INFECTIOUS DISEASES Flashcards
Multiple erythematous macules and petechiae on palms and soles of a patient with headache and malaise
What is the infectious condition?
Rocky Mountain spotted fever (RMSF)
What is the electrolyte abnormality associated with RMSF?
Hyponatremia
Abrupt onset of fever, chills, malaise, then with ulcerated skin lesion and tender regional lymph node
What is the infectious agent?
Franciscella tularensis
Retroauricular, posterior cervical, and posterior occipital lymphadenopathy in an unvaccinated patient
What is the diagnosis?
Rubella (aka German measles)
What is the unique oral finding in rubella?
Reddish-pink spots on soft palate
Rashes involving the axilla, groin, antecubital areas in patients with fever.
What is the diagnosis? Causal organism?
Scarlet fever
Caused by group A strep
Treatment of E.coli O157:H7 (Shiga-toxin producing)
Supportive care with fluid and electrolyte management
Toddler with weeks of progressive hoarseness, recurring wheezing, found to have stridor.
What is the diagnosis? Causal organism?
Juvenile laryngeal papillomatosis
Caused by HPV type 6 or 11
What are the causal organism and XR finding of juvenile laryngeal papillomatosis?
Caused by HPV type 6 or 11
XR finding: soft tissue lesion at the level of vocal cords
First line in pertussis-exposure prophylaxis
Azithromycin
(second line = Bactrim for age > 2 months)
Treatment of Salmonella diarrhea
Supportive care - NO antibiotics (unless patient has hemoglobinopathies, immunocompromised, or critically ill)
Stridor, throat pain, difficulty swallowing - XR shows a prominent prevertebral soft tissue swelling displacing the trachea forward
What is the condition? The most common causal organism?
Retropharyngeal abscess
Most common = Group A Strep (Strep pyogenes)
Treatment for suspected meningitis in neonate < 7 days
Ampicillin + Cefotaxime
Which organism children with persistent complement component deficiency are at risk for ?
Neisseria meningitidis
Treatment of cat-scratch disease
Azithromycin
What are main side effects of isonazid ? (3)
1 - Hepatitis / elevated LFTs
2 - Peripheral neuritis
3 - Hypersensitivity
What are main side effects of rifampin? (2)
1 - Discoloration of urine (orange)
2 - Render oral contraceptives ineffective
Most common complication of mumps in males?
Epididymo-orchitis
- acute onset of fever and severe testicular pain from swelling and erythema of scrotum
Mouth infection with beaded, branching chains of gram-positive rods and “sulfur” granules
What is the organism?
Actinomyces
Chronic draining lesions after water exposure
What is the organism?
Mycobacterium marinum
Perceptual distortions and lymphadenopathy
What is the syndrome? What is the causal organism?
Alice-in-Wonderland syndrome
Part of infectious mononucleosis (EBV)
XR of a young child with indolent back pain shows disc space narrowing and irregularity of the vertebral end plates.
What is the condition? What is the most common organism causing this?
Discitis
Most commonly caused by Staph aureus
Who should received prophylaxis for meningococcal exposures?
Individuals with close contacts WITHIN 7 days prior to onset of disease
Most common cause of swimming-related conjunctivitis
Adenovirus
Most common cause of bacterial conjunctivitis
Strep pneumo
Erythematous rash eruption over face and trunk 3-5 days after fever, child is otherwise well
What is the most likely diagnosis? Organism?
Roseola
HHV-6 or HHV-7
Persistent lymphadenitis, not improving despite appropriate cephalexin and/or clindamycin.
What is the most likely organism?
Mycobacterium avium-intracellulae
Unique lab finding associated with Chlamydia trachomatis infection in children?
Eosinophilia
Behavioral changes + involvement of temporal lobe on MRI
What is the diagnosis?
Herpes meningoencephalitis
First line treatment for UTI children > 2mo who is relatively well, no allergies
Cephalexin
(first-generation cephalosporin)
First line treatment for UTI children > 2mo who is relatively well, allergic to penicillin
Ciprofloxacin
Suboccipital lymphadenopathy and morbilliform rash in a patient with conjunctivitis
What is the diagnosis?
Rubella
Non-purulent conjunctivitis, posterior cervical lymphadenopathy, otitis media
What is the organism?
Haemophilus influenzae
Conjunctivitis, exudative pharyngitis, vesiculopapular rash
What is the condition?
Herpangina / Hand-foot-mouth
Non-purulent conjunctivitis, exudative pharyngitis, preauricular lymphadenopathy
What is the organism?
Adenovirus
Acute peripheral facial neuropathy and an erythematous vesicular lesions in ear canal
What is the diagnosis? What is the causal organism? Treatment?
Ramsay-Hunt syndrome
VZV
Acyclovir + steroids
Animal exposure, swollen ulcerative lesion with associated eschar formation
What is the diagnosis? Treatment?
Tularemia
Gentamicin (or streptomycin)
Animal exposure, swollen ulcerative lesion with associated eschar formation
What is the diagnosis? Treatment?
Tularemia
Gentamicin (or streptomycin)
Infant with eosinophilia and a cough
What is going on?
Chlamydia trachomatis infection
Generalized, confluent, erythematous, finely papular rash especially in groin and axilla.
What is the organism?
Group A strep
What is first line treatment for Lyme arthritis?
Doxycycline x 28 days
What are skin findings in cat-scratch disease (Bartonella)
Several cutaneous papules/pustules develop at the inoculation site.
Bluish-white papules covering the buccal mucosa
What is this finding ? What is the underlying agent?
Koplik spots
Measles
Swelling of joints and a reticular rash
Which virus causes this ?
Parvovirus B19
Prophylaxis for close contacts of individuals with invasive meningococcal disease
Rifampin x 2 days
What is the organism caursing discitis?
What is the blood cutulre finding ? WBC ? ESR/CRP?
Staph aureus
Usually negative blood culture
Usually NORMAL WBC
Elevated inflammatory markers ESR/CRP
Painful, grouped, deep-seated vesicles with clear fluid on erythematous base on finger.
What is the diagnosis? What is the organism? Treatment?
Herpetic whitlow
HSV-1
Oral acyclovir
Neonate with microcephaly, hydrocephalus, microphthalmia, chorioretinitis, generalized cerebral calcifications
What is the congenital infection?
generalized cerebral calcification = Toxoplasma gondii
(CMV presents with periventricular intracranial calcifications)
Neonate with microcephaly, hydrocephalus, microphthalmia, chorioretinitis, periventricular intracranial calcification
What is the congenital infection?
periventricular intracranial calcification = CMV
(generalized calcification = Toxoplasma)
Neonate born with severe limb malformations and microphthalmia
What is the congenital infection?
Varicella embryopathy
Neonate born with smooth philtrum, thin upper limp, small palpebral fissures, and growth restrictions, microcephaly
What is going on?
Fetal alcohol syndrome