Infectious Disease, part 2 Flashcards
Salmonella
Gram neg bacilli and a leading cause of bacterial foodborne illnesses involving undercooked beef, poultry, and eggs
Presentation of salmonella
Usually causes a self-limiting gastroenteritis over 3-7 days Fever- usually resolves within 48 hrs Abdominal cramping Diarrhea (no blood) Chills HA Myalgia
Work up of salmonella
If clinical presentation is suspicious for salmonellosis- dx can be made with stool cultures
Tx of salmonellosis
Supportive with fluids and electrolytes if needed
Abx do not shorten the illness and could prolong the duration. They are only used for pts at high risk for bacteremia
Hookworms
Acquired in soil contaminated by human feces thru the feet (rash on skin)
Larvae can embolize the lungs
Tx for hookworms
Albendazole 400 mg PO x 1 day
Schitosomiasis
Tropical parasitic infection in Africa mostly. Snail host.
Eggs end up in skin, brain muscle, eyes after swimming in infected water
Fever and bloody diarrhea
Tx of schitosomiasis
Praziquantel 20 mg/kg PO TID x 1 day
Tapeworms
Cattle and pigs can carry them.
Sx are vague and worms are passed during defecation
Tx of tapeworms
Albendazole 400 mg BID x 28 days
Ascariasis
Roundworm
Most common worldwide, usually asymptomatic and in tropical areas in contaminated soil
Severe infections present with lung migration, dyspnea, wheezing, and chest pain
Abdominal pain and passage of pieces of worms
Tx of ascariasis
Albendazole 400 mg PO x 1 day or mebendazole 100 mg BID x 3 days
Tirchonosis
Raw or undercooked pork or wild game
Severe infections cause nausea, dyspepsia and diarrhea
High eosinophilia count
Tx of trichonosis
Mebendazole 200 mg TID x 3 days
Pinworms
Spread by fecal-oral route or through contaminated food, clothing, and bedding
Perianal itching can lead to difficulty sleeping
Dx of pinworms
Tape test- sample taken near anus then viewed under microscope
Tx of pinworms
Albendazole 400 mg PO x 1, repeat in 2 wks
Treat entire household
Transmission of toxoplasmosis
Cats play an important role in the spread of toxoplasmosis. They become infected by eating infected rodents, birds, or other small animals
The parasite is passed in cat’s feces
Presentation of toxoplasmosis
Healthy people (nonpregnant) do not usually have sx. Immune compromised pts (HIV pts, those on chemo, or post organ transplant) can have fever, confusion, HA, and seizures Pregnant pts need to be sure to avoid exposure because damage to an unborn child can be of concern leading to miscarriage or stillborn child
Tx of toxoplasmosis
Pyrimethamine 50 mg daily for 1-3 wks, then 25 mg daily for 4 wks
Histoplasmosis
These fungal spores live in soil contaminated with bird or bat droppings
Humans become infected by inhalation of airborne spores
Presentation of histoplasmosis
Most are asymptomatic. Those who develop sx are immune compromised
Eventually the immune system will usually respond and the inflammatory response will form a fibrinous granuloma around the infection
This can show up incidentally on CXR as pulmonary granulomas or nodules
1-10% of individuals in endemic areas can have ocular findings of infection incidentally found on exam
Tx of histoplasmosis
Only if prolonged systemic infection of those that are immune compromised
Initially treat with amphotericin B for 14 days then itraconazole for 1 yr
Carriers of Rocky Mountain spotted fever and Lyme disease
Rocky Mountain- American dog tick
Lyme- deer tick
It does take >48 hrs of attachment for the tick to spread this
Hx/PE of Rocky Mountain spotted fever
High fever Severe HA Myalgias Nausea Vomiting and abd pain Then, 2-5 days after onset: -Rash appears a s 1-5 mm pink macules on ankles, wrists, and forearms that spread centrally- then petechiae
Tx of Rocky Mountain spotted fever
Doxycycline 100 mg BID x 7 days
Hx/PE of Lyme disease
Erythema migrans non-tender rash that enlarges at site of tick bite (bullseye rash) appears 3-30 days post-tick bite Fever Fatigue Chills HA Muscle and joint aches Swollen lymph nodes
Tx of Lyme dz
Doxycycline 100 mg x 10-14 days
Amoxicillin can be used in young children or cefuroxime
Syphilis
Spread by sexual contact with someone infected with Treponema pallidum
The syphilis sore has to come in contact with the person and is usually on the external genitals, vagina, anus, or rectum
Sores can also occur on the lips and in the mouth
Stages of syphilis
Primary syphilis- small sore/chancre
Secondary syphilis- rash begins on the trunk, eventually covers the entire body, even the palms and soles
Late and latent states- no sx- can last for yrs, then present as tertiary syphilis. With difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, and dementia
Dx of syphilis
RPR test and T. pallidum particle agglutination test
Tx of syphilis
Single IM injection PCN for those infected < 1 yr
