Infectious Diseases Flashcards
Differential for cellulitis (3)
- Nec-Fasc
- Allergic reaction
- Stasis dermatitis
What will happen when you start treating cellulitis?
Cutaneous inflammation will worsen during the initial 24hrs
How to differentiate between strep and staph cellulitis?
Staph: Purulent, abscess, draining wounds, penetrating trauma
Strep: Erisipelas, absence of drainage, raised indurated border, peau d’orange skin
What additional coverage against cellulitis should be included in pts with:
- Diabetes
- Neutropenia
- IV drug use
- Anaerobes, gram(-) bacilli
- Pseudomonas
- MRSA, pseudomonas
Lesions on anterior shin, bluish-black or ragged ulcers - diagnosis> Associated with?
Pyoderma gangrenosum
Assoc. with IBD
Cellulitis with leukomoid reaction and HIGH rising hematocrit - bug involved?
Clostridium sordelli
What % of blood and wound cultures are positive with cellulitis?
Less than 5%
Most common initial treatment for cellulitis in the hospital?
Clindamycin
What is Dalbavancin?
Outpatient parenteral antibiotic, similar to Linezolid. Can administer once a week only
SE of Daptomycin (3)?
CPK elevation (check renal fxn), rhabdo (at high doses), Eosinophilic pneumonia (rare)
SE of Vanc (2)?
Nephrotoxicity, Red-Man syndrome (with rapid infusion)
SE of Clindamycin?
Pseudomembranous colitis
SE of Doxycycline(3)?
Liver toxicity, Photosensitivity, Tooth discolouration (in kids)
SE of Cipro (3)?
CNS & GI disturbances, Teratogenic, Achilles tendon rupture
DOC against gram (-) and pseudomonas (2)?
Ciprofloxacin, Pip-Tazo (Piperacillin-Tazobactam)
SE of Meropenem (3)?
Nausea, HA, diarrhea
Main use of Clindamycin (2)?
Which group of bugs is resistant?
Anaerobes, Malaria (with chloroquine)
Resistant: Gram (-) aerobes: (pseudomonas, H.flu, Moraxella)
What are the 6 P’s of Compartment Syndrome?
Pulseless, Pain, Pallor, Parasthesias, Poikilothermia, Paralysis
Which 2 bugs should also be covered in IV drug users?
Pseudomonas & MRSA
Most common bug causing osteomyelitis? In diabetics? IV drug users?
S. aureus
Diabetics: Salmonella (actually S. aureus…)
IV drug users: Pseudomonas
Acute LLQ pain - differential?
Which procedure is often contraindicated, and why?
Diverticulitis, UC, Chrons, perf'd ulcer No colonoscopy (due to risk of perforation)
DOC for suspected diverticulitis?
Cipro (gram (-)) and metronidazole (anaerobes)
Leading cause of encephalitis?
HSV
How would HSV encephalitis present?
What tests to order?
Acute onset of bizarre behavior, speech disorders and hallucinations
Order HSV-PCR, HSV culture and MRI (will show temporal lobe issues bilaterally)
