Infectious Disease Flashcards
Common bacterial organisms for neonates (< 1 mo)
GBS
E. coli
Strep pneumo
Staph aureus
Common bacterial organisms for infants (1-12 mo)
GBS
E. coli
Strep pneumo
Staph aureus
Salmonella
Common bacterial organisms for immunocompromised
Gram-negative bacilli
(Pseudomonas, E. coli, Klebsiella)
Staph
Common bacterial organisms for asplenic patients
Encapsulated organisms
(strep pneumo, H flu, N meningitidis)
Usual bugs for neonatal meningitis
GBS
Listeria
E. coli
Enterovirus (spring/summer)
Usual bugs for meningitis in young children
Strep pneumo
N meningitis
Enterovirus
Borrelia
Rickettsia
Most common reportable STD in US
Chlamydia trachomatis
Newborn
Afebrile
Staccato cough
Tachypnea
Intracytoplasmic inclusion bodies
Chlamydia trachomatis
Diagnostic test and management for Chlamydia trachomatis
PCR
PO erythromycin or azithromycin
Erythromycin eye ointment for Chlamydia conjunctivitis ppx
Diagnostic test for chlamydiphilia pneumonia and management
Immunoflourescent antibodies
Azithromycin x 5 days
Or
Erythromycin x 14 days
Purpuric macular rash that starts on wrists/ankles or palms/soles and spreads centrally
Thrombocytopenia
Hyponatremia
Occurs in spring and summer
Most common fatal tick-borne disease in US
Rocky Mountain Spotted Fever
Diagnosis and management for RMSF
Direct immunofluorescence of skin biopsy
Doxycycline (even for < 8 yo)
Similar to RMSF
No rash
Leukopenia
Elevated LFTs
Inclusion bodies
Human erlichiosis
Neonatal sepsis
Childhood meningitis
Periorbital cellulitis
Pyogenic arthritis
Epiglottitis
Unimmunized
Management
H flu type B
Tx ceftriaxone or cefotaxime
Steroids can decrease risk of hearing loss
Prophylaxis for Hib exposure
Rifampin
If anyone in household is < 12 mo who has not received primary series of Hib vaccine or < 4 yo who is partially immunized or immunocompromised
Post exposure management for Hib
Unimmunized or incompletely immunized should receive Hib vaccine and proceed with regular vaccine series
Stage of pertussis
Typical cold-like symptoms
1-2 weeks
Catarrhal
Stage of pertussis
Paroxysms of coughing
Inspiratory whooping
4 weeks
Paroxysmal
Stage of pertussis
100 day cough
Waning symptoms
1-2 mo
Convalescent
Unimmunized
Coughing
Respiratory distress/failure
Lymphocytosis
Pertussis
Diagnosis and management of pertussis
PCR
Erythromycin, clarithromyxin, or azithromycin
Pertussis vaccine boosters: pregnant women, teenagers, all adults in contact of newborn infant
Post-exposure ppx
Asymptomatic close contacts
Erythromycin, clarithromycin, or azithromycin
Loose watery diarrhea
Vomiting
Abdominal
Cramps
Fever
Summer picnic
Salmonella
Carriers of salmonella
Chicken
Egg
Red meat
Unpasteurized milk and ice cream
Raw fruits and vegetables
Turtles, snakes, hedgehogs
Management for uncomplicated (non-invasive) Salmonella gastroenteritis
Supportive
Indications for salmonella treatment
Treatment
< 3 mo
Hemoglobinopathies
Malignancies
Severe colitis
Immunocomprmised
Ceftriaxone, azithromycin, quinolones
Headache
Abdominal pain
Malaise
High fever
HSM
Red or rose spots
Fever pulse dissociation
Immigrant
Management
Typhoid fever
Cefotaxime and ceftriaxone
Watery/bloody diarrhea
Fever
Seizure
Left shift on CBC
Pools, hot tubs, lakes, oceans
Shigella
Management for Shigella
Oral rehydration
Treatment only recommended for severe disease, dysentery, immunosuppressive
-ceftriaxone, azithro in children
-Cipro in non-pregnant > 18 yo
Osteomyelitis/osteochondritis
Puncture wounds
Otitis externa
Mechanical ventilators
Immunocompromised
CF
Pseudomonas
Management for pseudomonas
Zosyn
Gentamicin
Carbapenems and ceftazidime (pulmonary)
Cipro
Levo
Unpasteurized milk and dairy products
Exposure to cattle, sheep, goat
fever
Malaise
Management
Brucellosis
Tetracycline or Bactrim
Bloody/watery diarrhea
Recent antibiotic use
Pseudomembranous colitis
C diff
Diagnosis and management for c diff
Enzyme immunoassay
PO flagyl or PO vancomycin
Soap and water
Alcohol does not kill c diff
Sunburn-like sandpaper rash that blanches
