Infection CPC

Question 1

Widespread, bilateral ground glass shadowing with reduced exercise tolerance

Answer 1

PCP pneumonia

Question 2

Tx of PCP pneumonia

Answer 2

Co-trimoxazole

Question 3

PCP staining

Answer 3

Silver stain - grocott gromori

Question 4

What is a side effect of co-triimoxazole?

Answer 4

Widespread erythematous rash

Question 5

Risk of diff infections as CD4 count falls progressively

Answer 5

Question 6

Link between type of immunodeficiency and type of infection

Answer 6

Question 7

Who does actinomyces affect? Why is it an issue?

Answer 7

Alcoholics and immunocompromised patients

Indolent and slow growing - difficult to treat

Question 8

What type of bacteria is actinomyces? Which other bacteria is it associated with?

Answer 8

Gram positive rod

Branching

**closely associated with nocardia- another gram positive rod

Question 9

Classic histological staining pattern of actinomyces

Answer 9

Basophilic sulfur granules

**need to specifically request for this test

Question 10

What infections does actinomyces cause?

Answer 10

Classically causes lung and brain abscesses

Question 11

Why do prosthetic joint infections need surgical debridement?

Answer 11

Because bacteria can form biofilm making it difficult for antibiotics to penetrate so require surgical debridement

Question 12

What is the most important aspect of treating prosthetic joint infections?

Answer 12

Often need surgical debridement to prevent the infection from spreading

i.e. often antibiotics are not enough

Question 13

Treatment of c difficile infection

Answer 13

Non-severe

• Metronidazole
• If not responding within 72h–> switch to vancomycin

Severe

• Vancomycin +/- metronidazole

Question 14

Which ribotype of C difficile is harder to treat?

Answer 14

RIbotype 027

was assoictaed with an outbreak in june 2005

Question 15

WCC and CRP in c difficile colitis

Answer 15

High WCC

Normal CRP