infection Flashcards
Lyme disease rx:
1st line
2nd line (if cannot have above)
doxycycline
amoxicillin
latent TB rx (2 options)
3 months of isoniazid (with pyridoxine) and rifampicin
or
6 months of isoniazid (with pyridoxine)
active TB rx
initial phase (1st 2 months)
- Rifampicin
- Izoniazid
- pyrazinamide
- ethambutol
continuation phase (next 4 months)
- rifampacin
- izoniazid
rifampacin SE (4)
potent liver enzyme inducer
hepatitis
orange secretions
flu-like symptoms
isoniazid SE (4)
peripheral neuropathy: prevent with pyridoxine (Vitamin B6)
hepatitis
agranulocytosis
liver enzyme inhibitor
pyrazinamide SE (4)
hyperuricaemia causing gout
arthralgia
myalgia
hepatitis
ethambutol SE (1)
optic neuritis: check visual acuity before and during treatment
campylobacter rx
(treat only in severe infection as is usually self-limiting)
clarithromycin
necrotising fasciitis causative organism:
type 1
type 2
type 1: mixed aerobes and anaerobes (more common)
type 2: strep pyogenes
cellulitis management
& in penicillin allergic
- flucloxacillin
- clarithromycin, erythromycin (if pregnant), doxy
giardiasis (giardia lamblia)
RF (3)
foreign travel
swimming/ drinking river water
MSM
giardiasis (giardia lamblia)
features (8)
often asymptomatic
non-bloody diarrhoea
steatorrhoea
bloating, abdominal pain
lethargy
flatulence
weight loss
malabsorption and lactose intolerance can occur
giardiasis (giardia lamblia)
mgt
metronidazole
metronidazole interactions (2):
disulfiram-like reaction with alcohol
increases the anticoagulant effect of warfarin
chlamydia mgt (1st and 2nd line)
- doxycycline
- azithromycin
live attenuated vaccines
BOOMY
BCG
oral polio
oral typhoid
MMR
yellow fever
typhoid mgt:
ciprofloxacin (only in severe infections or immunocomprimised)
inactivated vaccines
rabies
HEp A
influenza (im)
toxoid (inactivated toxin)
tetanus
diphtheria
pertussis
how many tetanus vaccines confer life-long protection?
5
meningitis mgt
i. pre-hospital
ii. in hospital
iii. mgt of contacts
i. im benzylpenicillin
ii.cefotaxime (or ceftriaxone)
& amoxicillin (ampicillin if >50 or <3 months )
iii. oral cipro/ rifampicin
mgt of meningitis contacts
(contacts of confirmed bacterial meningitis if they had close contact within 7 days before onset)
oral ciprofloxacin or rifampacin
gas gangrene causative organism
clostridium perfringes
typhoid
i. causative organism
ii. transmission
i. salmonella typhi
ii. faecal oral
typhoid features: (4)
relative bradycardia
abdominal pain, distension
constipation (can also have diarrhoea)
rose spots (more common in paratyphoid)
typhoid cx (5)
osteomyelitis (especially in sickle cell disease where Salmonella is one of the most common pathogens)
GI bleed/perforation
meningitis
cholecystitis
chronic carriage (1%, more likely if adult females)
genital wart mgt:
i. multiple, non-keratinised
ii. solitary, keratinised
i. topical podophyllum
ii. cryotherapy
gonorrhoea (neisseria gonorrhoeae)
i. type of bacteria
ii. mgt
i. gram -ve dipplococcus
ii. stat im ceftriaxone 1g
if sensitivities known stat PO ciprofloxacin 500mg
if im refused –> PO cefiximine 400mg stat and PO azithromycin 2g
Hep B serology
i. acute infection
ii. immunity
iii. previous/ current infection
i. HBsAg (if present for > 6 months suggests chronic)
ii. anti-HBs
iii. anti–HBc
legionella pneumonia features: (5)
flu-like sx+ fever
dry cough
relative bradycardia
confusion
pleural effusion (30%)
legionella pneumonia blood results: (4)
hyponatraemia
lymphopenia
deranged LFTs
raised CRP
legionella pneumonia ix:
- urinary antigen
- CXR (mid to lower zone patchy consolidation, pleural effusion 30%)
legionella pneumonia mgt
macrolide –> erythromycin/ clarithromycin
most common causative organism for pneumonia post flu
s. aureus
most common cause of travellers’ diarrhoea
e. coli
mycoplasma pneumonia cx (2)
haemolytic anaemia
erythema multiforme
mycoplasma ix:
serology
most common organism responsible for exacerbations of bronchiectasis
h. influenzae
(also causes acute epiglottitis)
epiglottitis cause:
h. influenzae
bronchiolitis causative organism
RSV
croup causative organism
parainfluenza
common cold causative organism
rhinovirus
common cause of pneumonia in CF pts:
pseudomonas aeroginosa
pneumocystis jyroverci rx:
co-trimoxazole
Kaposi sarcoma causative organism
HHV-8
diarrhoeal illness:
1-6 hr incubation period
s. aureus
b. cereus (rice)
diarrhoeal illness:
12-48 hr incubation period
salmonella
e. coli
diarrhoeal illness:
48-72 hr incubation period
shigella
campylobacter
diarrhoeal illness:
>7 day incubation period
giardiasis
amoebasies
trichomonas vaginalis
presentation:
PV discharge: offensive, yellow/ green, frithy
vulvovaginitis
pH>4.5
asx/ urethritis in M
trichomonas vaginalis
ix
motile trophozoites on microscopy
trichomonas vaginalis
mgt
metronidazole 5-6 days
(or 2g stat dose)
genital ulceration causes:
HSV
syphilis
chancroid (haemophilus ducreyi)
chlamydia (lymphogranoloma venerum)
carcinoma
Bechet’s disease
granuloma inguinale (klebsiella granulomatis)
HSV presentation (4)
painful genital ulceration (+/- dysuria/ pruritus)
primary infection more severe than subsequent
tender inguinal lymphadenopathy
may have urinary retention
syphilis primary presentation:
painless ulcer
chancroid
causative organism
haemophilus ducreyi
chancroid
presentation
PAINFUL ulcers - sharply defined, ragged undermined border
UNILATERAL PAINFUL lymphadenopathy
what are the genital ulcers caused by chlamydia infection called?
lymphogranuloma venereum
diptheria (corynebacterium diptheriae)
presentation: (5)
hx travel to Eastern Europe/ Russia/ Asia
sore throat + “diptheric membrane” - grey pseudomembrane on posterior pharyngeal wall
bulky cervical lymphadenopathy (‘bull neck’ appearance)
neuritis e.g. cranial nerves
heart block
diptheria mgt
im penicillin
diptheria antitoxin
