Infectious Disease/ Immunology Flashcards
Pasteurella multocida is the most common bacteria from what?
Majority of animal bites are from cats and dogs.
Animal bites + human bites
Mx (2)
- Clean wound - nil need for suturing unless cometic concerns
- Coamox/ doxy+metro if pen allergic
Typical chest infection mx
Pen allergy
If suspected staph what do you give?
Atypical chest mx
HAP mx (2)
<5 days
> 5 days
Chest
Amoxicillin
Pen allergy = doxy or clarithro
Add fluclox if suspected Staph –> e.g influenza
Atypical chest
Clarithro
HAP
<5 days coamox/ cefuroxime
>5 days taz/ cephalasporin
Quinolone example
Ciprofloxacin
Pyleo abx
Prostatitis abx
Cephalosporin/ quinolone
Quinolone/ trimethroprim
Impetigo (3)
- Topical hydrogen peroxide
- fusidic acid
- fluclox/ erythro if widespread
Abx choice Throat infection Sinusitis Otitis media Otitis externa Periapical or periodontal abscess Gingivitis
Phenoxymethylpenicillin Phenoxymethylpenicillin Amoxicillin Fluclox Amoxicillin Metronidazole
Abx choice Gonnorrhea Chlamydia PID Syphillis BV
Abx choice
IM ceftriaxone
Doxy/ azithro
Ofloxacin + metro OR IM ceftriaxone + doxy + metro
Benzathine benzylpenicillin or doxy or erythro
Metro
C diff First presentation Second presentation Campylo Salmonella Shigellosis
C diff Metro Vanc Clarithro Cipro Cipro
A flu-like prodrome is usually followed by crampy abdominal pains, fever and diarrhoea which may be bloody
May mimic appendicitis
Complications include Guillain-Barre syndrome
Campylo
Two types of illness are seen
vomiting within 6 hours, stereotypically due to rice
diarrhoeal illness occurring after 6 hours
Bacillus cereus
Gradual onset bloody diarrhoea, abdominal pain and tenderness which may last for several weeks
Amoebiasis
Severe vomiting
Short incubation period
Staph Aureus
Bloody diarrhoea
Vomiting and abdominal pain
Shigella
Profuse, watery diarrhoea
Severe dehydration resulting in weight loss
Not common amongst travellers
Cholera
Prolonged, non-bloody diarrhoea
Giardiasis
Common amongst travellers
Watery stools
Abdominal cramps and nausea
E coli
Legionella Where is it from? Features (5) Dx (1) Mx (2)
Air conditioning 1. Flu like illness 2. Hyponatraemia 3. Abnormal LFTs 4. Dry cough 5. Pleural effusion 30% of pts Dx urinary antigen Mx Erythro/ clarithro
Infectious mononucleosis AKA Triad of sx Features (3) Dx
EBV Human herpes 4 (HHV 4) 1. Sore throat 2. Lymphadenopathy 3. Pyrexia
Features
- Splenomegaly - risk of splenic rupture, nil contact sports for 8 weeks
- Hepatitis - transient rise in ALT
- Haemolytic anaemia secondary to cold agglutins (IgM)
Dx
1. FBC and Monospot (heterophil antibody test) in 2nd week of illness
Cause of central line infections
Coagulase positive or negative?
Staph Aureua - coag positive or negative?
Staph Epidermis
- Coagulase-negative
- Cause of central line infections and infective endocarditis
Staph Aureus
- Coagulase-positive
- Causes skin infections (e.g. cellulitis), abscesses, osteomyelitis, toxic shock syndrome
Fine maculopapular rash on face spreading down body
Suboccipital lymphadenopathy
Rubella
HSV-1
HSV-2
Primary infection presentation
Rx
Oral ulcers Genital ulcers Gingivostomatitis Rx acyclovir If an outbreak >K28 then for CS
Syphillis Caused by which organism Primary features (2) Secondary features (3) Tertiary features (4)
Treponema pallidum
Primary
- painless ulcer - chancre
- local non-tender lymphadenopathy
Secondary
- fevers, lymphadenopathy
- rash on trunk, palms and soles
- buccal ‘snail track’ ulcers (30%)
- condylomata lata (painless, warty lesions on the genitalia )
Tertiary
- gummas (granulomatous lesions of the skin and bones)
- ascending aortic aneurysms
- general paralysis of the insane
- tabes dorsalis
- Argyll-Robertson pupil
Bronchiolitis
Respiratory syncytial virus
Croup
Parainfluenza virus
Common cold
Rhinovirus
Flu
Influenza virus
The most common cause of community-acquired pneumonia
Streptococcus pneumoniae
Community-acquired pneumonia
Most common cause of bronchiectasis exacerbations
Acute epiglottitis
Haemophilus influenzae
Pneumonia, particularly following influenza
Staphylococcus aureus
Atypical pneumonia
Flu-like symptoms classically precede a dry cough. Complications include haemolytic anaemia and erythema multiforme
Mycoplasma pneumoniae
Atypical pneumonia
Classically spread by air-conditioning systems, causes dry cough. Lymphopenia, deranged liver function tests and hyponatraemia may be seen
Legionella pneumophilia
Common cause of pneumonia in HIV patients. Typically patients have few chest signs and develop exertional dyspnoea
Pneumocystis jiroveci
A wide range of presentations from asymptomatic to disseminated disease are possible. Cough, night sweats and weight loss may be seen
Mycobacterium tuberculosis
Mx Meningitis caused by Listeria
Intravenous amoxicillin + gentamicin
Meningococcal meningitis
Intravenous benzylpenicillin or cefotaxime
Mx meningitis pen allergic
What medication should be given if meningitis other than abx?
Chloramphenicol
Dexamethasone
Mx of contacts of meningitis
Everyone who has been in close contact/ respiratory secretion exposure should be offered prophylaxis in the 7/7 prior to onset of symptoms + offer meningococcal vaccination
Ciprofloxacin