Infectious Flashcards
What patients should receive prophylactic antibiotics for dental procedures?
Previous history of endocarditis, prosthetic valve or material for repair, heart transplant patients, and severe or partially repaired congenital heart defects
How does Group B streptococcal pneumonia present in a neonate?
Rapid onset of respiratory distress following birth, low WBC count with a left shift, and a patchy infiltrate on chest x-ray
How does chlamydial pneumonia present in an infant?
It is generally a mild pneumonia that can develop in an exposed infant at several weeks of life.
How does TB meningitis present?
TB meningitis is most commonly seen between six months and four years of life. The first stage lasts one to two weeks and includes nonspecific symptoms, such as vomiting, irritability, listlessness, anorexia, and fever. The second stage begins abruptly with seizures, lethargy, hypertonicity, hydrocephalus, and focal neurologic signs. The third stage includes coma, hypertension, posturing, decompensation, and death.
What are the most common organisms found in septic arthritis?
In children, S. aureus. In sexually active teens, N. gonorrhea is a common cause
What patient populations should receive prophylactic antibiotics after a dog bite?
Infants, diabetics, and immunocompromised patients. Note that usually only 4% of dog bites become infected (usually Pasteurella multocida - treated with augmentin), so it is generally not recommended to treat healthy patients prophylactically
What symptoms does Cyclospora cayetanesis (protozoan) cause and how is it treated?
Can cause prolonged watery diarrhea and flatulence after an incubation period of about 7 days. Exposure is through contaminated foods (e.g. produce). Diagnosis is confirmed by identifying oocysts in the stool. Trimethoprim/sulfamethoxazole is the treatment of choice; ciprofloxacin is an alternative.
What parasitic infection causes B12 deficiency?
Diphyllobothrium latum
What are recommendations for an infant exposed to varicella in the perinatal period?
Per CDC recommendations, varicella-zoster immunoglobulin (VZIG) should be administered to the infant immediately after delivery if the mother had the onset of varicella within 5 days prior to delivery, and immediately upon diagnosis if her chicken pox started within 2 days after delivery. If untreated, about half of these infants will develop serious varicella as early as 1 day of age. If a normal full-term newborn is exposed to chicken pox 2 or more days postnatally, VZIG and isolation are not necessary because these babies appear to be at no greater risk for complications than older children. Acyclovir may be used in infants at risk for severe varicella, such as those infants exposed perinatally.
What are the features of congenital syphilis?
The clinical presentation of congenital syphilis is varied. Many newborns appear normal at birth and continue to be asymptomatic for the first few weeks or months of life. Most untreated infants will develop skin lesions, typically an infiltrative, maculopapular peeling rash that is most prominent on the face, palms, and soles. Involvement of the nasal mucous membranes causes rhinitis with a resultant serous, and occasionally purulent, blood-tinged discharge (snuffles). This, as well as scrapings from the skin lesions, contains abundant viable treponemes. Hepatosplenomegaly and lymphadenopathy are common, and early jaundice is a manifestation of syphilitic hepatitis. Liver function tests are elevated; hemolytic anemia and thrombocytopenia are common. Infants may have a saddle nose, a result of destruction of bone from syphilitic rhinitis. Among the later manifestations, or stigmata, of congenital syphilis is interstitial keratitis, which is an acute inflammation of the cornea that begins in early childhood (most commonly between 6 and 14 years of age). Interstitial keratitis represents the response of the tissue to earlier sensitization. Findings include marked photophobia, lacrimation, corneal haziness, and eventual scarring. Hutchinson teeth (peg or barrel-shaped upper central incisors), abnormal enamel, and mulberry molars (first lower molars with an abnormal number of cusps) are dental manifestations of syphilis.
What are features of congenital rubella?
Infants will be small, with intrauterine growth retardation. They may also manifest cataracts, microphthalmia, myocarditis, and a red or purple macular rash (“blueberry muffin” rash). Structural heart defects (such as a patent ductus arteriosis, pulmonary artery stenosis, and septal defects) are typical of congenital rubella, but not in the other TORCH infections. Laboratory anomalies may include a hemolytic anemia with thrombocytopenia, elevated liver functions, and pleocytosis in the spinal fluid. Affected children do not have a good prognosis.
What is the classic triad of a congenital toxoplasmosis infection?
Hydrocephalus, chorioretinitis, and intracranial calcifications
What are features of congenital CMV infections
CMV is the most common sort of congenital infection, with infection estimates ranging from 0.4% to 2.4% of all live births. Many cases are asymptomatic; others may develop cytomegalic inclusion disease: a multiorgan manifestation of disease including IUGR, hepatosplenomegaly, jaundice, petechiae or purpura, microcephaly, chorioretinitis, and intracranial calcifications. More than half of infants with this congenital infection develop sensorineural hearing loss.
What is the criteria for diagnosis of rheumatic fever?
The Jones criteria: polyarthritis, carditis, subcutaneous nodules, erythema marginatum, and Sydenham chorea. These are the major criteria (need at least 2 to diagnose, but note that the presence of Sydenham chorea by itself is enough to diagnose). Polyarthritis is the most common finding
What disease symptoms does Toxocara canis cause and how is it treated?
It is a common parasite of dogs. Dirt-eating children ingest the infectious ova. The larvae penetrate the intestine and migrate to visceral sites, such as the liver, lung, eye and brain, but do not return to the intestine, so the stools do not contain the ova or parasites (dx made by ELISA). Symptoms may include wheezing, cough, hepatomegaly, seizures, abdominal pain, decreased visual acuity and eosinophilia. Patients with minimal symptoms may be managed expectantly, while patients with more significant symptoms may be treated with albendazole.
