Infectious Disease - Academic Week Lecture Flashcards
What abx can you use to treat Staphylococcus aureus?
Clindamycin
Cloxacillin
Vancomycin
Cephalexin
*all have gram + coverage
What pathogen causes Streptococcal pharyngitis?
Streptococcus progenies (Group A strep)
A homeless person presents to the ER with a 3 month hx of recurrent, painful, self draining skin abscesses. What is the most likely pathogen?
MRSA
“Grape like clusters”
Staphylococci
“chains”
Streptococci
Catalase +, coagulase + gram positive cocci
Catalase +, coagulase - gram positive cocci
S. aureus
S. epidermidis
Catalase -, Beta hemolytic
S. pyrogens (GAS)
S. agalactiae (GBS)
What infections are caused by Staphylococcus aureus?
SSTI: impetigo, cellulitis, folliculitis, furnaces, carbuncles
Pneumonia, pulmonary abscesses
Endocarditis, meningitis, joint/bone
What toxin mediated reactions are caused by Staphylococcus aureus?
Food poisoning
Scalded Skin Syndrome
Toxic Shock Syndrome
What antibiotics can be used to treat MSSA?
Cloxacillin Cefazolin (Ancef) Cephalexin (Reflex) Vancomycin Clindamycin
What antibiotics can be used to treat MRSA?
Vancomycin TMP/SMX Clindamycin Linezolid Daptomycin
What infections are caused by Group A Strep?
Pharyngitis
Impetigo
Erysipelas
Cellulitis
What toxin mediated reactions are caused by Group A strep?
Necrotizing Fasciitis
Scarlet Fever
Toxic Shock Syndrome
What immune mediated diseases are caused by Group A strep?
Glomerulonephritis
Rheumatic fever
What is the treatment for Necrotizing Fasciitis?
Surgical debridement
IV Pen G
IV Clindamycin
IVIG
What infections can be treated with Pen G?
The Big 3:
- Streptococci
- Neisseria meningitidis
- Treponema pallidum (syphilis)
Plus others (C Diff)
What infections can be treated with ampicillin?
Pen G coverage +:
Enterococci, Listeria
H Flu
Ecoli, Proteus, Shigella, Salmonella
What infections can be treated with Piperacillin?
Amp coverage +: Klebsiella, Sebratia, Enterobacter, Citrobacter Pseudomonas B. fragilis MSSA
What infections can be treated with Cloxacillin?
Only covers gram +
MSSA (not MRSA)
S. Epidermis
Strep Species
(no gram neg-, no anaerobic)
What bugs cause community acquired pneumonia (CAP)?
Streptococcus pneumonia (typical)
Chlamydia (atypicals)
Mycoplasma
Legionella
What is used for out patient treatment of CAP (no modifying factors)?
Azithromycin
2nd line: doxy
What is used for out patient treatment of CAP?
COPD, no steroids past 3 months
Azithromycin, clarithromycin
2nd line: doxy
What is used for out patient treatment of CAP?
COPS, abs or steroids past 3 months
Levofloxacin, moxifloxacin
2nd line: amoxi/clav
Are macrolides good drugs for in or out patient care?
Out patient
(bacterial static - bind to 50S ribosomal subunit inhibiting protein synthesis) … wouldn’t use for someone septic
What is Roseola infantum caused by?
Human herpesvirus 6 (HHV-6)
How do you treat Herpes Zoster infection?
Treat with antivirals within 72 hours of onset:
Acyclovir
Valacyclovir (Vatrex)
Famciclovir (Famvir)
If there are herpes zoster lesions on the tip of the nose, what do you have to worry about?
Corneal involvement
What causes athlete’s foot?
Dermatophyte Trichophyton rubrum
Erythema infectious (fifth disease or slapped cheek disease) is caused by what
Human parvovirus B19
What viruses are DNA viruses?
All the Herpes viruses HPV ONLY Hep B Pox viruses (i.e. molluscum) Adenoviruses Parvovirus B19
(rest are RNA - Hep A,C,E, etc)
A 12 year old boy presents with fever and bilateral parotid enlargement, the most likely diagnosis is:
MUMPS!
note: patients need isolation, transmitted via droplet nuclei or direct contact
What is the Ontario MMR vaccination schedule?
12 months, 4-6 years
What viruses are most commonly involved in pharyngitis?
Adenovirus
X-ray lateral neck = thumbprint sign
Epiglottitis
What pathogens cause epiglottis?
Kids: H. influenza (more nontypel since vaccine); S. pneumonia
Adults: Group A Strep, H flu
What is the treatment for Epiglottis?
Maintain airway #1 concern
Ceftriaxone or Cefotxime
8 year old boy presents to the ER with a maculopapular rash associated with some cough, coryza, fever 39.0
Koplik’s spots on palate after day 3
Measles
What are complications of Measles?
Otitis media blindness pneumonia diarrhea encephalitis 1/1000 death 1/1000
What kind of bacteria is Bordetella pertussis?
Gram negative coccobacillus
What is the treatment for whooping cough?
Azithromycin or clarithromycin (up to 8 weeks into the cough)
Subcutaneous nodule at injury site with associated nodular lymphangitis which appears up to 6 months is seen in:
Sporotrichosis
see spreading up lymphatics
Child age 4 presents with fever, unilateral ear pain, bulging tympanic membrane for 24 hrs. What is the #1 cause bacteria?
Streptococcus pneumoniae
Treatment for acute otitis media?
Amox or amoxi/clav
What is the most common cause of empyema?
Pneumococcus (streptococcus) pneumoniae
A 10 year old girl with a new kitten has a large tender lymph node under the right axilla, otherwise well. Dx?
Acute bartonella henselae infection
Pathogens for the following cat exposure diseases:
Cat scratch
Cat feces
Cat bite
Cat scratch = bartonella
Cat feces = toxoplasmosis
Cat bite = pasturella
An HIV + patient presents with dysphagia and thrush
Oral-esophageal candidiasis
What is the txt for oral-esophageal candidiasis?
Oral fluconazole
At what CD 4cell count do you start prophylaxis against Pneumocystis jiroveci (carinii) in HIV patients?
200 cells/ml
What drug is used for prophylaxis against pneumocystis jiroveci (carinii) in HIV infected patients?
Trimethoprim sulfamethoxozole