ID Flashcards
What abx leads to increased mortality in VAP?
Tigecycline
What antifungal for aspergillus liver enzymes elevated on Voriconazole?
Isavuconazole if mild elevation
Amphotericin B if severe liver failure or worsening hepatitis (3-4x normal LFTs)
Coccidioidomycosis radiographic findings
Solitary nodules 10-20 mm in diameter in the periphery of the lungs
Can have thin walled cavities
Nocardia gram stain
Gram positive beaded organisms with a branching morphology
Nocardia infects which parts of the body
Lungs, skin (draining pustules), brain (abscesses)
Nocardia treatment
Bactrim, Amikacin, Linezolid, Imipenem, Ertapenem
First month post transplant infections
MDR MRSA Pseud Candida Gram negative organisms Viruses passed from donor or recipient
1-6 month post transplant infections
Depends on prophylactic meds
Opportunistic infections
Crypto
Hep C
Respiratory viruses
Mycobacterium
6-12 month post transplant infections
Community based organisms
BK Virus
When to start ART in TB with CD4 <50
ART within 2 weeks
Prednisone within 4 weeks
When to start ART in TB with CD4 >50
ART within 8-12 weeks
When to start ART in TB meningitis
No matter the CD4 not until at least >8 weeks
Treatment of MAC
Clarithromycin
Ethambutol
+/- Rifamycin
Treatment of Tularemia
Severe - Gentamicin, Streptomycin
Mild - Doxycycline, Ciprofloxacin
What antibiotics for K pneumonia carbapanemase resistant strain?
Tigecycline
Colistin
Ceftazidime-Avibactam
Normal CSF glucose
50-80
Normal CSF protein
15-45
Sensitivity and specificity of Legionella urine antigen
80 and 100% respectively for the serougroup 1 (80% of the ones found)
Treatment of anthrax meningitis
Cipro
Merrem
Linezolid
Clostridium botulinum presentation
Descending paralysis, wound infection
Echinocandin MOA
Noncompetitive inhibitors of the synthesis of 1,3-B-d-glucan which is an integral component of the fungal cell wall
Babesiosis lab findings
Hemolytic anemia
Thrombocytopenia
Elevated aminotransferases
Oval or pear shaped trophozoites with a a blue cytoplasm and red chromatin dots
Babesiosis epidemiology
Blood transfusion within 6 months
Northeast and upper Midwest US
Babesiosis treatment
Atovaquone and Azithromycin x 7-10d
Tularemia gram stain
Gram - coccobacillus
Sites of Tularemia infection
skin (ulcer)
pneumonia (biowarfare)
Severe C dif
WBC >15,000
Albumin <3.0
And/or
Creatinine >1.5
Baloxavir marboxil use
Anti-influenza medication
Baloxavir vs oseltamivir
Provides a greater reduction in viral load by 1 day after treatment but not in symptom alleviation
Baloxavir MOA
Prodrug, selectively inhibits cap-dependent endonuclease enzyme
Oseltamivir MOA
Inhibits the neuraminidase enzyme
Blastomycosis clinical pic
Acute or chronic PNA Extrapulmonary disease: Skin 20% Bone 5% CNS 2%
Blastomycosis incubation period
4-8 weeks
Blastomycosis endemic to
Mississippi
Histoplasmosis endemic to
Arkansas
Coccidioidomycosis under microscope
Very large spherules
Histoplasmosis under microscope
Small and round organisms, significantly smaller than the surrounding cells
How to treat carbapenemase-producing organisms
Ceftazidime-Avibactam
Meropenem-Vaborbactam
Colistin
Virus most likely to cause AE-COPD
- Rhinovirus
2. Influenza A
How to differentiate Nocardia from Actinomyces
On modified acid fast stain, Nocardia stains positive
Nocardia aerobic, actinomyces anaerobic
Chest wall infection not uncommon
Actinymycosis
Infections that cavitate
Actinomyces
Nocardia
TB
CF with pseudomonas treatment
Inhaled tobramycin or aztreonam
