Infections and antibiotics Flashcards
What is the most common bacterial cause of tonsilitis?
group A beta-haemolytic strep (strep pyogenes)
What is the bacteria associated with rheumatic fever?
group A beta haemolytic strep - usually strep. pyogenes from tonsilitis
What are the most common bacteria associated with infective endocarditis?
strep viridans
staph aureus
staph epidermidis
What causes croup?
parainfluenza virus type 1 or 3
what causes acute epiglottitis ?
human influenza type B
What causes bronchiolitis?
respiratory syncytial virus
what bacterial most commonly causes otitis media?
strep pneumonia
HiB
moraxella cararrhalis
what type of pneumonia is associated with having erythema multforme and eythema nodosum
mycoplasma pneumoniae
What antibiotic is used for bacterial tonsilitis?
Pen V
Clarithromycin/ erythromycin in penicillin allergic
What bacteria cause UTIS?
KEEPS
Klebsiella pneumoniae
Enterococci
E.coli
Proteus mirabillis
Staphylococcus aureus
what antibiotic is used to treat UTIs in adults
3 days trimethoprim or nitrofuratoin in women
men/complicated= 7 days
How are upper UTIs treated in children?
either IV or oral cephalosporin or co-amoxiclav
How are UTIs treated in pregnant women?
if early in pregnancy can give 7 days nitrofuratoin
If later can give 7 days cefalexin or amoxicillin
what bacteria causes syphilis?
treponema pallidum
how is syphilis treated?
IM benzathin penicillin
(alternative = doxycyline)
what test can be done for syphilis?
direct tests with swabs- dark field microscopy or PCR
serological tests: treponemal tests (TP-EIA or TPHA) or non-treponemal tests (RPR or VRDL)
what bacteria most commonly cause otitis externa?
pseudomonas aeruginosa and staph aureus
How is otitis externa treated?
mild- acetic acid 2%
Moderate- topical antibiotic and steroid
- neomycin (dexamethasone and acetic acid)
- neomycin and betamethasone
- gentamycin and hydrocortisone)
severe- oral antibiotics (flucloxacillin)
What might be used to administer antibiotics if very severe otitis externa
an ear wick (pope wick)
What needs to be checked before giving antibiotics for otitis externa
need to exclude perforated tympanic membrane- gentamycin and neomycin are ototoxic so can cause hearing loss if crossing the tympanic membrane
What bacteria most commonly causes mastitis?
staph. aureus
how is mastitis treated?
flucloxacillin 10-14 days
What bacteria causes lymes disease?
Borrelia burgdorferi
What antibiotics are given for lymes disease?
doxycyline if early disease
ceftriaxone if disseminated disease
How is lymes disease diagnosed?
ELISA test (not needed if eryhtema migrans is present)
- if negative repeat in 4-6 weeks
- if still negative = immunoblot test
What antiviral might be considered in those at high risk with influenza
oral oseltamivir or inhaled zanamivir
How is gonorrhoea treated?
IM 1g ceftriaxone
how is gonorrhoea treated in needle phobic?
400mg oral cefixime and 2g oral azithromycin
How is gonorrohoea diagnosed?
NAAT
HOw is chlamydia treated?
doxycycline 7 days
how is chlamydia treated in pregnant women?
azithromycin
What bacteria cause bacterial vaginosis?
gardnerella vaginalis
prevotella species
bacteriodes species
peptostreptococcus species
pathophysiology of how bacterial vaginosis occurs
bacteria such as gardnerella cause and overgrowth and replace normal vaginal bacteria- this leads to rise in pH
How is bacterial vaginosis treated for?
microscopy- shows clue cells
how is bacterial vaginosis treated?
oral metronidazole 400mg for 5-7 days
single dose 2g metronidazole (not if pregnant)
intravaginal metronidazole gel for 5 days
What criteria is used for bacterial vaginosis ?
amsel criteria
what makes up the amsel criteria?
vaginal pH > 4.5
typical discharge- thin, white, homogenous
positive whiff-amine test
clue cells on microscopy
what bacterial causes scarlet fever?
Group A beta haemolytic strep (strep. pyogenes)
How is scarlet fever treated?
oral pen V for 10 days (azithromycin if allergic)
complications of scarlet fever
otitis media
peritonsillar abscess
acute rheumatic fever
acute post strep glomerulonephritis
pneumonia, meningitis
How does scarlet fever present?
Sore throat, fever, headache
pinpoint sandpaper like rash
strawberry tongue
cervical lymphadenopathy
circumoral palor
when can children with scarlet fever return to school?
24 hours after commensing antibiotics
What bacteria causes whooping cough?
bordatella pertussis
what antibiotic is used to treat whooping cough
azithromycin or erythromycin
what causes slapped cheek syndrome?
parvovirus B19
What causes staphyloccocal scalded skin?
staph aureus which produced epidermolytic toxins
how is staphyococcal scalded skin treated ?
IV flucloxacillin
analgesia
hydration
hospital admission
what are some complications of mealses
otitis media
pneumonia
encephalitis
subacute sclerosis panencephalitis
what causes toxic shock syndrome?
toxin secreting staph aureus or group A streptococcal
what is the diagnostic criteria of toxic shock syndrome?
temperature >38.9
hypotension (systolic BP <90)
diffuse erythematous rash
involvement of 3 or more organ systems (GI, mucous membranes, renal failure, CNS, thrombocytopenia)
Pathophysiology of toxic shock syndrome
severe systemic reaction to staphylococcal exotoxins- in particular TSST-1 superantigen toxin
How is impetigo treated?
if limited disease- topical 1% hydrogen peroxide or topical fusidic acid
if severe- flucloxacillin
When can children with impetigo return to school?
when all lesions are dry and crusted, or over 48 hours after starting antibiotics
