ID Flashcards
where does staphaureus colonize
groin, axilla, nasal passages/resp tract
HA MRSA can be ____ or ____
hospital (over 24 hrs after hospitalization)or community onset (within 12 mo of exposure to HC)
CMV is caused by and spread via
cytlomegalovirus and is spread from person to person by sex, breastmilk, congenital, transplant
CVM signs and sx
similar to mono, but no exudate on tonsils and lymphadenopathy
CMV infects _____ ppl
immunocompetent
dx of CMV
CMV IgM
trmt CMV
ganciclovir + forcarnet
presentation is diff in CMV for immunocompromised bc…
sx are retinitis and encephalitis
2 diff strains of flu
A and B
incubation period of flu
1-4 days… doesnt spread after that
signs and sx of flu
fever nonprod cough, fatigue, myalgia, rhinitis, HA, sore throat
sx of flu
clinical; but can do rapid nasal swab
when do we test for the flu
if itll change trmt
who getts the trmt for the flu?
high risk pop
trmt for flu
antiviral Tamiflu which shorterns sx 1-3 days and dec risk of complications
who is flu vaccine recommended for
6 mo +
3 fungal infections
cryptococcus, pneumocystis, histoplasmosis
cryptococcus organism
cryptococcus neoformans… a yeast
transmission of cryptococcus
inhaled from pigeon poop in soil
signs and sx of cryptococcus
asymptomatic, but can cause lung disease in immunocompromised and spread to look like meningitis
dx cryptococcus
lung: sputum culture
meningitis: LP and gram stain CSF
MCC of fungal meningitis
cryptococcus
if you see cryptococcus, you may susspect the pt has ____
AIDS
pneumocystis organism and transmission
pneumocystis jirovecii; unknown maybe airborne
pneumocystis is usually seen in
immunocompromised
signs and sx of pneumocystis
asymptomatic, but im immunocompromised interstitial pneumonia with fever, SOB, nonprod cough
pneumocystis dx
- chest x ray shows diffuse infiltrate
2. Ct if infiltrate seen
trmt pneumocystis
PPX; trimethoprim/TMP for 14-21 days`
MC opportunistic infection of AIDS
pneumocystis
histoplasmosis organism and transmission
histoplasma capsulatum; bat/bird poop in soil we inhale
histoplasmosis areas affected
ohio and mississippi
coin like lesions on cxr are in
histoplasmosis for iimmunocompetent
if someone has pneumonia/pericarditis with mediatstinal/hilar mass/lymphadenopathy suspect this
histoplasmosis
sx of histoplasmosis
mild flu like sx to severe pneumonia
histoplasmosis usually affects this popul.
immunocompromised
dx of histoplasmosis
bronchoscopy
culture and sensitivity
trmt for histoplasmosis in immunocompetent
none
distinguish histoplasmosis from this condition
sarcoidosis
risk factors for NF
IVDA, immunocompromised, ETOH abuse
NF caused by?
usually GAS strain with exotoxin
ss of NF
pain out of proportion, crepitus, systemically ill, compartment syndrome, anesthesia of area, cellulitis appearance, necrosis
dx of nf
CT scan
only way to definitiely dx nf
surgical exploration, biopsy, and debridement
if nf is suspected, start this right away
broad spectrum ATB, but then change based on what culture shows
fourniers gangrene?
nf of the perineum, destroys gluteal muscles, scrotum area remember that NF is from GAS and this is polymycrobial
fourniers gangrene is mc in
old men
group b strep/ s agalactiae
newborns have pneumonia, meningitis, bacteremia, and sepsis
group b strep/ s agalactiae sx
fever, lethargy, trouble breathing/feeding, irritability,
how is group b strep/ s agalactiae prevented
its screened for in pregnancy and the mother gets iv atb suring pregancy
vancomycin resistant enterococci is gram ___ ___
+ cocci
common uti pathogen
VRE
vre primary risk
hospitalization, primarily spread by HC workers
risks for vre
prevoius vancomycin, chronic disease, hospitalization, contaminated surfaces
ss of vre
uti and bacteremia
vre prevention
wash hands, ppe, clean rooms well, change catheters, isolate infected pt
dx vre
C and S via rectal swab
vre trmt
remove catheter if uti and often resolved. if not, treat with atb
diphtheria transmission
respiratory secretions
diphtheria ss
sore throat, rhinorrhea, hoarseness, malaise, fever, cervical lymphadnopathy, gray pseudomembrane on throat that cant be scraped off
diphtheria can lead to
upper airway obstruction
dx diphtheria
nose and throat culture
diphtheria trmt
remove membrane, PCN or erythromycin, antitoxin if severe
this diptheria is MC
laryngeal
pertussis transmission
resp secretions, very contagious
pertussis incubation
1-3 wks
ss pertussis
whoop cough and forceful cough that lasts 6 wks, emesis
is there a vaccine for pertussis
yes Tdap
stages of pertussis
catarrhal, paroxysmal, convalescent
most contagoius stage of pertussis
catarrhal
paroxysmal stage of pertussis
rapid coughing bursts that may cause broken ribs
dx pertussis
PCR nasal swab and culture
trmt pertussis
azithromyacin, clarithromyacin
consider this if someone has a cough for over 2 wks
pertussis
“spider bite”
CA MRSA
ss CA MRSA
warm, tender, draining/necrotic lesion that looks like a spider bite, maliase, fever (not common)
if no palpacle fluctuance is felt but you suspect an abscess, you must do this
bedside US or CT/MRI
_____ and abscesses
ID
abscess trmt
ID, ATB if recommended (clindamycin, bactrim, doxycycline) and cephalexin if cellulitis is present along with the abscess
____ alone is NOT enough trmt for an abscess
atb
CA MRSA pt education
warm compresses on abscess/cellulitis, use hibiclens body wash if recurrent infections, use bactroban nasal cream f
GAS is aka streptococcus _____
pyogenes
group B strep is streptococcus_____
agalctiae
pharyngitis is AKA ____ and is MC in
strep throat and kids ages 5-14
transmission pharyngitis
droplets
ss pharyngitis
sudden onset fever, sore throat, tender cervical lymphadenopathy, tonsillar enlargement/exudate, NV, dec appetite, palatal petechiae rash
centor criteria pharyngitis
tonsillar exudate, tender cervical adenopathy, fever, no cough, one extra pt given if btwn 3-14 yo
centor criteria btwn 0-2
unlikely to have gas, dont get a strep test
centor criteria btwn 3+
get a rapid strep test
if the strep test is - you can get this, but its only 80-90% sensitive
throat culture
if streo test is +, what is the trmt
atb
cause of scarlet fever
strain of GAS that produces erythrogenic toxin
ss scarlet fever
sandpaper feel, sunburn look, pastias lines, desquamation, strawberry tongue
trmt GAS
PCN or amoxicillin
trmt for GAS with pcn allergy
cephalosporin, azithromycin, biaxin
is empirical atb trmt for gas recommended
no
peritonsillar abscess is often____
polymicrobial
gas complications
tonsillar abscess, rneumatic fever, PSGN, PANDAS
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