Infectious Disease Flashcards
What is the therapy for STI caused by N. gonorrhoeae?
IM Ceftriaxone, 500mg
What is the therapy for STI caused by C. trachomatis?
Doxycyline, 100mg BID x 7 days
What are the major causes of endocarditis?
Strep (viridans group and bovis), S. Aureus, and HACEK group gram negatives ( Haemophilus, Aggregatibacter Cardiobacterium hominis, Eikenella corrodens, and Kingella Kingae).
What is the treatment for native valve endocarditis?
It is directed by culture results. For strep species, Pen G or ampicillin or ceftriaxone (50mg/kg BID or 80mg/kg daily) for 4 weeks (vancomycin if allergic). For staph, nafcillin/oxacillin or cefazolin for 4-6 weeks (Vancomycin for 6 weeks if MRSA). For gram negatives, ceftriaxone (same dosing as above). Embolism, heart failure, or progressive valve dysfunction may require surgical intervention.
What is the treatment for PID?
Outpatient: IM Ceftriaxone (500mg), Doxycyline (100mg BID x 14 days), plus metronidazole (500mg BID x 14 days, to cover for Trichomonas and gram negatives such as those associated with bacterial vaginosus). Inpatient: Cefoxitin/Cefotetan + Doxy OR Clinda + Gentamycin. Discharge on doxycycline (plus metronidazole if Trichomonas, BV, or abscess were present) for 14 days total therapy.
What are the Kocher criteria for distinguishing toxic synovitis from septic joint?
- Fever > 38.5
- Refusal to bear weight
- WBC > 15,000
- ESR > 40
Patients with 0, 1, 2, 3 or 4 point have <1%, 3%, 40%, 93%, and 99% chance of having a septic joint, respectively.
Aspirated fluid in septic joint will typically have WBC > 50,000 with neutrophil predominance and glucose below serum glucose.
How are open fractures classified
Type I: Laceration < 1 cm, mild contamination, adequate soft tissue coverage.
Type II: Laceration >1 cm, mild to moderate contamination, adequate soft tissue coverage.
Type IIIA: Laceration of any size with severe contamination but adequate soft tissue coverage.
Type IIIB: Laceration of any size with severe contamination and inadequate soft tissue coverage (rotational or free flap required to close wound).
Type IIIC: Vascular repair required.
What the antibiotic prophylaxis for types I and II open fractures?
Cefazolin, add metronidazole if soil contamination.
What the antibiotic prophylaxis for type III open fractures?
Ceftriaxone, or cefazolin + gentamycin. Add metronidazole if soil contamination. Use pip-tazo if water contamination (plus doxycycline if sea water).
What the antibiotic prophylaxis for type III open fractures?
Ceftriaxone, or cefazolin + gentamycin. Add metronidazole if soil contamination. Use pip-tazo if water contamination (plus doxycycline if sea water).
