Infectious Disease Flashcards
Top 3 causes of common cold?
Rhinoviruses, coronaviruses, parainfluenza
Top 3 causes of nasopharyngitis?
Adenovirus, enterovirus, influenza
Also C. diphtheria, H. flu, N.meningititis
Top 3 causes of tonsillopharyngitis
GAS, Group C and G strept, H flu
Adenoviruses, Enteroviruses
20% bacterial, 80% viral
Acute sore throat, N/V/abd pain, HA
Anterior cervical lymphadenopathy
GAS pharyngitis
Treatment for GAS tonsillopharyngitis?
PCN V x 10 days
Complications of GAS tonsillopharyngitis?
RF (10 days), AGN, peritonsillar abscess
Pharyngoconjunctival fever
Adenoviruses
See with swimming pool exposure
Herpangina
Enteroviruses (coxsackie A)
CBC finding in pertussis? WHat is the best test?
Absolute lymphocytosis
Dx: culture/PCR and single serum PT serology
Treatment for pertussis
A macrolide ABX
Top 3 causes of AOM
S. pneumoniae (5% resistant to Amox), non-typeable H.flu (20% resistant to Amox), M.catarralis (almost all resistant to Amox)
What is the most frequent known cause of perinatally acquired viral infection?
CMV - 0.5-2.7% of births
Fetal infection in 50% of primary maternal infections
HSM Hyperbilirubinemia Petechiae, purpura and thrombocytopenia Microcephaly Ocular defects Cerebral calcifications Hemolytic anemia Interstitial PNA Deafness
CMV
What congenital anomalies are associated with CMV?
CV, hypospadias, GI, musculoskeletal
CMV Dx
- Inclusion cells in urine
- Virus isolation - culture urine, throat and CSF
- PCR blood, CSF
- Test for IgM specific CMV antibody (frequent false positives)
When is the highest risk of congenital rubella during pregnancy?
85% first 8 weeks
52% 9-12 weeks
16% 13-20 weeks
0% >20 weeks
Manifestations of congenital rubella?
10-30% in utero death 50-85% IUGR 35% cataracts 35% retinopathy 80-90% deafness 30-40% CHD 5-20% MR, meningoencephalitis, bone radiolucencies, HSM, interstitial pneumonitis, hepatitis, thrombocytopenia
Dx of congenital rubella?
- Cx for rubella virus via nasopharynx, urine and CSF
- IgM specific rubella antibody
- Persistent IgG rubella antibody
Major risk factors for perinatal transmission of hepatitis B?
- Presence of HBeAg (80-95%)
- Asian (40-70%)
- Acute hepatitis in 3rd trimester (60-70%)
- High titer of HBsAg
- Vesicular rash at birth
- LBW
- chorioretinitis
- brain damage
- SGA
- microcephaly
- intracranial calcifications
- microphtalmia
- cataracts
Congenital HSV
What are the two risk periods of VZ Infection?
Early pregnancy and at term (<5days before delivery or within 48 hours after delivery)
RIsk of HIV virus transmission from an infected mother in utero?
30-35%
Red blood cell aplasia and possibly fetal hydrops and abortion
Parvovirus B19 infection
5-8% risk of abortion
No associated congenital malformations
Cats, raw meat, travel, living in rural areas
Toxoplasmosis
MR Seizures Spasticity and palsy Severe impaired vision Hydrocephalus or microcephalus Deafness
Toxoplasmosis (only 10% normal)
Treatment for congenital toxoplasmosis?
Pyrimethamine and sulfadiazine x ~ 1year
Hepatomegaly Skeletal abnormalities BWt < 2500 grams Bullous skin lesions Hyperbilirubinemia Pneumonia Splenomegaly Severe anemia, hydrops, edema Snuffles
Congenital syphilis
Treatment of congenital syphilis
PCN G x 10 days
Pastia’s lines
Scarlet Fever
Circumoral pallor
Scarlet Fever
Post-auricular adenopathy
Rubella
Slapped cheeks, lace-like rash
Erythema Infectiosum (5th disease) Parvovirus B19
Diarrhea + Daycare
Rotavirus Giardia Cryptosporidium Shigella Campylobacter Ecoli, enterohemorrhagic
Diarrhea + chicken
Nontyphiod salmonella
Campylobacter
Clostridium perfringens
Diarrhea + hamburger
Enterohemorrhagic E.coli (+/-HUS)
DIarrhea + pork
Yersinia
Diarrhea + rice
B.cereus
Diarrhea + shellfish or salad
Norovirus
Diarrhea + raw fruits/veggies
Enterohemorrhagic E.coli
Nontyphoid Salmonella
Diarrhea + unpasteurized milk
Campylobacter
Nontyphoid Salmonella
Diarrhea + Picnic/banquet
S.aureus
B.cereus
Clostridium perfringens
Fall-Winter diarrhea
Rotavirus
Norovirus
Summer diarrhea
Enterohemorrhagic E.coli
Cryptosporidium
Giardia
Hemoglobinopathy or asplenia + diarrhea
Nontyphoid Salmonella
Iron overload + diarrhea
Yersinia
HIV + diarrhea
Cryptosporidium
Nontyphoid Salmonella
Hiking + diarrhea
Giardia
Swimming + diarrhea
E.coli (enterohemorrhagic)
Cryptosporidium
Petting zoo + diarrhea
Enterohemorrhagic E.coli
Cryptosporidium
Animals + diarrhea
Cryptosporidium Campylobacter Yersinia Nontyphoid Salmonella Enterohemorrhagic E.coli
ABX + diarrhea
C. difficile
Voluminous diarrhea
Cholera
Chronic diarrhea + flatulence
Giardia
Prolonged diarrhea
Cryptosporidium
Fever/pulse dissociation
Typhoid fever
Diarrhea –> typhoid fever
Salmonella typhi
Diarrhea –> bacteremia, osteomyelitis or meningitis
Non-typhoid Salmonella
Yersinia
Diarrhea –> arthritis
Yersinia
Diarrhea –> HUS
Enterohemorrhagic E.coli
Diarrhea –> Liver Abscess
Entamoeba histolytica
Diarrhea –> Seizures
Shigella
Diarrhea –> Guillain-Barre Syndrome
Campylobacter
Diarrhea –> Prominent cramping
Campylobacter
Clostridium perfringens
Clostridium difficile
Diarrhea –> Pseudoappendicitis
Yersinia
Diarrhea –> IBD presentation
Entamoeba histolytica
Diarrhea –> Pseudomembranous colitis
C. difficile
Rx Enterotoxigenic E.coli
Azithromycin
Ceftriaxone
Rifiximin
Ciprofloxacin
Rx Vibrio cholerae
Azithromycin
Erythromycin
Doxycycline
Rx Giardia
Metronidazole Furazolidone Albendazole Ntazoxanide Tinidazole
Relapse rate >10%
Rx: Cryptosporidium
Nitazoxanide
Rx: Shigella
Azithromycin
Ceftriaxone
Ciprofloxacin
Rx: Salmonella typhi
Ceftriaxone
Azithromycin
Quinolones
Rx: Non-typhoid Salmonella
Treatment NOT indicated in uncomplicated cases
Rx: Campylobacter
Azithromycin
Erythromycin
Rx: Enterohemorrhagic E.coli
ABX theoretically harmful and may increase risk for HUS
Rx: Entamoeba histolytica
Metronidazole or tinidazole
Iodoquinol clears cysts from intestines
