Infections

Question 1

Clinical clues for a pyogenic hepatic abscess

Answer 1

H/o diverticulitis, diarrhea, or recent GI instrumentation. Absence of high risk travel

Question 2

1st line treatment for pyogenic hepatic abscess

Answer 2

Broad spectrum IV abx +/- percutaneous drain (+ for large / complex abscesses)

Question 3

1st line treatment for amoebic hepatic abscess

Answer 3

Metronidazole.
percutaneous drain only if complex, not improving, and/or risk of rupture.

Question 4

Clinical clues for hydatid (Echinococcus) hepatic abscess

Answer 4

Distant exposure to Mediterranean/Central Asia.
Daughter cysts on imaging.

Question 5

Clues for a histoplasmosis infection include

Answer 5

Calcified lesions seen incidentally on chest imaging with patient around the Ohio / Mississippi river valleys.

Question 6

Management of an uncomplicated histoplasmosis infection

Answer 6

Observation / supportive care.
Antifungals if symptomatic.

Question 7

Most common organism causing late prosthetic graft infections (> 4 month postop)

Answer 7

S. epidermidis
forms biofilm over implanted foreign body

Question 8

Necrotizing fasciitis is most commonly due to

Answer 8

Polymicrobial infection.

Question 9

What are important virulent factors of Streptococcus / Staphylococcus species that cause them to be the initial infecting bacteria in NSTI?

Answer 9

M proteins & streptococcal pyrogenic exotoxins.

Question 10

What types of HPV are associated with anal cancer and high grade dysplasia?

Answer 10

HPV 16 and 18.
- 6 & 11 are associated with benign genital warts.

Question 11

Treatment for ampicillin-resistant VRE?

Answer 11

Linezolid and daptomycin

Question 12

What is paronychia and how do you manage it?

Answer 12

Infection of soft tissue around fingernails.
- Surgical excision of proximal nail to expose nail bed and drainage of wound.
- Oral abx (Augmentin).