Infectious diseases Flashcards
What are signs and symptoms of infectious disease
- systemic symptoms: fever, chills, malaise, nausea and vomiting
- 102º rule, divides conditions into two groups
what can a fever > 104 cause
delirium or seizures
acute infection fever
- lasts 7-10 days and goes up and down
sepsis and ongoing infections - Fever
> 10 days and up to 3 weeks
intermittent fever
temperature goes to normal within 24 hours (may come back)
Remittent Fever
fluctuates but not back to normal (normal with viral infections)
Sustained or continuous Fever
remains above normal within minimal variations
Recurrent or relapsing fever
fever for a few days and then goes away but then comes back
integumentary symptoms of infectious disease
- Purulent drainage from abscess, open wound or - skin lesion
- Skin rash, red streaks
- Bleeding from gums or into joint: Joint effusion or erythema
Cardio symptoms of infectious disease
- Petechial lesions
- Tachycardia (see aneurysm and thrombophlebitis)
- Hypotension
- Changes in pulse rate (may increase of decrease)
CNS symptoms of infectious disease
- Altered level of consciousness, confusion, seizures
- Headache
- Photophobia
- Memory loss
- Stiff neck, myalgia
GI symptoms of infectious disease
- Nausea
- Vomiting
- Diarrhea
GU symptoms of infectious disease
- Dysuria or flank pain
- Hematuria
- Oliguria
- urgency , frequency to use the bathroom
Upper respiratory tract symptoms of infectious disease
- tachypnea/dyspnea
- Cough
- Hoarseness
- Sore throat
- Nasal drainage
- Sputum production
- Oxygen desaturations
- Decreased exercise tolerance
- Prolonged ventilatory support
Why are older adults more susceptible to infections
- Changes in cell-mediated or t-cell and b-cell function
- Experience increased morbidity and mortality
- Need for additional vaccines and boosters
Infection defintion
an organism establishes a parasitic relationship with host (begins with transmission of an infectious organism)
What are the three outcomes of an infection
- Contaminate the body surface and be destroyed by first line of defense
- A subclinical infection may occur causing immune response of the host
- A clinically apparent infection - one or more clinical symptoms, infectious disease
More involve
The early it is caught the easier to resolve
Colonization
pathogen presented in host but host is asymptomatic
Incubation period
time between pathogen entering host and appearance of clinical symptoms
Latent infection:
after microorganism has replicated but remains inactive in host
Period of communicability:
this time period when an organism can be shed and infect others through direct or indirect contact
Types of organism
- virus
- mycoplasmas
- bacteria
- Rickettsiae
- chlamydiae
- Protozoa
- fungi
- prions
Mycoplasmas
are unusual, self-replicating bacteria that have no cell wall components and very small genomes
Rickettsiae:
primarily pathogens transmitted through a bite (mosquitoes and tics)
Chlamydiae:
require host cells for replication contain DNA and RNA
- susceptible to antibiotics
Protoza:
a single cell or group of non differential cells loosely held together and not forming tissues
Fungi:
are unicellular to filamentous organisms possessing hyphae (filamentous outgrowths) surrounded by cell walls and containing nuclei
Prions:
proteinaceous, infectious particles consisting of proteins but without nucleic acids
- transmitted from animal to humans
HAI
- Healthcare acquired infection aka nosocomial infections are infections acquired during hospitalization
- Joint infections
- Don’t have it going in but you get it going out
Reservoir
an environment in which an organism can live and multiply
The portal of exit:
place where parasites leaves reservoir (secretions, fluids, excretions)
Mode of transmission: routes
- Contact (direct or indirect)
- Airborne
- Droplet
- vehicle/vector borne
Portal of entry - examples
ingestion, inhalation, bites, or through contact with mucous membranes, percutaneously or transplacentally
What are the 3 lines of defense for the host
- external
- inflammatory process
- immune response
Principle pathogens:
regularly cause disease in people with apparently intact defense systems
Opportunist pathogens:
do not cause disease in people with intact host defense systems but can clearly cause devastating disease in many hospitalized and immunocompromised clients
Can still impact the host in an intact immune system
Pathogenicity:
the ability of the organism to induce disease, depends on the organism’s speed of reproduction in the host, the extent of damage it causes to tissues, and the strength of an toxin released by the pathogen
Virulence:
refers to the potency of the pathogen in producing severe disease and is measured by the case fatality rate
Ways to control transmission of infectious diseases
- The use of barrier an desolation
- Comprehensive immunizations including the required immunization of travelers to or emigrants from endemic areas
- Drug prophylaxis
- Improved nutrition, living conditions and sanitation
- Correction of environmental factors
- Handwashing
- Social distancing
Transmission based precautions and prevention guidelines
- Standard precautions: Personal protective equipment, Gloves, Face protection, Gowns, Cleaning equipment
- Airborne precautions
- Droplet precautions
- Contact precautions
Specific time frames for return to work
- depend on Based on incubation period, how it is transmitted, symptoms etc.
