, retinal hemorrhages.
Chikungunya (virus)
Spread by mosquitos. Sudden onset high fever, rash, JOIN PAIN. Can cause chronic joint pain.
Dengue fever
Spread by mosquitoes. Fever, myalgias, rash that looks like measles. In small number of cases, can cause hemorrhagic fever.
What types of diarrhea are treated with abx?
Salmonella only if immunocompromised, tx with cipro.
Shigella tx with Bactrim.
Campylobacter tx with erythromycin.
Giardiasis tx with metronidazole.
