Infectious Disease Flashcards
Bacterial (5), viral (3), and parasitic (3) causes of infectious diarrhea (plus 5 noninfiectious)
- Campylobacter
- Salmonella
- Shigella
- E. Coli
- Rotavirus
- Norovirus
- Astrovirus
- Giardia
- Cryptosporidium
- Entamoeba histolytica
- C. diff
- Malapsorption
- Drug effects
- IBD
- Endocrine tumors
- Hyperthyroidism
Percent of C. diff infections that progress to toxic megacolon
3-8%
American College of Gastroenterology Severe C. diff classification variables
Any 2 of:
- WBC > 15k / mL
- Albumin < 3 g/dL
- Abdominal tenderness
American College of GAstroenterology Severe-Complicated C.diff classification variables
Any 1 of:
- Admission to ICU
- Hypotensive or requiring pressors
- Fever > 38.5 C (101.3)
- Ileus
- Mental status changes
- WBC > 35k / mL
- Lactate > 2 mmol/L
- End organ failure
Reason that IV Flagyl is useful in C.diff treatment
Enterohepatic circulation
Some (not complete) indications for colectomy for C.diff colitis
- Lactate > 5 mmol/L
- WBC > 50k /mL
- Multisystem organ failure
Type 1 NSTI bacteria
polymicrobial to include gram positive, negative, and fungal
Type 2 NSTI bacteria
monomicrobial
- Beta hemolytic strep
- clostridium perfringens
- Staph aureus
Type 3 NSTI bacteria
water associated - vibrio vulnificus
Labs to get if concerned about NSTI (LRINEC score)
CRP
CBC w diff
BMP (sodium, cr)
ABG
Score > 8 is very concerning.
Important element of surgery for NSTI in addition to debridement
send fluid or tissue for gram stain and culture.
most common cause of SBP
E. coli
C. diff toxin that causes intestinal necrosis
Toxin A
qSOFA parameters
Resp rate > 22
GCS < 15
SBP < 100 mm Hg
NHSN SSI criteria
within 30 days of procedure
skin or subQ tissue
Purulent drainage or bacterial growth or wound opened or clinical diagnosis by physican
Transmission rate of exposure to Hep c
0.1%, no post exposure prophylaxis recommended
Emphasemetous cholecystitis most commonly caused by
Clostridia species
Mechanism of fluconazole
Binds p450 on fungus 14 alpha demthylase
Caspofungin mechanisms
inhibits fungal cell wall synthesis
Amphotericin mechanism
binds to fungal cell walls sterols causing lysis
Infectious cause of GI bleeding in HIV patients
CMV