- Clinical tests play into as well
Gram negative infections
- bacterial infection
- enterobacteriaceae: kebsiella, e-coli, proteus, serratia, yersinia
- All gram negative (this is what they test for to see if you have these bacteria- response to staining
Clostridioides what is it?
change in protective flora of the enteric system
- cuts down on good bacteria
Clostridioides clinical manifestations
abdominal tenderness, cramping, diarrhea
- symptoms with 24 hours and loose bowl
can cause dehydration
Clostridioides treatment
- stop taking antibiotics
- take flagyl, vancomycin, fidaxomocin, taken with probiotics
( these are higher. levels antibiotics)
Staphylococcal infections general
- bacteria are Among the most common bacterial pathogens normally residing on the skin
- Staphylococcal bacterial are the leading cause of nosomial and community acquired infections accounting for about 13% of all hospital infections each year if they penetrate skin
Staphylococcal s-aureus strain
a) what is it and how is it spread?
b) risk factors?
c) common infection sites?
d) how does it start?
- most common strain that causes problems
- spread by direct contact but needs a skin breech
- risk factors: surgical or burn cases, diabetes, neutropenic, chronic diseases, prosthetics, HIV
- bones, joints, kidney, lungs and heart valves are the most common sites
- suppuration (bubbles) and abscess formation
- if caught early prognosis is good
Streptococcal infections: streptococcus pyogenes range of diseases it causes
- skin infection to acute self-limited pharyngitis to post infectious syndrome of rheumatic fever and post streptococcal glomerulonephritis
Streptococcal infections: Group A Streptococci (GAS) - transmission
- is typical transmitted via contact with respiratory droplets
two categories of GAS Streptococcal infections:
- suppurative
- nonsuppurative
Suppurative Streptococcal infections:
- strep throat, scarlet fever, impetico, necrotizing fascista, streptococcal cellulitis, streptococcal myositis, puerperal sepsis, toxic shock syndrome
nonsuppurative Streptococcal infections:
- rheumatic fever,
- acute post streptococcal glomerulonephritis
Streptococcal infections: Streptococcal pharyngitis (strep throat) clinical manifestations
- sore throat,
- fever,
- rash/ palatal petechiae,
- tonsillar enlargement,
- tender cervical lymph nodes
Streptococcal infections: Streptococcal pharyngitis (strep throat): diagnosis
- physical exam, throat culture and lab testing
Streptococcal infections: Streptococcal pharyngitis (strep throat): treatment/complications
- antibiotics
- complications: post streptococcal sequelae, acute rheumatic fever or acute arthritis
Streptococcal infections: Scarlet fever - general
- usually follows untreated strep throat but may also occur after wound infection s
- common in children 2-10
acquired by inhalation or direct contact to oral secretions
Streptococcal infections: Scarlet fever: scarlet fever - clinical manifestations
rash first appears on upper chest and then to extremities
- Spares the soles and palms
- strawberry tongue
- sore throat
- fever
Streptococcal infections: Scarlet fever - diagnosis
- presentation
Streptococcal infections: Scarlet fever - treatment
- antibiotics
Streptococcal infections: impetigo - general
- principally caused by GAS
- most commonly in children aged 2-5 especially in hot and humid weather
Streptococcal infections: impetigo clinical manifestations
- most common on face, red itchy sores
- clear or fluid pus
crusty
Streptococcal infections: impetigo diagnosis
- observation
Streptococcal infections: impetigo treatment
- antibiotics
Streptococcal infections: impetigo complications
- can lead to lymphadenitis (causes streaking due to overloading the lymphatic system) or cellulitis
Streptococcal cellulitis and lymphangitis - clinical manifestations