Spares the face, palms, soles
Pastia lines
Perioral pallor
Scarlet fever
Skin rash
We’ll-defined borders
Develops quickly
Erysipelas
Skin rash
Ill-defined borders
Develops slowly
Cellulitis
Sore throat
Fever
Erythema/edema of posterior pharynx
Palatal petechiae
Strawberry tongue
Strep pharyngitis
Fever
Pharyngeal exudate
LAD
rash
No palatal petechiae or strawberry tongue
Arcanobacterium harmolyticum
Tx: erythromycin, azithro, clarithro
Not pencillin
Rapidly evolving rash
Erythema
Marked inflation
Bullous formation
Pain out of proportion
Necrotizing fasciitis
Well known risk factor for invasive GAS and necrotizing fasciitis
Varicella
Fever
Nausea, vomiting
Diarrhea
Erythroderma
Shock, organ failure
Toxic shock syndrome
Management for hospital acquired MRSA
Vancomycin
Management for community acquired MRSA
Bactrim or clindamycin
Management for MRSA abscesses < 5 cm
I&D only
No antibiotics
Three types of botulism
Food-borne
Wound
Infantile
6 Ds of Botulism
Diploplia
Dysphagia
Dysarthria
Dying to pee and poop (retention)
Dysphonia
Descending symmetrical paralysis
Pathophysiology of botulism toxin
Blocks release of acetylcholine into the synapse
Anaerobic, gram positive, spore forming rods
Clostridium tetani, botulinum, perfringens
Management for botulism
Supportive
Antibiotics not indicated
Aminoglycosides can potentiate paralytic effect
Antitoxin for infant botulism
Penicillin or Flagyl for wound botulism
Painless indurated ulcer (chancre)
Erythematous, rounded slightly raised
Clean edges/base
Primary syphilis
Polymorphic rash that includes palms and soles
Mucocutaneous lesions
LAD
Condylomata lata
Secondary syphilis
Gumma
Neurosyphylis
Tertiary syphilis
Testing for syphilis
RPR
VDRL
If history of syphilis +/- treatment, FTA-ABS positive for life
Management for syphilis
Penicillin G
(Cross placenta)
When to treat newborn if mother who was treated for syphilis during pregnancy
If mother treated within 1 mo of delivery
If mother treated with anything other than penicillin
If baby’s tigers higher than mother’s
Snuffles
Bullous lesions
Osteochondritis
Pseudoparalysis
Hutchinson triad (interstitial keratitis, CN 8 deafness, Hutchinson teeth)
Congenital syphilis
Membranous nasopharyngitis
Bloody nasal discharge
Bull neck
Irregular staining, gram positive, non spore-forming, nonmotile, pleomorphic bacillus
Corynebacterium diphtheria
Treatment for C diphtheria
Erythromycin or PCN x 14 days
Plus
Single dose of equine antitoxin
Gram positive cocci in chains
Neonatal and catheter associated bacteremia
Management
Enterococci
Ampicillin and vancomycin
Gram negative coccobacilli
Suppurative arthritis
Osteomyelitis
Bacteremia
Management
Kingella kingae (moraxella)
Cephalosporin or Unasyn
Facultative anaerobic, nonspore forming, motile, gram positive bacillus
Multiplies intracellularly
Food borne (lunch meat, cheese, ice cream)
Pregnant women
Advanced age
Newborns
Immunocompromised
Management
Listeria monocytogenes
IV ampicillin + aminoglycoside (gentamicin)
Not cephalosporins
Aerobic, nonmotile gram negative catalase and oxidase positive diplococci
Grown in chocolate or blood agar
Meningitis
Petechial/purpuric rash
Management
Neisseria meningitidis
Cefotaxime or ceftriaxone
Risk factors for N meningitidis
Dormatories
Military boot camps
Terminal complement component deficiencies
Asplenia
Overcrowding
Poverty
Malnutrition
Meningococcal prophylaxis criteria and treatment
Household contacts
Child care/preschool within 7 days of illness
Direct exposure to secretions within 7 days
Slept in same area within 7 days
Prolonged contact in close proximity within 7 days
Health care workers exposed directly to secretions without mask in first 2 days of therapy
Rifampin
Most common cause of bacterial gastroenteritis in the developed world
Campylobacter jejuni
Blood diarrhea
Spiral-shaped
Daycare centers
Animals
Improperly cooked poultry
Untreated water
Can mimic intussusception and appendicitis
Management
Campylobacter jejuni
Hydration + Azithromycin