Infectious Disease Flashcards
Toxic Shock Syndrome
Staph Aureus
Strep
Fever Diffuse red macular rash 1-2 wks later desquamination on palms/soles Hypotension Systemic involvement
Syphilis
T. pallidum
Primary = chancre (painless), heals 4-6 wks
VDRL/RPR (often negative in primary)
Secondary = rash, renal infection, liver infection…
Tertiary = gummatus lesions, neurosyphilis (tabes dorsalis), Argyll-Robinson pupil
Tx = PCN G 2.4mu single dose, if late in disease will need 3x weekly doses
Neurosyphilis needs PCN q4h x2 wks
Jarish-Herxheimer RXN - fever/toxic
Invasive bacterial GI bugs
Salmonella - eggs/chickens
Shigella - febrile, dysentery
Campylobacter - chickens
Yersinia - chickens
These get abx
Diarrhea
If fever, systemic symptoms, traveler = give cipro/immodium
If no fever, sick contacts, no systemic c/o, no travel = symptomatic only
**No abx for patients at risk for HUS (E.coli H7) - kids or old patients with grossly bloody diarrhea
Weigh their diarrhea against risk of C.diff
Gonorrhea
Disseminated GC = gunmetal grey lesions
Septic arthritis
Tenosynovitis
Tuberculosis
Cough, fever, night sweats, weight loss, hemoptysis
Primary usually in lower lobes
PPD converts in 6-8 wks
Re-activation TB apical
Ghon complex = calcified primary focus
Ranke complex = Ghon complex plus calcified lymph nodes
Both mean primary TB has healed
TX = (9 months) INH, rifampin, ethambutol, pyrazinamide
Necrotizing Infections
Fournier’s gangrene = involving scrotum or perianal skin
Gas gangrene from clostridial species, recent trauma or surgical wound, pain earliest symptom
Persistent tachycardia
Tx = abc with anaerobic coverage (amp/gent/clinda), wide debridement
Cryptococcus
Meningitis in immune compromise
Dried pigeon poo
India ink stain, crypto antigen in CSF/serum
Tx = oral fluconazole, if severe Amp B
Histoplasmosis
Ohio and Mississippi river valley
Bird/Bat poo
Most asymptomatic unless immune deficient
Old patients with COPD, HIV with CD4 under 100
CXR with diffuse miliary infiltrates
Tx = systemic antifungals
Toxoplasmosis
Cat poo
HIV reactivates it and causes encephalitis and brain lesions, can affect retina
Ring enhancing on CT
Tx = pyramethamine
Malaria
Fever, shaking chills
Anopheles mosquito
Infects RBC’s - thick and thin blood smear with Giemsa/Wright stain
P. falciprum is the worst - can cause cerebral edema, encephalopathy, pulmonary edema, DIC, hypoglycemia in kids
Tx = chloroquine (or quinine and doxy)
Quinine causes hypoglycemia
Lyme Disease
Ixodes tick
Borrelia burgdorferi
Stage 1 = erythema migrans
Stage 2 = disseminated (CNS, heart block, bell’s palsy)
Stage 3 = late persistent stage, nonspecific joint pain, subacute encephalopathy, synovitis
Tx = doxy
Rocky Mountain Spotted Fever
Ricketsia rickettsii
Viral syndrome after exposure
Rash on wrists/ankles inward, covers palms/soles
Can lead to myocarditis, ARDS, DIC, HSM
WBC, low platelets, hyponatremia, hematuria
TX = doxy
Parainfluenza
Croup/Bronchiolitis
Steeple sign
Cool mist, steroids
Opportunistic infections
CD4
Any = TB
Under 200 = PCP
Under 100 = Toxo, cryptococcus
Under 50 = CMV
