Infectious Disease Flashcards
what is the presentation of mycoplasma pneumonia
- milder form of pneumonia
- bullous myringitis (associated with pharyngitis and/or AOM)
- cough
- scant sputum
- also referred to as “walking pneumonia”
What are the atypical causes of pneumonia
- mycoplasma
- legionella
- chlamydia
how do you diagnose mycoplasma pneumonia
- NP swab is diagnostic
- CXR (nondiagnostic, could be clear or have patchy infiltrates)
- auscultation is typically CLEAR
How do you treat mycoplasma pneumonia
azithromycin or doxycycline
what is the etiology of mononucleosis
EBV (human herpesvirus 4)
How is EBV transmitted
saliva and blood products
what are the signs and symptoms of mononucleosis
- malaise/fatigue
- sore throat
- tonsillar enlargement
- myalgia
- posterior LAD
how do you diagnose mononucleosis
- monospot test
- EBV antibodies
How is mononucleosis treated
- fluids
- antipyretics
what is the etiology of erythema infectiosum (fifths disease, slapped cheeks)
parvovirus B19
what is the communicable period for erythema infectiosum (parvo, slapped cheeks, fifths disease)
contagious before the rash, joint pain and swelling
what is the presentation of erythema infectiosum (parvo, slapped cheeks, fifths disease)
- fever, rhinitis, HA
- slapped cheeks rash
- lacy reticular rash over proximal extremities
- painful joints
How do you diagnose erythema infectiosum (parvo, slapped cheeks, fifths disease)
clinically
How do you treat erythema infectiosum
- symptomatic relief
- IVIG for immunocomp patients
What is the etiology of hand foot and mouth disease
coxsackievirus
what is the communicable period of hand foot and mouth disease
until after blisters have disappeared
what is the clinical presentation of hand foot and mouth disease
- fever
- sore throat
- malaise
- vesicles of palms, plantar, mouth, and buttocks
how do you diagnose hand foot and mouth disease
clinically
what is the treatment of hand foot and mouth disease
supportive
(topical oral antiseptic for mouth sores and OTC pain meds for general discomfort)
where does HSV1 vs HSV2 tend to present
- HSV1: oral
- HSV2: genital
what is the presentation of HSV
- vesicles forming crusts and moist ulcers
- viral prodrome
what can cause HSV flares
- febrile illness
- hormonal changes
- stress
- sun exposure
how do you diagnose HSV
- cultures
- tzank smear (multinucleated giant cells)
how do you treat HSV
- antivirals (shorten duration)
- symptomatic relief (viscous lidocaine)
how long do you treat HSV
- initial outbreak: 7-10 days
- recurrences: 3-5 days
what is the etiology of influenza
influenza A or B
what is the presentation of influenza
- sudden onset fever, chills, HA, myalgia, malaise
- nonproductive cough, sore throat, nasal discharge
How do you diagnose influenza
- rapid flu test
- viral culture
What is the treatment for influenza
- antivirals (only within 48 hours of onset of symptoms)
- supportive
What are the options for influenza antiviral therapy? what is different about them
- neuraminidase inhibitors (tamiflu, relenza, rapivab) this covers A AND B!!
- NMDA receptor antagonists (amantadine, rimantadine) these ONLY cover A!!
what are the flu vaccine reccomendations
all patients over 6 mo.
children under 8 who have never had the vaccine before should receive two doses.
what is the etiology of measles
rubeola virus
what is the communicable period of measles
4 days prior to the rash and 4 days after the rash
what is the presentation of measles
Initial symptoms are mild for 2-3 days:
* low grade fever
* dry cough
* sore throat
* koplik spots
then symptoms worsen with rash:
* red blotchy skin rash starting on face along hairline and spreading to extremities
* fever as high as 104-105
what is the treatment for measles
- post exposure vaccine for non immunized patients
- supportive care
communicable period for mumps
up to 5 days after parotid gland swelling begins
what is the presentation of mumps
- fever
- HA
- muscle aches
- parotitis
what is the treatment of mumps
supportive care
what are the complications of mumps
- orchitis (males who have reached puberty)
- encephalitis
- oophoritis/mastitis (females who have reached puberty)
- deafness
what is the communicable period for rubella
contagious from 10 days before the onset of rash until 1-2 weeks after the rash disappears
what is the presentation of rubella
- mild fever and headache
- congestion and conjunctivitis
- rash beginning on face and spreading to extremities
- postauricular and occipital LAD
what can congenital rubella lead to
- microcephaly
- deafness
- cataracts
- cardiac defects
how do you diagnose rubella
IgM antibody titers
what is the treatment for rubella
supportive treatment and isolation
what is the presentation of pertussis
- catarrhal: sneezing, cough, runny nose
- paroxysmal: forceful whooping cough
- convalescent: symptoms diminish
How do you diagnose pertussis
nasopharyngeal culture
how do you treat pertussis
azithromycin
what is the presentation of pinworms
perianal, nocturnal pruritus
how do you diagnose pinworms
scotch tape test
what is the treatment of pinworms
- Albendazole or mebendazole
- treat family members
- wash clothes and sheets
what is the etiology of roseola
HHV 6 and 7
what is the presentation of roseola
- high fever lasting 3-5 days
- abrupt loss of fever with developement of rash
what is the treatment for roseola
supportive
what is the etiology of varicella
varicella zoster virus
what is the communicable period of varicella
1-2 days before rash until all blisters have scabbed
what is the presentation of varicella
vesicle on an erythematous base (dewdrop on a rose petal vesicle)
how do you diagnose varicella
clinical and can be confirmed with serologic testing (PCR swab of lesion or IgM titer)
how do you treat varicella
- symptomatic relif (calamine lotion, clip fingernails, tylenol)
- acyclovir/ valacyclovir for those at high risk.
- varicella immunoglobulin for high risk individuals
what is pulmonary mycobacterium avium complex
the MCC of nontuberculous mycobacteria lung disease. It isn’t contagious and is MC in immunocomp people (HIV/AIDS or underlying lung disease)
what is the presentation of pulmonary mycobacterium avium complex
- productive cough
- weight loss
- fever
- night sweats
presentation of disseminated mycobacterium avium complex
- fever
- weight loss
- SOB
- cough
- abd pain and diarrhea
- seen in advanced aids
what type of MAC is MC in children?
lymphadenitis
what is the treatment of MAC
macrolides
ethambutol
rifampin
fluoroquinolones
-for 12 months
