Infectious diseases Flashcards
Risk factors for C diff
Clindamycin, cephalosporins, co-amox, PPIs
C diff management
First line - oral vancomycin
Second line - oral fidaxomicin
Third line - oral vancomycin +/- IV metronidazole
Recurrent C diff management
Within 12 weeks of symptom resolution - oral fidaxomicin
After 12 weeks of symptom resolution - oral vancomycin OR fidaxomicin
Lyme disease management
Early Lyme - 14-21 day course of doxycycline (or amox if contraindicated)
Disseminated disease - ceftriaxone
Lyme disease presentation
Early features (within 30 days)
- Erythema migrans - painless bullseye rash at site of tick bite
- Systemic features - headache, lethargy, fever, arthralgia
Later features (after 30 days)
- CV - heart block, peri/myocarditis
- Neuro - facial nerve palsy, radicular pain, meningitis
Lyme disease diagnosis
If erythema migrans present can be diagnosed clinically
Enzyme linked immunosorbent assay (ELISA) antibodies to Borrelia burgdorferi - may need to be repeated after 4-6 weeks if negative and tested within 4 weeks of symptom onset
Immunoblot test if positive ELISA or still suspected in people with symptoms >12 weeks
HIV exposure management
PEP ASAP up to 72h after exposure for 4 weeks
HIV test at 12 weeks after completion of PEP
Hep B exposure management
Booster of HBV vaccine if they are a known responder
HBIG and booster vaccine if they are a non-responder
Hep C exposure management
Monthly PCR - if seroconversion then interferon +/- ribavirin
Mycoplasma pneumoniae CAP
Atypical
Dry cough + atypical chest signs/XR findings
Autoimmune haemolytic anaemia and erythema multiforme
Legionella pneumophilia CAP
Atypical
Hyponatraemia and lymphopenia
Air conditioning
Klebsiella pneumoniae CAP
Alcoholics
Pneumocystic jiroveci CAP
HIV
Dry cough, exercise-induced desaturations and absence of chest signs
Bacillus cereus
Reheated rice D&V
