Infectious Diseases Flashcards
What is a centripetal rash and in what condition is it seen?
- From ankles/wrists to trunk
- Rocky Mountain Spotted Fever
Toxic shock syndrome treatment
Clindamycin (treats causative organism AND decreases synthesis of exotoxin)
Erythema infectiosum cause & presentation
(Fifth disease)
Human parvovirus B19
Prodrome of low-grade fever, malaise & HA followed by slapped cheek rash that later spreads to extremities & trunk (lacy appearance)
Can precipitate aplastic anemia in sickle cell disease
Roseola infantum cause & presentation
Most commonly caused by herpesvirus 6
High fever that resolves and is followed by blanching maculopapular rash on trunk/neck —> extremities
Scarlet fever cause & presentation
Strep pyogenes (GAS) exotoxin
Sandpaper rash, circumoral pallor, strawberry tongue & Pastia’s lines (axilla)
Tularemia cause, presentation & treatment
- Francisella tularensis (pleomorphic gram-negative coccobacillus); vector-borne (ticks & flies)
- Flu-like symptoms; ulceroglandular (papule at inoculation site that then ulcerates); if aerosolized, may affect eyes, oropharynx and lungs
- Streptomycin or gentamicin
Neisseria meningitidis prophylaxis
Rifampin
Jones Criteria for Rheumatic Fever
Evidence of strep infection + (2 major OR 1 major + 2 minor OR 3 minor)
Major: arthritis, carditis, subQ nodules, erythema marginarum & Sydenham chorea
Minor: fever, arthralgia, elevated ESR/CRP & prolonged PR interval on EKG
CD4 count for PCP
< 200
Disseminated gonococcal infection presentation
- Fever/chills
- Rash
- Painless pustules (necrotic or purulent center with erythematous base)
- Tenosynovitis
- Septic arthritis
- Polyarthralgias
CSF study for cryptococcal meningitis?
India ink stain
Rocky Mountain Spotted Fever organism?
Rickettsia rickettsii (gram-negative obligate intracellular bacterium)
Rocky Mountain Spotted Fever epidemiology?
Children ages 5-9; most common in Carolinas, Oklahoma & Virginia
Rocky mountain spotted fever presentation
5-7 days after tick bite, develop fever, HA (severe), photophobia, myalgias, nausea & maculopapular rash (starts on wrists, palms, soles & ankles before spreading centripetally to upper extremities & trunk; face spared)
Babesiosis
Malaria-like illness transmitted by Ixodes tick characterized by spiking fevers, HA & anorexia (NO rash)
CMV retinitis CD4 count
<50
Measles (rubeola) presentation, management & complications
- pres: high fever, 3 C’s (cough, coryza & conjunctivitis), Koplik spots (red spots with blue/white center on buccal mucosa), discrete red maculopapular rash starting on forehead spreading down to trunk
- mgmt: human immune serum globulin (ISG) if given within 6 days of exposure
- comp: acute disseminated encephalomyelitis (ADEM), subacute sclerosing panencephalitis (SSPE), PNA (most common cause of death), diarrhea
Ehrlichiosis & anaplasmosis epidemiology, pathophysiology, presentation, labs, management & complications
- epi: South Central & South Atlantic US, June-August
- path: gram-negative, obligate intracellular coccobacilli residing within circulating leukocytes
- pres: 9 days after tick bite, abrupt onset of fever, HA, myalgias & rigors
- labs: leukopenia (w/ bands), thrombocytopenia, elevated AST/ALT, LDH & AP
- mgmt: doxycyline (rifampin if severe tetracycline allergy)
- comp: optic neuritis, ARDS, meningitis, pericarditis, renal failure & DIC
Sporotrichosis etiology, risk factors, presentation & management
- eti: sporothrix schenckii (dimorphic fungus)
- RF’s: landscaping & gardening
- pres: suppurative subcutaneous nodules progressing proximally along lymph channels
- mgmt: itraconazole (AmphB if severe/disseminated)
Psittacosis etiology, risk factors, presentation & management
- eti: Chlamydia psittaci (obligate intracellular gram-negative organism)
- RF’s: bird owners, vets, pet-shop employees
- pres: high fevers, HA, myalgias, nonproductive cough, hepatosplenomegaly
- mgmt: doxycycline (erythromycin in children & pregnant women)
Malaria fever pattern
- early: paroxysms occurring at irregular intervals each day
- late (s/p rupture of infected RBC’s): vivax, ovale & falciparum every other day; malariae every 3rd day
Malaria treatment
- uncomplicated, chloroquine-sensitive areas (Central America & Caribbean): chloroquine/hydroxychloroquine
- uncomplicated, chloroquine-resistant areas (South America, South Asia & Africa): atovaquone-proguanil
- complicated: artesunate (IV)
