Infectious 3 Flashcards
What to do for patients with positive serology and negative PCR for HCV?
repeat serology–If positive–indicate the previous infection
Positive serology and negative PCR?
Recent infection
Right side IE complication?
Rare peripheral symptom
Common septic PE
HF is not common
Often lack audible murmur
Cause of post influenza bacterial pnumonia?
S, Pneumonia
CA-MRSA
S, Pneumonia?
MCC(especially age >65)
Rare in young
Lobar pattern
CA-MRSA?
MCC in young adult
Rapid,diffiuze necrotising pnumonia
Multiple cavitary lesions, pulmonary infiltrate
Leukopenia
Other screening to do inpatient with gonococcal urethritis?
HIV
HBV
Syphilis serology(But if positive no need for additional Tx, ceftriaxone treat it)
Hydatid cyst of the liver?
Unilocular(Echinococcus granulosus)
Multilocular(Echinococcus Multilocularis)
Usually asymptomatic
can involve any organ
Contact with a dog is a risk(it is a carrier)
Eggshell calcification cyst in the liver is diagnostic
Albendazole is the treatment with surgery
Is spilled during surgery it can cause anaphylaxis
What to do inpatient with active CMV infection(e.g colitis)
Retinal examination
How to diagnose CMG organ(GI and other ) infection?
Tissue biopsy
viremia not diagnostic
C.trachomatis infection?
Treat with azithromycin
Partner with contact in last 60 days should be screened and treated
Reinfection is common
The HACEK group of bacteria?
1) Include (Haemophilus species, Aggregatibacter species, Cardiobacterium hominis, Eikenella corrodens, and Kingella species)
2) Are a small, heterogeneous group of fastidious, gram-negative bacteria
3) Frequently colonize the oropharynx and
4) Have long been recognized as a cause of infective endocarditis(<3 %)
Coccidiosis?
Inhalation of arthroconidia SW USA(Arizona,California) Pneumonia Artheralgia Erythema nodusum Erythema multiform
diagnosis?
serology
Culture
Managment?
In healthy–Just do a follow-up
Inpatient with underlying disease–Dissemination(bone, CNS and skin is common)–Need antifungal(ketoconazole,fluconazole)
Cutaneous larva migrant cause?
hookworm larva
Human is incidental host
Contact with the ground by barefoot is the risk
from dog or cat
CM?
Primarily affect LE
Cutaneous(deep involvement is rare)
erythematous pruritic papule at the site of entry
Intensely pruritic, migrating serpiginous reddish-brown track
Diagnosis?
Clinical
eosinophil is normal
Managment?
Ivermectin
Risk for legionella pnumonia?
Water contact within last 2 week
CM?
Fever >39 Relative bradycardia Neurologic symptom(confusion) GI symptom (Diarrhea) Unresponsive to BL and AG antibiotic
Laboratory?
Hyponatremia
Hepatic dysfunction
Hematuria and protinuria
sputum gram stain show many or small microorganisms
Diagnosis?
Urine Ag test
Culture(charcoal yeast extract)
Managment?
Macrolide/FQ
Prophylaxis for travelers?
HAV vacine
Typhoid vaccine
atovaquone-proguanil, doxycycline, or mefloquine > 2 weeks prior, stay and 4 weeks after return
mefloquine S/E?
Neuropsychiatric (anxiety, depression and restlessness)
EHEC?
MCC of bloody diarrhea without fever Shiga toxin(pathogenesis and diagnosis) Caused by eating uncooked beef Tx--Supportive AB- Not recomended B/C of it increase risk of HUS
Bloody diarrhea with fever etiology?
C.Jujuni
Nontyphidal salmonella
L.Monocytinogen
B.Cerus diarrhea?
Reheated rice
Due to preformed enterotoxine
Resolve within 48 Hr
Vomiting more predominate(1-6hr)
epidemiology of chikungunya fever?
T & ST parts of C/S America Asia and Africa
Transmited by Aedes mosquito(also D & Z)
CM?
IP(3-7) day Flu-like symptoms Sever polyarthralgia(usually present) Maculopapular rash LDP Conjunctivitis Low PLT and Lymphopenia Elevated TA
Managment?
supportive
methotrexate if develop chronic arthralgia(>50 % develop it)
Secondary syphilis?
Centrifugal rash involves palm and sole LDP(epitrochlear is pathognomic) C.Latum(gray genital papule) Oral lesion' hepatitis
Differential?
RMSF(centripetal rash) Endemic Typus(spares hand and palm)
Treatment?
1 dose penicillin
the first thing to do inpatient suspected of IE?
Blood sample from 3 different puncture site
What to do in patients Negativ TST?
No additional test
But in case of a positive repeat test
Meningiococus for HIV aptient?
vaccinate and give every 5 years as a booster
etiology of acute epididymitis?
AGE <35(N.G and C.T), More STI related
Age >35(choliform bacteria like E.Coli),More Obstraction related
