Infections Flashcards
What are five common infections caused by Strep pneumoniae
-itis problems (MOBS CAP)
Meningitis
Otitis media
Bronchitis
Sinusitis
CAP
Good antibiotic options for treating acute otitis media or sinusitis
Usually caused by gram positive
Amoxicillin
Augmentin
Bactrim
Good antibiotic options for treatment of acute endocartitis
Vancomycin + Ceftriaxone
Treating Staph aureus
Good antibiotic option for treating peritonitis due to ruptured viscus
Usually caused by Coliforms or Bacteroides fragilis
Treat with metronidazole plus cephalosporin (3rd generation)
or
Piperacillin/tazobactam (Zosyn)
Good antibiotic option for treatment of intra-abdominal infections
Usually treating E. coli, Klebsiella, bacteroides fragilis, or Enterococci
Cefuroxime or Ceftriaxone
Ciprofloxacin/Levofloxacin
Plus metronidazole
Good antibiotic option for the treatment of cellulitis
Usually caused by Staph aureus or Group A Strep
1st generation cephalosporin (cefazolin)
Vancomycin - should be used based on local incidence of MRSA
Clindamycin
Linezolid
Good antibiotic option for treating sepsis
Could be any pathogen
Vancomycin plus 3rd or 4th generation cephalosporin
or
Zosyn
or
Imipenem
or
Meropenem
Antibiotic of choice when treating Staph, strep, gram negative rods
Cefazolin
Antibiotic of choice when treating MRSA
Vancomycin
Symptoms of Gonorrhea
Often asymptomatic
Similarities between men and women:
Dysuria
Urinary frequency
Mucopurulent discharge (green with women, white/yellowish with men)
In Women:
Labial pain and swelling
Lower abd pain
Fever
Dysmenorrhea
Diagnostics and treatment of Gonorrhea
NAAT (Nucleic Acid amplification test) - urine test
Treatment:
Ceftriaxone 1g IM x1
If concern for Chlamydia as well: Doxycycline 100mg PO BID x7 days
Need to report to health department
What is the bacteria that causes syphilis
Treponema pallidum
Diagnostic and treatment for syphilis
Diagnostic testing: VDRL or RPR
If this comes back positive:
—Treponema pallidum particle agglutination assay (TP-PA)
—Fluorescent treponemal antibody absorption (FTA-ABS)
Treatment:
Primary/secondary:
Benzathine Penicillin G 2.4 million units IM x1
Tertiary:
Benzathine Penicillin G 2.4 million units IM weekly x3 weeks
Report to the health department
What is the most common STD?
Chlamydia
What are the causes of dyspareunia?
Dyspareunia - painful intercourse
Chlamydia
Trichamonas
Menopause
Pelvic Inflammatory Disease (PID)
Treatment for Chlamydia
Azithromycin 1 gram PO x1
or
Doxycycline 100mg PO BID x7 days
Report to the health department
What is vulvovaginitis and how does it present clinically?
Inflammation or infection of the vulva and vagina
Trichomoniasis, bacterial vaginosis and candidiasis are commonly responsible for vulvovaginitis
—Trich is the only one sexually transmitted
Trichomoniasis: Malodorous, frothy, yellowish-greenish discharge, pruritus, petechiae (strawberry patches) on cervix and vaginal walls, dyspareunia, dysuria
Bacterial vaginosis: Water, gray, fishy-smelling discharge, vaginal spotting
Candidiasis: Thick, white, curd like discharge: vulvovaginal erythema with pruritus
Diagnostics for vulvovaginitis
Can use NAAT
If you use microscopic wet-prep
Trich: Normal saline mix shows trichomonads
BV: Normal saline mix shows clue cells
Candidiasis: KOH mix shows pseudo hyphae
Treatment for vulvovaginitis
Trich: Metronidazole 2g PO x1 or 500mg PO BID x7 days depending on how bad
BV: Metronidazole 500mg PO BID x7 days
or
Metronidazole gel 0.75% applicator intravaginally daily x5 days
Candidiasis: Miconazole intravaginally x7 days
Clotrimazole intravaginally
Difference between syphilis and chanroid ulcer
Syphilis is painless
Chanroid is painful - often not seen in women
Treatment for chancroid
Azithromycin 1g PO x1
or
Ceftriaxone 250mg IM x1