- redness
- shiny
- swollen
- bullae
- fever
- pain
Streptococcal cellulitis and lymphangitis diagnosis
- observation
Streptococcal cellulitis and lymphangitis - treatment
- antibiotics
Streptococcal infections: Streptococcal toxic shock syndrome (STSS) where does it mainly occur
- females
- vaginal
- pharynx
- mucosa
- skin
Streptococcal infections: Streptococcal toxic shock syndrome (STSS) symptoms
- initial 24-48 hours influenza like
- pain
- necrotizing fasciitis
- systemic signs: tachypnea, hypotension, delirium, organ failure
- bright red on hand sand feet
Streptococcal infections: Streptococcal toxic shock syndrome (STSS) treatmetn
- IV antibiotics
surgical debridement
Streptococcal infections: necrotizing fasciitis clinical manifestions
- tenderness
- pain
- fever
- edema
- progresses rapidly along fascial plane,
- skin darkens
Streptococcal infections: necrotizing fasciitis diagnosis
- difficult pain disproportionate to appearance initially
- deep pain
- imaging and blood testing
Streptococcal infections: necrotizing fasciitis treatment
- surgery, broad spectrum antibiotics
Streptococcal infections: Streptococcal myositis- clinical manifestations
- severe pain and inflammation in affected muscle with few abnormalities of overlying skin
Streptococcal infections: Streptococcal myositis- diagnosis
- at time of surgery and biopsy
Streptococcal infections: Streptococcal myositis- treatmetn
- surgery, broad spectrum antibiotics
Streptococcal infections: Puerperal sepsis- clinical manifestations
- following abortion or delivery
- fever abdominal pain
- hypotension
- TSS
Streptococcal infections: Puerperal sepsis- diagnosis
- observation
- surgery
Streptococcal infections: Puerperal sepsis- treatment
- surgery
- broad spectrum antibiotics
Streptococcal infections group B streptococci:
- part of normal vaginal flora found in 40% of pregnant women
- 50% of newborns are colonized
- 1% of babies colonized develop infections
- bacteremia, meningitis, pneumonia, hypotension
- acquired as they pass through birth canal
Streptococcal infections group B streptococci: S. agalactiae treatment
- antibiotics
- in adults: most common in skin, soft tissue infections, primer bacteremia and pneumonia
- UTI, upper respiratory, septic arthritis, osteomyelitis, endocarditis and meningitis
- higher rate of mortality in compromised adults
Streptococcal infections group B streptococci: Pneumonia and others caused by S. Pneumoniae - clinical manifestations
- acute onset of fever, chills, pleuritic with pleuritic chest pain, and dyspnea with productive cough or purulent sputum that may be blood tinged
- progresses radpily over 24-48 hours and the mortality rate is hight without treatment
Streptococcal infections group B streptococci: Pneumonia and others caused by S. Pneumoniae - diagnosis
- lab examination of fluids
Streptococcal infections group B streptococci: Pneumonia and others caused by S. Pneumoniae - treatmetn
antibiotics and immunizations
Streptococcal infections group B streptococci: clostridial myonecrosis (GAS Gangrene)
the death of body tissue usually associated with loss of vascular supply followed by bacterial invasion and putrefaction
Streptococcal infections group B streptococci: clostridial myonecrosis (GAS Gangrene) - clinical manifestations
- sudden sever pain, ischemia, tender edematous
- skin darkens
- discharge initially
- cellulitis
- myositis
Streptococcal infections group B streptococci: clostridial myonecrosis (GAS Gangrene)- diagnosis
- radiographs, CT, MRI, culture, biopsy
Streptococcal infections group B streptococci: clostridial myonecrosis (GAS Gangrene) - treatment/complications
- surgical debridement and antibiotics and psychological support
- complications: tachycardia, hemolytic anemia, septic shock, liver necrosis, renal failure
